This new JAMA article reviews the literature. At a glance, it may add to the growing perception among journalists, primary care physicians and others – including ordinary women – that mammography’s effectiveness has been, again, disproved.
What I choose to remember about Shirley Temple is that she lived for 41 years after having a mastectomy for breast cancer. In 1972 she spoke openly about her medical condition, and encouraged other women to seek medical care if they noticed a lump, and not to be afraid of the disease. She made it easier for us, today, to talk about breast cancer treatment and options.
While therapy has improved quite a bit since 1985, the greatest benefit derives from most women avoiding the need for life-long treatment by having small tumors found and removed before they’ve spread.
What Deb did, and I thank her for this, is offer an extreme example of patient-centered care. Among other things, she did everything possible to assure that the people caring for her perceive her as a human being who loves dancing.
The new Metastatic Breast Cancer Alliance includes a spectrum of agencies, young and old, working together. The goal is to promote knowledge and research about breast cancer metastases – to develop more effective, less toxic treatments, and to improve the lives of people living with Stage 4 disease.
The problem with Tamoxifen is that it has anti-estrogen effects that many young (and older) women consider undesirable. Already our breasts have been cut. Feeling “feminine” is not trivial.
There’s no right answer…Jolie’s essay reflects the dilemma of any person making a medical choice based on their circumstances, values, genetic test results and what information they’ve been given or otherwise found and interpreted.