Tue Nov 27, 2012, 12:05 PM
hedgehog (36,063 posts)
More info on the usefulness of mammogerams:
Tumor Biology Matters
Could it be that dense tissue represents a local microenvironment that promotes cancer development, but not spread? Or that the low breast density seen in obese women creates a microenvironment that makes tumors more aggressive? That is something we need to study. Tumor biology might also explain why the risk factors for developing breast cancer may not necessarily be the same as the factors that influence a woman's risk of dying from breast cancer. In other words, maybe dense breast tissue increases the risk of getting cancer, but not dying of it. If this is true, it might mean we don't need to treat the tumors of all women with dense breast tissue the same way, or the same as we would a woman with fatty breasts.
It's especially important to think about these findings in the context of the mammography debates and the push for breast density legislation. All too often, a recommendation like the one the US Preventive Services Task Force made for routine mammography screening to begin at age 50 is interpreted as a conspiracy to cut health care costs that will ultimately increase breast cancer deaths. Or, we look to legislation, like the laws we've seen about breast density, as a way to get women more screening-even though there is no evidence that more screening is better.
We have repeatedly bumped up against the limits of what screening can do. We need to focus more on the tumor's biology and the microenvironment that surrounds it, it we are going to end this disease. The recent study on breast density showed us, yet again, that women who are obese when they are diagnosed with breast cancer are more likely to die of breast cancer than women who are not obese. Doctors need to do more than tell women about their breast density or remind them to get a mammogram. They need to be teaching women the importance of exercising, losing weight (if necessary) and eating a well-balanced diet-both before and after a breast cancer diagnosis.
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More info on the usefulness of mammogerams: (Original post)
Response to hedgehog (Original post)
Tue Nov 27, 2012, 04:08 PM
SheilaT (20,736 posts)
1. One of the unexamined issues here
and in many other areas of health care, is that we are not all exactly alike, and those difference can lead to illness in one person but not in another, a bad reaction to a medication in one and a complete cure in another. And so on.
I do realize that for the most part the best we can do is go by what works -- or doesn't work -- for most. And we are moving in the direction of figuring out where an individual's DNA is a factor.