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Breast Self-Exam is Important

I'm a bit taken by the latest propaganda from cancer and breast cancer groups, the media folks and others in the attempt to down play the importance of Breast Self Examination (BSE).

Of course along with the negative information given out lately about BSE there is always some need to tell you to you get more cumulative, breast-cancer-causing radiation exposure with your annual screening mammogram.

I was happy though to hear that a member of Congress, Debbie Wasserman Schultz from Florida, making a strong point in favor of BSE. She found her own cancer this way.

I urge you, and to young women especially, to read more here, learn about BSE, and include it in your personal care routines every month.

And remember Breast Thermography: For Earliest Detection and Intervention

Women Denied Truth On Breast Cancer Testing
By Sarah Boseley

Women must be told the full truth about breast screening, which may in some cases expose them to surgery and radiotherapy more damaging than the early cancerous tissue it detects, argues a controversial paper in the British Medical Journal today.

The paper says women are being patronised by being denied the proper information on which to make their decision to be screened or not. "The question of whether the benefits of screening outweigh the harms is essentially a value judgment. The problem is that, up to now, this judgment has been made by paternalistic agents of the state rather than by women," the authors say.

While deaths from breast cancer have dropped since screening began, there is no unambiguous data as to what part screening has played alongside the improvements in cancer treatment that took place over the same period.

The number of cancers has risen in recent years, but few realise that this is because screening is detecting them at a very early stage, when cells have just begun to undergo cancerous changes, say Hazel Thornton of Leicester University's department of epidemiology and public health, Adrian Edwards of the University of Wales department of primary care and Michael Baum, professor of surgery at University College, London, who helped set up the screening programme in 1987-8 but is now a consistent critic.

A fifth of the cancers now detected are ductal carcinoma in situ - where cells inside the milk ducts have begun to turn into cancer cells. This disease, the authors write, "has an uncertain natural course and those women who have heard of it find it hard to understand, as do many doctors; it is an early stage of disease that results in a 40% mastectomy rate". Women are faced with a difficult decision: whether to undergo surgery or wait and see whether cancer develops.

Women invited for NHS screening are not told, the paper says, that the US preventive task force found that 1,224 women aged 40 to 74 needed to be screened for 14 years to prevent one death from breast cancer.

"These are pertinent facts for a woman to know when attempting to decide how to manage her risk. The [US] researchers concluded that the age at which the trade-off between benefit and harm becomes acceptable 'is a subjective judgment that cannot be answered on scientific grounds'."

There are tensions between the drive to get as many women screened as possible and promoting real informed choice among women, say the authors. "Most women who are screened have neither suffered nor been educated about the reality of the uncertainties, harms and limitations of screening or the consequences of finding pathology of borderline importance."

Women want balanced information, they say. "Although some doctors may be concerned about admitting scientific uncertainty, honesty can enhance patients' respect for the profession.

A paper in the Lancet today says that women whose ductal carcinoma in situ is detected should undergo radiotherapy after the tissue is removed. Scientists from Cancer Research UK and the medical research council say trials have shown that radiotherapy reduces the chance of recurrence by 60%, while the cancer drug tamoxifen cuts it by only 10%. © Guardian Newspapers Limited 2003

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