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Women’s Health And The Mammogram Controversy

Despite the urgings of national health organizations for women to have annual or biannual mammograms after the age of 40, uncertainty and controversy about the procedure persists. Based on cumulative evidence, screening mammography has become standard health care in many countries. However, the value of the procedure has been challenged by two Danish researchers who reviewed the major clinical trials of screening mammography declared that five of the seven trials were flawed and that none demonstrated that it saved lives.

The report, originally published in the Lancet in January 2000, was written by Peter Gotzsche and Ole Olsen from the Nordic Cochrane Center in Copenhagen. It found that most of the seven studies reviewed were invalid, in part because they failed to assign women to screened and non-screened groups. The two studies that did randomize women correctly, the researchers said, showed no value to mammography. Cancer experts from around the world overwhelmingly denounced this report. Even the researchers’ own institution distanced itself from the report, stating that the findings had not been submitted to the Nordic Cochrane Center’s usual rigorous review.

After the storm of criticism, the Danish authors have reevaluated their original data and declared that it “confirmed and strengthened” their original conclusions, stating that “screening mammography is unjustified because there is no reliable evidence that it reduces mortality.”

Many women are now wondering if they should continue to have annual mammograms. After all, for many years women were told to do self examinations of their breasts, but recently that advice was discontinued after a large study found it completely ineffective at reducing the death rate from breast cancer.

However, other experts have challenged the iconoclastic report and contend that mammography is lifesaving. The American Cancer Society found no reason to alter its recommendation for annual mammographic screening for women over 40 years of age. The National Cancer Institute found that the screening test contributed to a pronounced drop in the death rate from breast cancer. The study, published in The New England Journal of Medicine, concludes that 28 to 65 percent of the sharp decrease in breast cancer deaths from 1990 to 2000 was due to mammograms. The remainder was due to powerful new drugs to treat breast cancer.

In the era since mammography has become widely used, the size of tumors at the time of detection has declined along with the death rate from breast cancer. During the early 1980’s, when only 13 percent of women in the United States received mammograms, the average tumor size at detection was about three centimeters. By the late 1990’s, 60 percent of women were having regular mammograms, and the average tumor size had shrunk to two centimeters, according to data from the Cancer Society and the National Center for Health Statistics.

This seemingly small difference in tumor size is extremely significant in terms of prognosis. On average, the larger a tumor is, the longer (or faster) it has been growing, with a subsequent correlation between tumor size and metastasis. More aggressive, debilitating treatment must be undertaken against large tumors, and even with this, survival chances of women with large tumors are worse than those of women with smaller tumors.

Of course, there are always exceptions, and some small tumors are aggressive and spread early, while some larger tumors are slow-growing and remain localized. Currently, it is impossible to distinguish between them by mammography. Even after biopsy and microscopic exam, it is difficult to predict how a tumor will grow.

There have been claims made that the recent reduction in breast cancer mortality, nearly 2 percent a year since 1990, is due to improved drugs and treatment. However, there is evidence that early detection has made a major contribution. A 29-year follow-up of breast cancer deaths in two Swedish counties published in 2001 revealed a 63 percent decline in the death rate from breast cancer in women who were offered mammography, and no decline in the death rate in unscreened women, even though the same improved treatments were available to all.

Currently, all major U.S. medical organizations recommend screening mammography for women 40 and older, claiming that the procedure reduces breast cancer mortality by 20 to 35 percent in women ages 50 to 59 and slightly less in women 40 to 49 at 14 years follow-up.

Mammography is an imperfect screening tool. It sometimes produces false-negative results: in women under 50, mammography is likely to miss 20 to 25 percent of existing cancers, and in women over 50, it misses 8 to 10 percent. Because of this, when a woman or her physician feels a suspicious breast lump that does not appear on a mammogram, it should be examined by some other means, such as biopsy.

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Breast Cancer: What Women Should Know

Breast Cancer: What Women Should Know


From relative obscurity, breast cancer has become one of the leading causes of deaths among women in the world.
In 2001, about 200,000 cases of breast cancer have been reported in the United States, making it the second leading cause of cancer death in the US. It is, in fact, the most common malignancy problem that is affecting women in North America and Europe today.

But what is breast cancer and how do people get it?

Breast cancer occurs when malignant tumors in the breast grow and start to affect other tissues in the body. There is still no clear indications how tumors are created but what is often observed is that cancerous cells usually comes from ducts or glands.

