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Thanks Paul
Yes I agree with your points and the lack of standardization does add fuel to the fire.I think in BC the point is also that if you catch it very small maybe the body would self repair so accurate diagnosis and staging is something that needs work. Perhaps qualys  and cost to treat early

Instead of late is important too. Does anyone know best data on this? Also if the BC is familial how useful is genetics screening

Amy Price
Empower 2 Go 
Building Brain Potential
Http://empower2go.com
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On 24 Feb 2012, at 03:45 AM, Paul Elias <[log in to unmask]> wrote:

this is a very difficult discussion and topic and many sensitivities...I will answer it as a male and thus from the view of prostate..yet from the start one can argue that these are 2 different cancers and sequelae...but only my opinion...

I think Amy the real challenge with the area of screening is that it is and can be effective..of course it can, yet if when screened and detected there is a cure...the challenge when I consider screening to some illnesses is the issue of screening yet to discover you have a condition yet one with limited options...the question then becomes...why screen? what was the value of that? so if the screening results in medicalization of the person yet with no real hope, then what is the advantage of this? no doubt if you catch something early in the sequelae and can deal with ti completely, then this is a success...and here there is value yet the issue then becomes how often to screen? I think the challenge is the varying age categories that screening takes place as no consistency and the reality of people in some stage of illness when they present and then get screened or investigated. In the ideal world with a bottom less pit of money and a compliant population, maybe we should screen everyone for everything by 30 when the risk of illness starts to increase. again, my opinion yet in a very difficult discussion and topic. 

 
 
 
 
 
Best,

Paul E. Alexander
 




--- On Fri, 2/24/12, Amy Price <[log in to unmask]> wrote:

From: Amy Price <[log in to unmask]>
Subject: lead time error
To: [log in to unmask]
Received: Friday, February 24, 2012, 5:43 AM


"For some diseases, early detection does not help to prolong life because earlier treatment is no more effective than later treatment.In these situations, early detection simply increases the years of disease from the time of diagnosis rather than increasing years of life. This is called ‘lead time bias’. "

Who thinks this applies to breast cancer and why or why not? I have two trees one says that screeening does not change life expectancy, I originally thought they dont know because it has not been long enough but screening has been in place since the 80s so 30 years  should be enough....on the other hand researh points to increased life expectancy and quality of life if the primary tumour is excised in metastic breast cancer.....so could this mean that unless it is big it doesn't matter the body will self repair or does it say other forces to increase malignancy have come into paly and the life of a 50 year old is much different than it was in the eighties.

I need to say this picture of lead time is almost too horrible to contemplate and my mind keeps freezing but what if all that is done made no difference what is the point of screening to make someone miserable? Does early treatment make a difference and if so how much?

Best
Amy