Getting the science right

This is a quick post, mainly to link to a great blog post about Komen's real problem: they haven't been considering the science of tumor biology in their approach. It echoes much of what I've written here, but with a little more information and an important context.

The blog post is on Discover Magazine's website; it's titled Komen for the Cure's biggest mistake is about science, not politics. 

We took this picture shortly after she started pulling huge
chunks of hair out in 2006. She wanted to document
the process, so there are many pictures of Sandy-going-bald
on my computers.

The blog post does a good job of explaining why it's not only incorrect but detrimental to continually tell women that early detection is the key to saving lives from breast cancer.

As much as I rail against the emphasis on screening mammography, I want to be clear about a couple of things:

• Diagnostic mammography is very different from screening mammography, and it's important. Anyone with concerns about something she (or he) feels in a breast or armpit should have a mammogram. Mammography, ultrasound, MRIs, and biopsies are the best diagnostic tools we have right now.

• Any woman who wants regular mammography for peace of mind should have access to it, and it should be covered by insurance. However, she should also have accurate information about the benefits and the risks of routine mammography. 

• Routine mammography makes much more sense for high-risk women.You have a higher risk of developing breast cancer if a close family member had it (especially if it struck early, before the age of 50), if you test positive for one of the BRCA mutations, or if you've had breast cancer in the past. There are other risk factors, too. Women should be discussing their individual situations with their doctors and determining what makes the most sense for them.

• Statistically, routine mammography between 40 and 50 results in the most harm with the least benefit. Between 50 and 75, it provides the least harm with the most benefit. After 75, it may not provide significant benefit; the jury's still out on that one.