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To: gao seng who wrote (3096)	4/3/1999 7:14:00 PM
From: gao seng	Respond to of 4122

The slamogram mammogram - where's the proof? Where is the scientific evidence that says that mammogram's are effective for women under 50? I can find none. Contrary, I can only find the opposite. Without such evidence, any claim to superiority is uncontestable. The following excerpts and links provide some of the basis for my concern: ______________________________________________________________________ MAMMOGRAM TWO-STEP PERFORMING A BRISK ABOUT-FACE, THE GOVERNMENT BACKS REGULAR SCREENINGS FOR WOMEN IN THEIR 40S For women and their doctors, early detection of breast cancer has always had a crapshoot quality to it. Regular mammograms seem like a wise precaution, but the tests may be expensive and unreliable--and in a very small number of cases, may actually help stir up the very disease they're designed to spot. Neglecting mammography can be even riskier, giving an incipient tumor a chance to take hold and grow. This year the confusion only increased, with the medical community clamoring for clarity just as various cancer advisory groups issued conflicting guidelines. " -- What troubles some people is not the substance of the NCI's decision (calling for once-a-year mammograms for all women in their 40s) but how it was made. Changing medical policy because new data suggest it is one thing; changing because public pressure demands it is another. "The public and Congress spent months lobbying the NCI to issue a new statement," says epidemiologist Russell Harris of the University of North Carolina. "That's a pretty interesting way of doing science if you ask me." cgi.pathfinder.com ______________________________________________________________________ MAMMOGRAMS NO BENEFIT BEFORE AGE 50 In sharp contrast to the recommendations of the American Medical Association and the National Cancer Institute, a new study says that mammograms offer few lifesaving benefits for women in their 40s. The research, published in tomorrow's issue of the Journal of The American Medical Association and conducted by a team at the University of California at San Francisco, backs up the National Cancer Institute, which last year stopped recommending that women in their 40s get regular mammograms. "At the time the NCI changed its policy, people said it was a penny-pinching approach to preventive care," saysTIME Health Care reporter Janice Castro. "Now the organization is vindicated." But today, neither the American Medical Association nor the American Cancer Society said they would change their longstanding policies, which say that women in that age group get a mammogram every year or two. The University of California study found that regular mammograms reduce the risk of dying of breast cancer for women over 50. cgi.pathfinder.com ______________________________________________________________________ EARLY MAMMOGRAMS DON'T HELP "This is part of the ongoing controversy about when a woman needs a mammogram," saysTIME's Christine Gormanabout a new study in the Journal of the National Cancer Institute. The study says that women who begin mammography before the age of 50 may not be increasing their chances of early detection of breast cancer. The American Cancer Institute -- a private, non-profit organization -- continues to recommend regular mammographic exams starting at age 40. "The problem for patients," saysTIME's Janice Castro, "is that if there is *no scientific basis for early mammography, insurance companies will refuse to pay for it. Any woman who feels she needs it may have to pay for it out of her own pocket." A mammography costs up to $200. cgi.pathfinder.com ______________________________________________________________________ POTENTIAL BENEFITS & RISKS OF MAMMOGRAMS If 10,000 women have a mammogram, 640 women will have an abnormal mammogram and an average of 2 extra diagnostic tests will be done for each of these women. One hundred and fifty of these women will have a surgical biopsy. Of the 640 women with an abnormal mammogram, 17 will turn out to have invasive breast cancer but, mammograms may prevent only one breast cancer death among these women. More deaths from breast cancer are not prevented because many breast cancers detected by mammograms could be diagnosed later and still be cured. Also, some cancers detected on mammograms are already too advanced at the time of detection to make a difference. The time, worry and discomfort of the 623 women who must have extra tests, even though they don't have breast cancer, may be acceptable to some women even though mammograms may only prevent one death of the 17 who turn out to have breast cancer. These numbers are based on the best available data and are a conservative estimate of the number of abnormal examinations, diagnostic tests and surgical biopsies performed and lives saved. mammography.ucsf.edu