One out of three women with cancers found on mammogram may be overtreated!

This headline is calculated to make you sit up and take notice. And undoubtedly many of you did. I’d venture to guess that there are also many survivors are now worried that they did not need that chemotherapy that they so heroically underwent.

The facts: The headline belies the data.

The study that is being widely reported is similar to the study published six months ago which suggested that 25-30% of cancers found on mammography would go away by themselves if they were not treated.

The concept is that not all cancers are the same.  There are “bad” ones and there are very good ones. And some of the lesions we currently call cancer may not really be cancer at all, at least in the way we currently define it. And I think that’s the real problem—the definition of cancer. 

Current thinking suggests that a cancer cell alone is not threatening.  Rather, a cancer cell needs to be in a local environment that will promote its growth.  As anyone who has gardened knows, planting a seed will not guarantee a plant; the seed must have the right conditions to grow, it may even need some fertilizer. This leads to the concept of “cancer without disease” — cancer cells that are dormant and will actually only wake up and grow if and when the right conditions occur. Do you treat these cells the same way you might treat a cancer that is aggressively invading outside of its territory? Probably not.

Interesting, but what does it mean to you?  Right now, nothing, I am afraid. Since we are currently  unable to tell which cancer cells are which or which conditions are necessary, we have to treat every breast tumor as life threatening.  But this study should be a wake up call to scientists to get to work to figure it out.  The current treatments for breast cancer are not without significant life-long side effects, and it would be great if we could save one in three women from experiencing them. 

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14 Responses to Overtreated?!?!

  1. Scott says:

    I would have to say I would disagree with your comments. Right now EARLY DETECTION is the only thing affects cancer deaths. My just died after a 5 year battle at the age of 42, she was diagnosed stage I, 2cm, no lymph node involvement. And less than a year later it spread to her spine. Sure wish she would have had a mammogram to detect earlier than SBE.

  2. Debby Jo says:

    This clarification was very helpful. As our news media outlets become ever more profit oriented, they depend on shocking headlines to sell, not on the content of the article to inform. I would appreciate bylines on your site to credit the authors. Thanks!

  3. Kathi says:

    Scott, I’m so sorry about your lady. I don’t think Dr. Love would disagree with you. But as a breast cancer survivor myself, I have been astonished at the slash-and-burn, scorched-earth, controlled chaos sort of enterprise that is cancer treatment. Somewhere along the line, it hit me that it’s such a crude process. Here we are, “putting men on the moon,” as the saying goes, inventing nano-technology. And the only way we can come up with to treat cancer involves mutilating, burning & poisoning everyone????? I’m all for more research to fine tune this. It’s nuts. I realize it’s what we’ve got & I’m grateful to be alive to complain about it. But, hey, I think we can do better.

    Hugs to you, Scott.

  4. Scott says:

    Well thanks Kathi. You’re right, cancer treatment is crazy. My problem is I don’t think they’re heading in the right direction. They still keep chasing chemo options and get excited when they improve from 25 weeks to 29 weeks. It’s just my opinion but I think they need to work on early detection options – especially for young women.

    Best wishes for a long and healthy life.
    Scott

  5. Ken Schueler says:

    Important issue Susan. One question is certainly the sensitivity & specificity of tests to monitor for breast cancer. We know the blood serum markers CA 27-29, CA-15-3,etc. are not adequate. Self examination is essential, imaging can be enhanced by MRI (eg, dense breast tissue).My focus is on treatment decisions based on the molecular biology of each patient’s tumor. If there is at least 1 cm3 of tumor tissue available I recommend that women patients arrange before a lumpectomy to have .25 grams of frozen tumor tissue( on dry ice ) sent to one of the specialty labs(e.g., http://www.carisdx.com ) for a cDNA microarray assay to reveal specific gene & protein expressions, optimal targets and therapeutic agents most likely to work. Plus the Oncotype DX test of 21 genes is routinely used now to determine the risk factor for recurrence for women with Stage I or II, node negative ER positive breast cancer-some recent research suggests the test may have validity with node positive tumors as well.

