This week's big medical news has been the change in recommendations for women getting mammograms (http://www.wtop.com/?nid=106&sid=1814506). I realize that being male means I am completely unqualified to discuss this subject. Therefore, I will do my best to refrain from opinion. Simply allow me to make two points:
To begin, this is not the first time a professional group expressed doubt in the effectiveness of mammography. Nearly seven years ago, the PDQ Screening and Prevention Editorial Board found flaws in studies that were the basis of the recommendations at the time, thus causing them to amend the recommendations (http://www.nytimes.com/2002/01/24/health/24BREA.html). In fact, some members "thought it was unlikely that there were benefits that could make the test worthwhile."
Second, some doctors have become worried about the radiation exposure due to medical imaging (http://www.reuters.com/article/scienceNews/idUSTRE5226IR20090303; http://www.nytimes.com/2009/08/27/health/research/27scan.html?emc=eta1) Hundreds of thousands are annually exposed to more radiation from diagnostic tests than would be allowed for nuclear power plant employees. This alone could result in tens of thousands of additional cancers.
Thursday, November 19, 2009
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You're right about the scrutiny of mammography having seemingly long-ignored until now. But these new government recommendations went so far as to say that breast self-exam was shown to have little to no effect on outcomes either. Now, where there may be shortcomings with how many doctors and other organizations tell women to do a self-exam (some methods are probably useless) there are indeed effective ways of doing breast self-exam that will catch cancerous growths early enough to do something about them. And this entire claim about mammography becomes really, really tough to swallow when we see just how much our breast cancer survival rates have gone up over the last decade or so.
ReplyDeleteMammacare is one enterprise founded on tactile method of breast examination and their methods(and patented silicone teaching models)allow women to find sometimes cancerous lumps that are sometimes not even detected by mammography. They are headquartered here in my adopted hometown of Gainesville, and I have volunteered to learn their method of self-exam. I really wish more women knew about it (kind of like your vitamin d concerns, it probably is better, cheaper, safer than mammography and is certainly painless.) I was able to find something using this method of examination (turned out to be nothing) but it really impressed by OB that I was able to detect it.
Now that you have broken the ice, I will make a couple comments.
ReplyDeleteFirst, as this article points out, studies are showing that vitamin D can inhibit tumor growth in breast cancer (http://www.sciencedaily.com/releases/2009/02/090204172437.htm).
Second, a few doctors are turning to the technology of thermography (http://en.wikipedia.org/wiki/Thermography). There is an interesting article in The Original Internist entitled "Beating Breast Cancer" that discuss the application of thermography in detecting malignant tumors (http://www.clintpublication.com/documents/March_OI_2009_Pub.pdf).
Finally, as I touched on in the original post, a growing number of doctors are concerned about exposing women every year or two to a massive dose of ionizing radiation. Mammography may in fact be the shoe-fitting fluoroscopes of the 21st century. Hopefully, less invasive technologies such as thermography as well as tactile methods you describe will become the norm.
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