Breast Cancer Screening Programme


Breast Cancer Screening Programme

FTLComm - Tisdale - Thursday, August 14, 2003
Though one in eight women in North America will be affected by breast cancer, it is not the issue that seems to be a major topic of conversation. Yet back at the end of May, Tisdale saw hundreds, perhaps thousands, turn out to participate in the fund raising "Relay for life". Everyone in that crowd knows about breast cancer.
With so many victims, everyone knows a family affected and shares in the chronic tension that is associated with this disease. To make the disease even more confusing there seems to be no end to the news stories about studies and controversy as to detection and treatment. There has been considerable criticism over the years of the medical profession over the treatment of victims so that we hear studies that report that patients who have radical mastectomy (removal of the breast) have no greater survival rate than those who were untreated. A whole folklore of information and misinformation abounds with little hope of this storm of stuff letting up.
Among the most controversial issues is the whole concept of early detection. It is commonly believed by all, that early detection gives the patient a better chance of having successful treatment. At this point that "fact" is even in dispute, as some studies suggest that despite the efforts of doctors, some patients survive more than five years after the disease is detected and some do not. The latest twist on this issue is that the five year survival rate is increasing while some authorities are pointing out that detection is improving and the rate remains the same for survival, only the detection is occurring two years earlier.
One way or another, these news stories seem to be doing nothing to improve the condition and science seems not to be able to provide any real solution to handling the disease once it is found. It is no wonder that women seem to want very much to ignore the threat and that may even explain why women continue to smoke while confronted with the overwhelming evidence of its harmful effects and I am not suggesting here a link with breast cancer, but rather to point out the fatalism that seems to pervade women's attitudes toward truly overwhelming threats.
Last year, television star and health food proponent Susan Summers announced on the Larry King Live television show that she had breast cancer and was going to have it treated using holistic treatments. It was all well and good for her to declare that her choice wasn't for everyone, but many, including this writer, feared that many people will just "take their chances" as they see yet another example of individuals lacking much faith in the conventional medical system.
As with so many things, knowledge and a grounding in the basic information available, is the best way for everyone to face this issue. I spent the morning visiting web sites and reading the data available and discovered that the news stories and their sensational survey results are mostly "infotainment," news, intended to get attention, rather than provide us with meaningful needed data.
The Saskatchewan programme to screen women using a mammogram is in Tisdale this week and many of you will no doubt have wondered, just as I have, is this a valid programme, given that the medical scientific world of today, is really still in the dark ages and there is always a possibility that medical treatments and diagnostic tools may be as harmful, or even more harmful, than the disease itself.
Clearly, the research I did this morning and the information available, suggests that for women over forty the mammogram is the only test that will provide a person with early detection, but there is the possibility, that it will only detect seven out of ten cases. Still, that is better than nothing and when combined with regular medical checkups and appropriate awareness, (monthly self examination) the chance of early detection is dramatically increased. For women over forty, the low level of radiation used in the mammogram is not considered by most experts as a threat and when weighed against the alternatives, all medical authorities are in agreement and that is, the mammogram is far less a risk than no mammogram.
For women under age forty the material in their breasts is more than a challenge for a mammogram to detect and this is true for women over forty who are particularly fit. The problem of false positives is three to two percent but interpretive confusion requiring a woman who has had a mammogram to be further examined or have ultra sound seems to be a problem.
Let's face it, medical care is not an exacting science, that's why doctors are said to be "practicing" and with a life threatening condition like breast cancer there is a great need for better human relations. The folks in the mammogram unit, the family doctor, even the receptionists, all need to sort out a strategy that would be ready to cope with the terror that the first time mammogram patient feels and it would seem to me that a counsellor should be in that team somewhere to give the patient an opportunity to discuss their fears and frustration.
Worst case scenario is not that a patient has breast cancer, life is in itself uncertain and we all accept our mortality, but the worst case scenario is the lonely uncertainty that comes with a phone call to make an appointment, a referral to a specialist, or other unknown possibilities.
So, let's work out some ground rules for this problem:
    • Take a look at the references with this story, then do some addition research yourself, before you go for a mammogram.
    • Before that first mammogram talk to someone about the impending ordeal, those who have gone through it will tell you what to expect and share with you their fears and trepidation. It is important not to feel alone with this one.
    • Your partner is not your counsellor, he is your other self and will be of no more help than you are talking to yourself. ( I am a trained counsellor and a hopeless wreck when it comes to my wife's health.)
    • Under no circumstances avoid the issue, denial is not only dangerous, it can harm everyone you love.
In the cold hard world of reality, we all need to look at cancer in what ever form, as a fact of human life. We must accept the cheer leading as just that "cheer leading". "Cancer Can be beaten" maybe, definitely we need to continue the efforts and raise funds for research, but we must also accept it as a one of those beasts that hurts and hurts a lot. In our family we consider heart disease a blessing, as all of those of us who have gone before, did so suffering horrible deaths with various forms of cancer. But then, there was my grandmother. She was a cancer survivor, had one breast removed, had several operations and lived to be an elderly woman. Her husband had died quickly of stomach cancer in the late forties, she lived on until the 1980s. Hardly a scientific study, but to me, she was living proof that medical science could definitely prolong life and she made the best of it.
The provincial programme of free mammogram breast cancer scanning is outstanding and I am convinced that it is doing its part to find potential breast cancer victims in time to give they and their doctors an even chance to cope with a formidable opponent.

Timothy W. Shire

Saskatchewan Cancer Agency
Saskatchewan Cancer Agency information brochure on screening mammography
Breast Cancer Action Saskatchewan
Pidduck, Angela, The Mammogram Ordeal, The psychological issue of dealing with a mammogram are perhaps the most formidable, this is an outstanding account that is well worth your time.
Angela Pidduck <>
Family Practice notebook, a family medicine resource, Mammogram, this is an outline that shows the basics and is really a concise dealing with the issue We bring Doctor Knowledge to you, Mammogram,
Imaginis (sponsored by Siemens) Breast Cancer Screening / Prevention (the manufacturer of mammography equipment sponsors this page so you need to consider that as you read the extremely detailed information)

Science Blog, Sonogram may be better than mamogram for detecting certain breast cancers. This is a report on the findings of Australian researcher Dr. Houssami who reports that for younger women sonogram is better but this quote is really important

Dr. Houssami cautions, "This study is not about screening--it is about diagnosis of women who are referred for testing because they are experiencing breast symptoms. There is a critical difference, our study has nothing to do with screening; mammography is the only proven screening test for breast cancer." Breast Health
Chatelaine,Breast cancer information centre, this is a thorough but simple discussion of the topic with lots of additional links.
The breast cancer site
CBSNews Many Mammogram Misreads Reported, September 18, 2002
Eisner, Robin, Mammogram Controversy, December 17, 2000, ABC News
Easton, Megan, Study challenges mammogram effectiveness in breast screening, September 19, 2000, University of Toronto
Paulsen, Monte, Should you get a mammogram?, MotherJones web site


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Editor : Timothy W. Shire
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