Last Tuesday, I shared that I’d been sent to an oncologist. Last Thursday, I shared that my prognosis is 98% nothing wrong. Today, I want to abstract an article the oncologist gave me about screening practices.
This article comes from the New England Journal of Medicine and is a report on the assessment of the International Agency for Research on Cancer Working Group.
Okay, so there’s:
- Ultrasonography plus mammography
- Tomosynthesis plus mammography
- Clinical breast examination (the doc does it)
- self breast examination (the patient does it)
- MRI plus mammography
The most important harms associated with early detection of breast cancer through mammographic screening are false positive results, overdiagnosis, and possibly radiation-induced cancer. … After a careful evaluation of the balance between the benefits and adverse effects of mammographic screening, the working group concluded that there is a net benefit from inviting women 50 to 69 years of age to receive screening.
Adding ultrasonography or tomosynthesis can increase rate of detection, but ultrasonography can increase false positives (which means unnecessary stress and biopsies), and tomosynthesis increases the radiation dose.
…clinical breast examination combined with mammographic screening increased the breast-cancer detection rate by 5 to 10 percentage points as compared with mammography alone.
Overall, surveys in general populations have shown that the numbers of women who report practicing breast self-examination are probably too few to have had an effect on mortality from breast cancer.
So that’s why my oncologist recommended I continue annual mammograms and annual clinical breast exams, rather than sending me for further tests. With only a 2% lifetime risk of breast cancer, at the age of nearly 65, I’d be running a bigger risk by doing anything else.
YMMV, and you should always consult your doctor before making any medical decisions.
On a totally different subject, today’s Tuesday, and I’m posting at Fatal Foodies about my own contribution to World Cuisine, gnocci stir-fry.
A WRITING PROMPT FOR YOU: Make your main character have to make a medical decision.
JaneJune 16, 2015 at 9:36am
Great explanation/editing. Very succinct.
See that 5-10% statistic?
I found that the most overwhelming thing about researching my odds in the literature is that the statistics are used indiscriminately and usually without clear info on exactly what is being compared (or to what, etc.).
(Don’t worry. I’ll try to be brief.)
Say I have an 8% overall risk of getting breast cancer. That means out of 100 women, 8 will probably get it. Sometime. This is an actual statistic from the medical community.
Suppose a treatment offers me a reduction in chances of recurrance of 2%. SO what does that mean? What was my chance of recurrance to begin with? Is it back to 8% of a regular person? Is it higher now that I’ve been treated for BC? If my actual improvement of chances at a recurrance is lowered by this proposed additional treatment by 2%, is that 2% against the 10% chance of recurrance, now leveling me back down to the 8% chance that is hanging over everybody else’s head? Is there some other way to look at this?
I’ll stop right here. It’s not worth going any further. And I don’t want to break my head.
Marian AllenJune 16, 2015 at 4:46pm
My brain hurts!
Yeah, I totally need to study statistics. I think most of us quote them but don’t understand them.
A.C. FloryJune 16, 2015 at 9:14pm
I’m glad you’re 98% healthy, and I think it’s refreshing to find a specialist who still believes in ‘first do no harm’. I had persistent cervical dysplasia for well over 30 years before it tipped over into a [treatable] cancer, and even then it was my own fault as I didn’t have any testing done for the 6 years prior. So if it ain’t broke don’t fix it. That said, of course, you must never neglect those checkups!
Marian AllenJune 17, 2015 at 7:52am
I’m a firm believer in checkups, Meeka! Healthcare workers and editorialists keep telling me the drawbacks of the Affordable Care Act, but they can’t overlook the fact that more people can afford simple basic checkups now to catch conditions at earlier stages.
A.C. FloryJune 17, 2015 at 6:28pm
lol – I’m Australian so I take affordable health care as a right. I truly can’t understand the negativity, especially as preventative medicine is so much cheaper in the long run.
Marian AllenJune 17, 2015 at 10:04pm
I don’t understand it either. Makes NO sense to me. It just seems mean-spirited and short-sighted.