Progress Means Following the Science

There is so much to say about the new US Preventive Services Task Force Recommendations on breast cancer screening that I hardly know where to begin.  And I know you all will have things to say too and I look forward to your comments.  It may take us several days to get through all of the issues.  But I encourage everyone to stop, take a deep breath, and really look at what the Task Force has to say, and then let’s think about what is best for women.

I want to start by saying there can be no advancement in curing disease without paying attention to the science.  What we wish may be true is one thing, but looking at the evidence and acting on it has always been what brings progress in curing disease.

We have to face the fact that 40,000 women keep dying each year from breast cancer, despite the current screening practices.  We need to figure out what will really have an impact and make a difference – better screening, better treatments, better prevention – but we need to acknowledge that we just haven’t figured it out yet.

Back when mammography was first introduced, everybody assumed breast cancers were all the same.  And that they grew in a linear course, first growing large, then spreading to the lymph nodes, then on to the rest of the body.  Finding it “early” would mean it could be prevented from spreading and taking a life.  We now know differently.  There are several kinds of breast cancers.  Some are slow growing and non-threatening, whether they are found small or large.  Others are so aggressive and threatening, it doesn’t matter how small they are when you find them.  We don’t have the tools to find these aggressive cancers early enough.  We don’t know what makes these tumors lay the groundwork for metastsis or spread of the cancer, or how to stop it.

We need progress.  We need much more research.  And accepting the current screening methods as acceptable and even good, when the scientific evidence shows that they are not  is preventing us from getting that progress we need.

Tomorrow I will look at the new recommendations and discuss the scientific basis for the changes.


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  • Maria Wetzel  On November 24, 2009 at 12:16 pm

    First of all, thanks for the blogging, Laura. I know many of us look forward to seeing the latest in our In box.
    I think we can look at the brouhaha over the changes in recommendations as a call to action.
    As advocates we can have a say in what kind of research is done. We don’t just need more research, per se; we need very focused research on finding the earliest changes, studying those changes to find the markers than will reliably show which changes we have to worry about. We need focused research on the whole continuum of tissue changes.
    We also need to work seriously on changing the message that early detection is everything, thus, mammograms save lives.

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