Although women’s health organizations advise women to massage the breast daily and to feel for any lumps, it may a long time before a cancerous cell get big enough for us to feel it. By that time, it may already be too late. Doctors make use of mammograms for their diagnosis.

Breast at risk

All women are actually at risk, with the risk increasing with the presence of some risk factors that are already part of the natural cycle, for example, aging. Family history of breast cancer can also significantly affect the prognosis as heredity has been found to play a role. Women who got their periods before they were 12 years old and those who never had or had children after 30 years old are also more likely to develop breast cancer.

There are also risk factors that medical science can help alter such as hormonal problems through replacement therapies. Women are also advised to decrease their consumption of alcoholic drinks, exercise every day and decrease the use of birth control pills. Breastfeeding has been found to decrease the risk of breast cancer development.

Although there are some factors that women can avoid to prevent breast cancer from developing, cause and effect relationships between these factors and breast cancer is still debatable. For women who are already at high risk, doctors often recommend a drug called Tamoxifen, which is known to decrease the risk by as much 50 percent when taken in five years. Still, like all medications, Tamoxifen has side effects such as hot flushes, vaginal discharges and sometimes even blood clots. Taking the drug can also lead to pulmonary emobolus, stroke and uterine cancer, although these are all isolated cases.

Another avenue that women can go to is Vitamin A, which some studies show to be effective in decreasing the risk. Still, research is still in the initial stages and nothing has been proven yet. Other things that are being linked to the breast cancer fight are phytoestrogens, which can be found in soya, Vitamin E, and Vitamin C.

But until something concrete is found in research, the only thing that women can do to ensure that they are safe from breast cancer is early detection. This can be done through daily self-examinations as well as annual check ups and mammogram tests. It is also important that women know the beginnings of breast cancer. Here are some of the signs that they should watch out for.

Lumps in the breast and in the underarms
Scaling of the skin of the breast and of the nipple
Redness in the skin of the breast and of the nipple
Changes in the size of their breasts
Discharges from the nipple

If these signs are observed, it is best to consult a specialist so that you can know whether you have breast cancer or not.

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Read This Great Guide On How To Combat Cancer

Cancer is a deadly disease that ruins the lives of millions. Cancer produces abnormal cells that form malignant tumors in the body, while slowly causing organs to lose their ability to function properly. Cancer can be treated if it is found before it can cause major damage. The tips in this article can help you catch cancer.

It is important to know that pathology reports can make a mistake. If you are told that you have cancer, you may request that your doctor do another biopsy or test. You do not want to begin cancer treatment only to find out that you do not even have cancer.

You should continue to work even if you have been diagnosed with cancer. Cancer does not have to be a life stopper unless you let it. As long as you are still physically able to work, you should. It will keep your mind occupied and show you that you still have a great purpose.

When you are dealing with cancer, you want to have a sufficient support group. This support group can get you through the worst of times and even the best of times, offering the support that is needed and the motivation you need to continue with your treatment and therapy measures.

For cancer patients who are not satisfied with their current treatment, know that you can get a second opinion. Sometimes, another oncologist may know of treatment options that can help you. If you are unsure where to go for treatment, you can look online for good cancer treatment centers in your area.

You will need to drink plenty of water to help flush the toxins out of your body after receiving your treatment. The treatment you are receiving is very strong and after it has done its job, it needs to be removed as quickly as possible from your body. You should strive to drink eight 8 oz glasses of water a day.

In addition to doing self-breast exams and having your mammograms, be sure to visit your doctor for regular exams. For women in their 20s and 30s, it should be done by a doctor at least once every three years. Women over thirty should have them examined at least once a year.

If you recently found out that you have cancer and you do not have or are not eligible for health insurance, talk with a social worker. Cancer treatment is very expensive and many people cannot afford it. A social worker may be able to help you with a payment plan or get your bills discounted.

Is Breast Cancer in men possible? Yes! Even though it may be rare, it is important for men to realize that they can also get Breast Cancer. Many men are unaware of the symptoms because they think only women can get it. If you are a man and you feel a lump in your chest, be sure to go to your doctor!

As stated before, cancer is a disease that kills millions. It causes abnormal cells to be produced that form organ debilitating tumors. If cancer is caught in its early stages, it can be treated and lives can be saved. By using the tips from this article, you can eliminate cancer before it claims another life.

