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When my sister got breast cancer, I let my family doctor know. She had previously been on board with my choice to use thermography as my breast screening tool, but was no longer, so I started having mammograms. We know that mammography is not only an imperfect tool, but carries its own risks.
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"Mammograms save lives," read the headline from the Canadian Breast Cancer Foundation. My heart sank. Not only is this headline unlikely to be true, it's possibly dangerous. Recent research is adding up to what I would call a wholesale re-questioning of the need for mammography based on the fact that the overall benefits seem to be vanishingly small and the harms -- including unnecessary cancer scares, biopsies and surgeries -- considerable.
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Unfortunately, our ability now to test for and find insignificant abnormalities in people often leads to medical interventions that offer little or no benefit but still carry all the potential harms. Harm as a consequence of necessary treatment can be accepted, but exposing healthy people to harm from treatment that they should not have had in the first place is unacceptable.
There was quite a storm following the recent Canadian National Breast Screening study finding that mammograms do not prevent death from breast cancer. But the mammogram debate is one that won't end with this particular study.
On the day of my own yearly mammogram, a grumpy technician walks into the cold, dark room and begins, ever so nonchalantly, to wrestle one of my poor boobs into submission and I wince. Yet in spite of the wild indignation that having my breasts squished conjures up in me, I thank God for these technicians and radiologists because without them, we'd all be a lot worse off.
This week saw a U.S. recommendation that PSA screening for prostate cancer should no longer be routine care for men at average risk. The evidence, in other words, has spoken. So, many are now asking the question: if doctors are no longer supposed to screen in certain populations for two of the most common cancers, is the age of medical screening over?
In spite of evidence from many western countries, including the U.S., screening advocates persist in attributing observed mortality declines to screening, not to improved therapy. In fact, the evidence is strong that it is therapy, not screening, that accounts for the mortality decreases.
TORONTO - The release this week of revamped Canadian breast cancer screening guidelines has set off a war of words between those who support the recommendations and those who predict that following th...