  6. Susan Love says:

    Scott, you are right about the fact that the emphasis is on the wrong thing. It needs to be on finding the cause and prevention. The problem with “early detection” is that it assumes all cancers are the same and that they all have the potential to be found at a curable point. I wish that were true. Some cancers are so aggressive (like your mom’s) that even if she had had a mammogram (usually don’t work in women that young) it still wouldn’t have made a difference. We need to focus on finding what causes the disease especially in young women so that we can prevent it. We have a vaccine for cancer of the cervix….now we need to have something similar for cancer of the breast. Get everyone you know to join the Army of Women to help us find the answer!

  7. Susan Auld says:

    My Gyn found a lump, I went a mammogram & ultrasound. Was first told everything looked normal, a few hours later received a call saying after further review, a second opinion was recommended.
    Breast surgeon does not feel this is of any concern and could be “monitored”, BUT then scheduled me for a Stereotactic Biopsy anyway !
    After reading the recent European studies, I’m very inclined to cancel the biopsy, and do another mammogram in 6 months. I don’t have any worry that this lump is anything thing more than changes in breast density due to “aging”(I’m 45) and yes I have sagging breasts !
    My only real concern is what will my regular Doctors think of me if I refuse the biopsy at this time??
    Any thoughts are greatly appreciated.

  8. Carol says:

    Diagnosed with Stage 2 Grade 2 invasive ductile carcinoma in 2006(no positive lymph nodes), I had lumpectomy, chemo and radiation therapy. Recently I have started to break ribs on the left side when I cough, although the oncologists swear it has nothing to do with the radiation tratments. I have no doubt that they are wrong as I have worked in the field of Health Physics and radiation protection for over 30 years. You cannot convince me that receiving 6050 rad of ionizing radiation has not done permanent damage to the matrix of my ribs. Should I have had chemo and radiation therapy? Based on all the support and knowledge and answers and research I did, I chose to. Will I regret it? I don’t know. I’m almost three years free of cancer. Right now, I think, with my oncologist help, I made the right decisions for me.And right now, that’s all that matters.

  9. Lucy says:

    To Susan Auld:

    I am a breast cancer patient who is currently going through radiation treatment. I really think that you should consider the biposy. I understand how you feel about taking more tests. I was fearful of it myself but the biopsy will give you more information so that you can make better decisions. I did the biopsy and that’s how they confirmed the cancer. If I had ignored it, the cacner would have spread. Better to deal with it than ignore it. Good luck to you. Hugs, Lucy

  10. Ana says:

    I am a breast cancer patient. When I was diagnosed it was Stage IIIA and more than 4 lymph nodes affected. Started chemo immediately for 8 cycles, just had bilateral mastectomy and reconstruction via tissue expanders with positive outcome. No cancer found on breast nor lymph nodes. Now I am debating whether I need the radiation therapy for 6 weeks. I would appreciate anyone’s experience….
    Thanks,
    Ana

  11. Joann says:

    I (52yo) was recently diagnosed. This has been a very long difficult process and it’s not over yet! FEB: mammo [new calcifications found] Mar: follow up mammo [followed by ultrasound finding

  12. S. Kenny says:

    Diagnosed with Stage 1 invasive lobular ca in 2001. er+ Lumpectomy, axillary node dissection (no positive nodes), & 25 rounds of radiation.

    June 30 diagnosis from Mammo, u/s, biopsy, MRI found

  13. S. Kenny says:

    Looks like my email was cut off.
    June 30 diagnosis from mammo, u/s, biopsy MRI found new Invasive Ductal Carcinoma. Very small tumour. Could it dissolve on its own?

    I have a gut feeling this tumour is gone & I don’t want the mastectomy. Is another MRI the way to check, another biopsy? Another ultrasound? I don’t know how to recheck?

  14. Kay says:

    Kathi – I agree with so many of the things you said! Although I have worked as a Medical Technologist and as a researcher in veterinary medicine, it was not until I was diagnosed with breast cancer (1 yr. ago) that I realized that it didn’t seem like breast cancer treatment had come that far compared to some forms of leukemia. I’ve watched the improvement of test methods for so many diseases since I graduated in 1976. In many ways, the “slash, burn, & poison” treatment options that were presented to me weren’t that much better than when my 78 yr. old grandmother had a radical mastectomy in 1969. She suffered from lymphedema for the remaining 20 yrs. of life. I refused the “poison” part after seeing so many chemo patients from my years in the medical lab. So many suffered and we lost them anyway. I choose to live or die on my own terms.

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