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The Forum > Article Comments > Overdosing on diagnosis > Comments

Overdosing on diagnosis : Comments

By Helen Lobato, published 7/12/2009

As many as a third of women diagnosed with breast cancer may not actually need treatment.

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me too! I lived with a breast tumour for 10 years until, at the age of 37, I was finally bullied by a large private breast clinic in sydney to have it removed. My GP at the time, a young woman, was unaware of the lack evidence supporting mammogram for women my age and was stunned when I told her - she dismissed me of course and I got a new GP. The pressure I endured for not having a mammogram left me feeling dreadful. My decision was based upon the scientific evidence at hand which I located and read myself. Breast clinicians would note in my file my resistance, even though they could not state why they thought the tumour was cancerous: 'it just might become cancerous' (subtext: and it will be your own fault if it does). Now that's fear mongoring in my view, not a considered professional or scientific response. The even more bizaar thing was that the tumour, 5X3cm, was not detectable on the mammogram! but visible to the nakad eye. Following the surgery the surgeon suggested I'd better reconsider my position on mammogram as I was nearly 40 - even though the tumour he removed was not cancer. When I challenged him he conceded I was right. He agreed the efficacy of mammogram was negligable - even for women over 50 (30% I'm told).

Mammogram is a scam in my view. I'll never have another one. Dealing with ignorant and dishonest 'professinals' was emotionally draining and demoralising.
Posted by nelle, Monday, 7 December 2009 10:56:25 AM
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The problem has been around for some 30 years: essentially it boils down to how do you balance the "saving" of a relatively small number of women from a breast cancer death, against the discomfort, anxiety, side–effects from chemotherapy & radiation, and the risks of general anaesthesia, in a much larger number of women who do not have an invasive or particularly worrying breast lump ? One way uses dollars, but when this is done everyone gets quite upset. I do not know of any good answer, but am certain that more open discussion would help.
Posted by Gorufus, Monday, 7 December 2009 12:12:45 PM
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'However, in 2001, researchers from the Nordic Cochrane Center in Sweden found that screening was likely to reduce the relative mortality risk of breast cancer by 15 per cent, not the 30 per cent that most groups quote' Climategate and now breastgate. Who can we believe?
Posted by runner, Monday, 7 December 2009 4:42:33 PM
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Thank you Helen for another timely and informative article.

<< We will not have our breasts squashed between two plates of steel and irradiated. We will take our chances. >>

Fine fighting words. :) I've had one mammogram, when my doctor detected a small lump which in the end proved to be benign, but no way, never again. I hadn't read up on it at the time, but I intuitively felt as those plates came down that the pressure and the radiation were not without their own risks, and I've certainly firmed up on that view since.

<< Surely a better way is to prevent this cancer by giving due attention to our diets and lifestyles; simple measures such as getting enough vitamin D, avoiding transfats, eating organic as much as possible, and omitting the regular mammograms. >>

I coudn't agree more. I've been receiving regular government reminders about being overdue for another mammogram. How much better off we'd all be if we instead received information on the dangers of trans fats and how they're present in a huge range of processed foods, including bread and margarine, which many people believe to be healthy food choices. Denmark banned trans fats in 2003 and other countries have since followed suit, but no, our food authorites still consider saturated fats to be the big danger.

<< With the advent of screening, the incidence has jumped to almost 300 cancer diagnoses per 100,000 women. >>

We've had nearly two decades now of breast screeening in Australia, so I guess some of that increase in diagnoses could in part be due to a general increase of cancer rates within the community in that time. So while part of it's down to better detection, I'm guessing there are increased rates of cancer anyway, due largely to our increasingly toxic lifestyles.

Runner

<< Climategate and now breastgate. Who can we believe? >>

You'd better watch out, Runner. Prostgate's sure to be just around the corner.
Posted by Bronwyn, Monday, 7 December 2009 9:43:48 PM
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Strangely, I almost found myself agreeing with an article that Helen Lobato wrote. Fortunately, the end of the article kept my perfect record intact of disagreeing with every article she has written on OLO.

Lobato is correct that increases in detection technology mean that breast cancers are being detected earlier and smaller breast cancers are being detected. Some, perhaps as many as a third, of these cancers may not end up killing the patient if they were not treated. The real problem is that at this stage it is difficult to determine which tumour detected early will go on to kill the patient and which will not. It is easy to predict after the fact, but by then it is too late. Secondly, early intervention means less drastic treatment, so just waiting for the tumours to grow is not a viable option.

It is Lobato’s choice to not get tested, but then she needs to accept the consequence of that choice. What is not acceptable is for Lobato to encourage others not to get tested. Breast cancer still kills too many women young and early detection is the best chance of saving those lives.

Vitamin D supplementation may have very limited utility http://jnci.oxfordjournals.org/cgi/content/abstract/100/22/1581 http://cebp.aacrjournals.org/content/16/3/422.full and certainly is not a substitute for testing. Consuming organic food has not been shown to have any impact on breast cancer rates.
Posted by Agronomist, Tuesday, 8 December 2009 8:42:23 AM
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What a timely article!

I'm 51 and have finally been bullied in going for my first mammogram. Although my mother had a tumour removed, she was in her early 70's (it was her 2nd mammogram!) it was for a 'slow growing tumour'. My mother at the time tried to pin down the doctor whether old age was more likely to kill her or the tumour. To no avail. Afterwards she was urged to go on a course of oral chemo-for 5 years. She was aghast. Made me do extensive research on the drug involved.

Consequently found out that it reduced the risk of the possibility of the same type of tumour recurring it increased the risk of Ovarian cancer by 10%. To the horror of her doctor she choose to 'risk' breast cancer rather than the less publicized, possibly less sexy, ovarian cancer.

It is absolutely as Bronwyn points out. Become aware of what you eat and exercise and enjoy life.
Posted by yvonne, Tuesday, 8 December 2009 5:49:15 PM
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