The whole current controversy surrounding mammography centres on the issue of overdiagnosis. Does it exist if so how common is it?  Without doubt removing tumours is much better than not and the earlier the clinical stage the better the survival experience  again without doubt. The evidence is overwhelming. But the question is are there some tumours for which treatment is unnecessary  to which the answer is probably yes, and there may be many. But deciding which is not anywhere near reliable enough right now. Hence the controversy.  In my view the guidelines are woefully inadequate and I think women are not given anything like enough information to take proper decisions on an impossible question. That however is no excuse in my view.


Klim McPherson MA Phd FFPH FMedSci
Visiting Professor of Public Health Epidemiology
Nuffield Dept Obstetrics & Gynaecology
Emeritus Fellow of New College
University of Oxford
Mobile 07711335993

From: "Dr. Amy Price" <[log in to unmask]<mailto:[log in to unmask]>>
Reply-To: "Dr. Amy Price" <[log in to unmask]<mailto:[log in to unmask]>>
Date: Wed, 21 Dec 2011 00:39:20 +0000
To: "[log in to unmask]<mailto:[log in to unmask]>" <[log in to unmask]<mailto:[log in to unmask]>>
Subject: Breast tumours

Dear all,

Does anyone know how to find out if people who have breast cancers removed have a higher longer survival rate than those who do not? The question was raised that perhaps those with lesions and successful surgery could have perhaps left them in there with no ill results?  The thinking was that if it is cancer within a set number of years they will die anyway with or without intervention.

I was too emotionally invested to look at this clearly initially however wilful ignorance does not solve problems but can be a source of alienation. What evidence is there that screening and consequent treatment is not helpful? I do understand that mass screening may be a waste of resources in terms of numbers needed to treat but it seems that the suggested guidelines seem to be evidence starved as well.

Many thanks if someone could direct me to helpful links in this area.


Amy Price PhD
Building Brain Potential