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Women and Lung Cancer: Researchers Look For Gender Connection. Female Cancer Patients Sought For Large-Scale Clinical Trial

According to a recent survey on health concerns, women fear breast cancer most. Despite the fears expressed in the survey, conducted by the International Communications Research of Media for the Society of Women‘s Health Research in 2005, lung cancer is actually the leading cancer killer of women. Lung cancer takes the lives of approximately 68,000 women each year.

While smoking is the biggest risk factor for lung cancer, there is growing evidence that points to gender differences in the risk of developing lung cancer and the implications for treating the disease in men and women.

For example, while the number of men diagnosed with lung cancer has been going down, the number of women has risen 60 percent since 1990. In addition, women who are nonsmokers are 2.5 times more likely to develop lung cancer than men who are nonsmokers.

Scientific evidence points to estrogen as a factor in the difference between how lung cancer acts in men versus women. That biological difference promises to have important implications for lung cancer treatments.

It is believed that the estrogen in women may influence lung tumor growth by causing the synthesis of tumor-promoting proteins. Since women have higher levels of estrogen than men, and younger women have higher levels of estrogen than older women, this may in part be responsible for their higher risk for nonsmall cell lung cancer (NSCLC).

Developing therapies that are favorably influenced by estrogen may provide a gender-targeted therapeutic approach to the treatment of the disease.

Researchers are currently studying a novel approach to targeting lung cancer in women that relies on a chemotherapy agent that exploits the presence of estrogen in women and its effect on the metabolism of proteins in the cancer cell. Cell Therapeutics, Inc. (CTI) developed XYOTAX (paclitaxel poliglumex) initially as a lung cancer drug for all patients-regardless of gender. Retrospective analysis of two Phase III clinical trials found the drug, as compared to standard chemotherapy treatments, had a significant survival advantage in women while having equivalent survival in men.

New clinical trial

Now, Cell Therapeutics is embarking on another clinical study exclusively in women to see if the theory proves true in a larger population of women. The trial, known as PIONEER, is the first approval trial for lung cancer exclusively targeting women and is expected to enroll 600 patients with advanced lung cancer.

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Mammograms for Breast Augmentation Patients

Swim Across America, Seattle, WA, USA - Seattle Cancer Care Alliance
Source: Flickr


Despite the possibility of your implant rupturing from the pressure, doctors still recommend that women who have undergone a breast augmentation have a mammogram.

Women who are considering breast augmentation should be aware that implants can interfere with finding breast cancer during a mammogram. This is because the implant shows up as a solid white shape, obscuring tumors above or below. In addition to making tumors more difficult to detect, implants cause “false positive” results as well when extensive scarring and calcium deposits mimic the appearance of cancer, making the deposits difficult to distinguish from tumors on a mammogram. Biopsy may be necessary to determine whether these are cancerous.

Specific mammogram techniques have been developed to ensure that as much breast tissue as possible is examined in women who have undergone breast augmentation surgery. This requires taking extra images, called displacement views, which expose the woman to more radiation.

In 2004, Miglioretti and her colleagues published a study in the Journal of the American Medical Association indicating that 55% of breast tumors were not initially detected on mammograms for women who have undergone breast augmentation surgery, although the extra images were used.

This compares to about 30% of tumors that were not initially detected for women who did not have breast augmentation surgery. These tumors were subsequently detected in later mammograms.

Another problem is that calcium deposits can be seen on mammograms and can be mistaken for possible cancer, resulting in additional surgery to biopsy or remove the implant to distinguish these deposits from cancer. Calcium deposits may be felt as modules or bumps under the skin around the implant.

The displacement views do not protect against rupture, which becomes a greater problem as implants age. Dr. Lori Brown, an FDA scientist, published an article in 2004 in the Journal of Women‘s Health, indicating that the FDA has received dozens of reports of implants rupturing or leaking during mammography.

Ultrasound and MRIs can be used to detect breast cancer instead of mammograms, but this adds to the cost of screening and may not be covered by health insurance.

The bottom line is to ask yourself if the benefits of breast augmentation outweigh the risks of more serious diseases and complications. No one can answer this question for you, except you and of course, your doctor.

Disclaimer
The information presented here should not be interpreted as medical advice. If you or someone you know is considering breast augmentation surgery, please seek professional medical advice for the risks and benefits of this type of surgery.