technology:cancer detection

  • Cancer du sein : inutilité de la mammographie par rapport à un examen sans mammographie. Au contraire, effet négatif puisqu’un cancer sur cinq détecté par mammographie serait un «sur-diagnostic».
    Suivi sur 25 ans de cinq ans de dépistage en 1980-85 au Canada
    Twenty five year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study: randomised screening trial | BMJ
    http://www.bmj.com/content/348/bmj.g366
    (l’ensemble de l’article est consultable)

    Results
    During the five year screening period, 666 invasive breast cancers were diagnosed in the mammography arm (n=44 925 participants) and 524 in the controls (n=44 910), and of these, 180 women in the mammography arm and 171 women in the control arm died of breast cancer during the 25 year follow-up period. The overall hazard ratio for death from breast cancer diagnosed during the screening period associated with mammography was 1.05 (95% confidence interval 0.85 to 1.30). The findings for women aged 40-49 and 50-59 were almost identical. During the entire study period, 3250 women in the mammography arm and 3133 in the control arm had a diagnosis of breast cancer, and 500 and 505, respectively, died of breast cancer. Thus the cumulative mortality from breast cancer was similar between women in the mammography arm and in the control arm (hazard ratio 0.99, 95% confidence interval 0.88 to 1.12). After 15 years of follow-up a residual excess of 106 cancers was observed in the mammography arm, attributable to over-diagnosis.

    Conclusion
    Annual mammography in women aged 40-59 does not reduce mortality from breast cancer beyond that of physical examination or usual care when adjuvant therapy for breast cancer is freely available. Overall, 22% (106/484) of screen detected invasive breast cancers were over-diagnosed, representing one over-diagnosed breast cancer for every 424 women who received mammography screening in the trial.

    http://www.bmj.com/highwire/filestream/686204/field_highwire_fragment_image_m/0/F3.medium.gif
    Fig 3 Breast cancer specific mortality, by assignment to mammography or control arms (all participants)

    • Pour mémoire, sur Ameli.fr
      Mammographie de dépistage du cancer du sein - ameli-santé
      http://www.ameli-sante.fr/cancer-du-sein/depistage-cancer-du-sein.html

      Une femme sur huit développe un cancer du sein au cours de sa vie. C’est entre 50 et 74 ans que les femmes sont le plus exposées. Il est donc important qu’elles bénéficient de la mammographie de dépistage : un moyen efficace, simple et gratuit pour détecter un cancer du sein le plus tôt possible.

    • Wéé, #bonne_nouvelle ! Résumé : mieux vaut se faire palper les seins régulièrement que de souffrir cet écrasement médicalisé ! #cancer #mammographie #technologie_médicale #business

      Cela me rappelle une sage femme qui voulait absolument installer un monitoring pour une naissance à la maison alors qu’avec un simple #stéthoscope_en_bois elle avait entendu que l’enfant était une fille. Il faut donc plus de gynécologues, des formations spécifiques et surtout redonner de la confiance à la pratique médical plutôt qu’aux robots.

    • Proponents of mammograms often point out that women whose breast cancer is diagnosed by mammography alone live longer than those whose cancer is diagnosed by physical exam. This study found that as well, but the apparent advantage was illusory, the researchers concluded. For one thing, if a cancer is sufficiently aggressive and resistant to treatment it will likely prove fatal no matter when it is detected. Finding it in 2011 by physical exam, as opposed to 2007 by mammogram, simply means that the woman lives longer knowing that she has cancer, not that she lives longer overall.

      Mammograms, the study found, increase perceived survival time without affecting the course of the disease.

      http://www.reuters.com/article/2014/02/12/us-mammograms-idUSBREA1B1RJ20140212

    • #mammographie, la #stratégie_du_doute à l’œuvre, sur FoxNews. Ça n’a pas loupé, dès le titre Controversial study

      Controversial mammogram study : What you need to know | Fox News
      http://www.foxnews.com/health/2014/03/03/controversial-mammogram-study-what-need-to-know

      While the study authors say the women were randomly placed in either the mammogram group or the control group, some members of the medical community claim that, after examining the women at the onset of the study, nurses may have put women with larger cancers into the mammogram group so they would receive better care and improve their odds of survival, says Dr. Marisa Weiss, president and founder of Breastcancer.org

      Le site en question, sous des aspects balancés, incite vivement et « scientifiquement » à recourir à la mammographie.
      Ce qu’il faut retenir sur le sujet d’après ce site « objectif » (je n’ai retenu que les titres)
      Mammography : Benefits, Risks, What You Need to Know
      http://www.breastcancer.org/symptoms/testing/types/mammograms/benefits_risks

      Five important things to know about mammograms
      1. They can save your life.
      2. Don’t be afraid.
      3. Get the best quality you can. ults.
      4. Mammography is our most powerful breast cancer detection tool.
      5. An unusual result requiring further testing does not always mean you have breast cancer.

      Suivent (retour à FoxNews) d’autres arguments tout aussi attendus… et la qualité de la vie ? et le progrès technique ? en plus ça veut rien dire ! et c’est sans danger !

      Other Issues
      Even if this new research were based on a truly randomized trial, there are still some issues with it, says Weiss. For one thing, it looks only at survival—and not at other factors like quality of life.
      (…)
      Technology has also advanced quite a bit since the data was collected for this study.
      (…)
      As for the issue of over-diagnoses—and the fact that study authors say one in five of the tumors detected by mammography fall into this category—Weiss says there’s no one medical definition as to what that means exactly.
      (…)
      That said, the risk associated with getting a mammogram—namely, a small amount of exposure to radiation (about the same amount you’d get by getting an X-ray at your dentist’s office)—is minimal.

      DONC…

      So at this point, Weiss encourages all women over the age of 40 to keep their yearly mammogram appointment. “It’s irresponsible to say mammography doesn’t lead to improved survival based on this study,” says Weiss.

      On vous l’avait bien dit : ce sont des chercheurs, ils sont irresponsables !