Thank you for the work you do!

your commentary was forwarded to me by a colleague from the National Cancer Institute who is aware of our work on breast cancer detection and was incensed about the erroneous conclusions drawn from press reports of the recent Canadian study.

Your observations on cost and effectiveness are correct

This large Canadian study by Ciarelli and her colleagues (and prior ones) finds a significant increase in detection when using both procedures rather than mammography alone – They state :

“Roughly 7.5 cancers were detected per 1000 women with breast exam and mammography compared with 5.4 cancers without breast exam.”

and

“Breast cancer detection rates were higher in mammography centers that offered clinical breast examination in addition to mammography, Chiarelli and colleagues found.

As usual many press reports played down the major finding and instead elected to warn women that feeling lumps is likely to increase false positives. (I presume this is because most journalists subscribe to the mantra: If it dont bleed it don’t lead.)

Of course, without training both mammograms and clinical breast exams miss real cancers and increase attention to non-cancerous lesions.

It is also true that most breast cancer are discovered by hand and usually the woman’s.

references at: http://www.mammacare.com/news.php

All primary screening for breast caner depends entirely on the human sensory skill whether its professional eyes searching a black and white mammogram (X-Ray) or fingers searching a breast for suspicious lumps.

It is not surprising that the major finding of the study was that both senses are required. But without skill-based training and practice neither is reliable.

MK Goldstein, Ph.D.
Senior Scientist
The MammaCare Foundation
and http://www.mammacare.com

bookwomanblue: I’m with you. I first heard about this on the news with Charles Gibson tonight. I hope young people watching over dinner weren’t paying attention. :-/

Thank you both!