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Turtles, birds, bears and breast cancer . . .

This morning as I was reading the health section in the Washington Post I was squirming and fidgeting in excitement. The article, My doctor told me to get a routine mammogram. Here’s why I won’t by Christie Aschwanden, included a description by Barnett Kramer, director of the National Cancer Institute’s Division of Cancer Prevention, about the three different kinds of breast cancer and compared them to turtles, birds and bears. I thought the analogy was perfect.

Turtles
are cancers that won’t harm you because they grow slowly and don’t metastasize. A study published by H. Gilbert Welch M.D., in the New England Journal of Medicine , showed that one-third of women who are diagnosed with cancer are treated for this harmless cancer and risk being harmed in the testing and treatment of it.

Birds
are deadly cancers that grow and spread so quickly that they can’t be detected on a mammogram.

Bears
grow slowly enough that they can be detected by a mammogram and be treated.

So the next question is, how do we do we know whether an abnormality discovered during a mammogram is a turtle, bird or bear? Scientists are working on finding genetic markers that will help doctors decide how a particular cancer will progress so until they do, we can only wait and watch.

The article also included statistics from the U.S. Preventive Services Task Force (USPSTF) that show that while one life can be saved out of every 1,900 women between the ages of 40 to 49 can be saved, there can be 1,330 false alarms with 665 breast biopsies and 8 breast cancer diagnosis where treatment will not make a difference to how the cancer would have progressed.

My concern is for all the women who, because they are frightened, undergo unnecessary and harmful testing and treatment because the emphasis is on how mammogram testing saves lives and so little is said about the harms.

Let’s educate ourselves so we can decide what is best for us. Here’s a good place to start . . . the USPSTF recommendations http://www.uspreventiveservicestaskforce.org/recommendations.htm

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