Mammography and ambiguity

The NY Times has published a very extensive information article on the problems with current mammography.  While there are powerful groups who regularly advocate for frequent mammography, the reality is there are many significant problems with the way it is used these days.

My view is that it is necessary for us to face these problems directly instead of pretending that mammography has no down side.

 “…Nearly a year earlier, in 2007, a pathologist at a small hospital in Cheboygan, Mich., had found the earliest stage of breast cancer from a biopsy. Extensive surgery followed, leaving Ms. Long’s right breast missing a golf-ball-size chunk.

Now she was being told the pathologist had made a mistake. Her new doctor was certain she never had the disease, called ductal carcinoma in situ, or D.C.I.S. It had all been unnecessary — the surgery, the radiation, the drugs and, worst of all, the fear.

“Psychologically, it’s horrible,” Ms. Long said. “I never should have had to go through what I did.”

Like most women, Ms. Long had regarded the breast biopsy as the gold standard, an infallible way to identify cancer. “I thought it was pretty cut and dried,” said Ms. Long, who is a registered nurse…

..Diagnosing D.C.I.S. “is a 30-year history of confusion, differences of opinion and under- and overtreatment,” said Dr. Shahla Masood, the head of pathology at the University of Florida College of Medicine in Jacksonville. “There are studies that show that diagnosing these borderline breast lesions occasionally comes down to the flip of a coin.”

much more via Prone to Error…

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