Please get a mammogram

[LSLGuy]

@ThelmaLou

Sorry if I sounded argumentative. In my mind I wasn’t addressing anyone in particular, just stating my pov prior to exiting the discussion.

No sweat. Sorry if I sounded aggressive as well.

These are difficult emotive topics and it’s easy for emphatic-ness (?) to be misread as hostility.

Be well. You too susan.

[Doctor_Jackson]

@elbows

In a country with universal health care, there is naturally a cost savings in prevention, early detection, etc, for any desese. My province has a Breast Screening program, that sends you a letter, when it’s time, every year! Your Dr enrols you whenever they think it’s time, depending on risks factors etc.

It really does save millions of dollars when you detect it early, and intervene! And saves lives too!

I think the discussion here is around this:
Early detection can only save money in those cases where the test detects the disease early enough to make treatment easier. The test costs money every time it’s run. The following numbers are made up to present an example If the test costs $1,000 each time and is run 1,000 times, that equals $1 million. If, out of that 1,000 tests only one cancer is found early enough to save radical treatment, some amount of money is “saved”. The financial equation becomes “Does that savings offset the overall costs of the test?” The wrench in the equation is “How much is it worth to save/prolong 1 life?” It’s an ugly question, but weighs heavily on the decisions made.

[Surreal]

@Enderw24

Surreal, I disagree with some of your analysis. Or links, anyway. Your first link starts with the researchers declaring “If we assume that screening reduces breast cancer mortality by 15%…” Now, I don’t know why they decide to make that assumption. I haven’t read the paper or the abstract. But just making the assumption pretty clearly contradicts you main point. If screenings reduce breast cancer mortality by 15% then it is absolutely an effective tool. Does it - on the whole - waste time and money overall for the population? Maybe. Maybe not.But that’s not the question. The question is whether a mammogram is effective and the researchers quite clearly concede that point in their assumptions.

Let me illustrate my point by looking at one recent study from the British Medical Journal:

breastscreening.pdf

They conducted a randomized controlled trial of 89,835 Canadian women ages 40-59 and followed up on them 25 years later. Half of the women got regular mammograms and the other half had no mammograms whatsoever during that period. Here are the results:

**                                   Mammograms        No Mammograms
Number of women                      44,925             44,910
Number of breast cancer deaths     500 (1.113%)      505 (1.124%)**

As you can see, the difference is negligible.

Furthermore, 1 in 424 women who received mammograms were misdiagnosed (false positives) and given unnecessary treatment including radiation, surgery, and chemotherapy.

[Wesley_Clark]

Reviving this thread because I saw this today and thought it was interesting. The side effects from overtreatment for breast cancer kill as many (and probably slightly more) people than are saved who actually have breast cancer who would’ve died had it not been for the mammogram and treatment.

What If Everything Your Doctors Told You About Breast Cancer Was Wrong?

Mammograms do help a small number of women avoid dying from breast cancer each year, and those lives count, but a 2012 study published in the New England Journal of Medicine calculated that over the last 30 years, mammograms have overdiagnosed 1.3 million women in the United States. Millions more women have experienced the anxiety and emotional turmoil of a second battery of tests to investigate what turned out to be a false alarm. Most of the 1.3 million women who were overdiagnosed received some kind of treatment—surgical procedures ranging from lumpectomies to double mastectomies, often with radiation and chemotherapy or hormonal therapy, too—for cancers never destined to bother them. And these treatments pose their own dangers. Though the risk is slight, especially if your life is on the line, a 2013 study found that receiving radiation treatments for breast cancer increases your risk of heart disease, and others have shown it boosts lung cancer risks too. Chemotherapy may damage the heart, and tamoxifen, while a potent treatment for those who need it, doubles the risk of endometrial cancer.

In a 2013 paper published in the medical journal BMJ, breast surgeon Michael Baum estimated that for every breast cancer death thwarted by mammography, we can expect an additional one to three deaths from causes, like lung cancer and heart attacks, linked to treatments that women endured.

There is a chart on the side showing the NNT are 1000, so you have to screen 1000 women to save 1 life.

It is a wash, and when you factor in all the illness and psychological trauma from overdiagnosis it is possibly much worse to get screened than not.