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Dear all, I have downloaded several papers on BC and screening and they are as clear as mud to me. Numbers needed to harm are low and numbers needed to treat or diagnose are high. I was initially emotionally invested in this but when I saw the serious discussions from rational, compassionate persons it has caused me to reconsider my save all at any cost position. I hesitate to say more because of my lack of medical knowledge but it does seem that it is a large industry so it would be challenging to stop that thoroughfare and of course the consequences of false negatives in true malignancy are tragic. Here are my questions and I apologise in advance if they seem too direct, emotional or ignorant. I think it is not possible to make relevant population choices without knowing the dynamics; . Are there other combinations of markers like elevated cd34, estrogens etc that could more accurately predict when intervention is needed? . How big does a cell mass have to be and how does rate of growth enter the equation (can this be measured routinely?)before it is dangerous (we all have some wayward cells but many times they will self correct) . I read several papers where removing the primary tumor is helpful for longevity and quality of life even in the face of metatistic activity, and it seems helpful in areas like colon cancer as well but I understand that screening is not changing overall survival rates...why? . Does early chemotherapy help for long term survival...the camps seem divided on whether it should be 'saved' for later or whether early aggressive therapy is best. I say this because if the person is 'cured' of a lump that would have self corrected is this really a cure? . In looking at chemotherapy agents it seems they mostly cut off blood supply or block growth factors or hormone receptors and one has to wonder if this is a real long term solution. . If you were asked to create policy on this what would be the questions worth asking? Best Regards and many thanks, Amy COI: Relatives with BC, already tried the other side of the ditch, and have a class assignment Amy Price Http://empower2go.org Building Brain Potential