October is Breast Awareness Month.
One of the tiny little problems of being a nurse is that some folk think you have the knowledge base of a doctor - which of course you don't!
They will show you lumps and bumps and ask your opinion - or ask you this and that and expect an answer. I can't give them one and suggest they see their doctor. I have often been asked about mammograms and until earlier this year - would always suggest it made good sense to go ahead.
I have had one myself which proves I am ancient! Of late, I have been swayed by medical opinion that it is perhaps not a good idea. Or is it?
October is Breast Cancer Awareness Month. Astra Zenaca, who manufacture Arimidex and Tamoxifen, founded the Awareness Month in 1995, its aim being to promote mammograms as the most effective weapon in detecting breast cancer.
Is this Big Pharma serving their best interests, directing medical care or just a nice thing to do; maybe the latter?
Although hearing similar stories last year, the seeds of doubt were sown in my mind in January, when I read reports such as this in The Telegraph. It suggested that, despite a reported 1,400 lives saved per year - there is no evidence that the breast screening programme has saved lives and in fact, women have wrongly been told that they have breast cancer and undergo unnecessary surgery on tumours that would not progress to being harmful.
This article was based on this at the Nordic Cochrane Centre and was swiftly refuted by NHS choices who claimed that the research was a narrative review critiquing the 2008 Annual Review of the NHS Breast Screening Programme (NHS BSP), which reported on twenty years of mammogram screening in the UK. See here for further details.
In March this year this article appeared in The Telegraph stating that two lives are saved 'for every woman unnecessarily treated'. It is interesting reading. It is admitted here that leaflets supplied did not inform of potential risks of screening.
Adverse effects of mammographic breast screening include:
Psychological and physical morbidity - mainly associated with false-positives.
False negatives - approximately 5% of cancers in women over the age of fifty are mammographically invisible.
A diagnosis of cancer that would not have become symptomatic during a woman's lifetime.
Radiation risk - an estimate that one extra breast cancer develops every year in women over fifty, after a latent period of up to ten years, for each million women screened.
There is undoubtedly harm related to breast screening - but there must be some good!? A detection rate of 6.2 cancers - although some would be of the 'no harm' kind (?) - per 1000 women screened; of these, invasive cancers accounted for 1.4 per 1000. This reported 1.4 - to me - suggests the risk is worthwhile? However, if you visit NNT it seems that breast screening is a harmful waste of time.
Furthermore, regular self-examination is a waste of time too! See here!
There is so much conflicting information, I am left a little confused! I think I shall probably attend my next, unless something more robust convinces me otherwise. I will still recommend that other women do too. But should I? Should I say - "Look at the evidence and make your own decision"?
What are your thoughts?
PS We must (as girlies) take some responsibility for our health! Poor diet, obesity and binge drinking may lead to breast cancer!