Talk:Breast cancer

BC Culture, Politics of BC (re "Is every lump...?"

(Although this is without annotation, Review Articles in Peer-Reviewed journals (and.or Introduction Sections of other articles) could be sources of appropriate annotation of my comments.)

Discussion of BC Culture was the only obvious (on skimming article) critical remark about BC politics. I am glad this is there, but there is more that is missing: The huge increase in ability of mammography's ability to detect suspcious lesions results in dramatic increase # of "unnecessary" biopsies. (The concept of "unnecessary" biopsy is specious, though, because, e.g., with melanoma, it would be rare to call a biopsy "unnecessary" just because it showed that the suspected lesion was benign. When reporting risks and complications of mammography, one thing mentioned is the increased anxiety (and life-interruptions when "something unknown" results in a biopsy that would not have been indicated, except for the ability of mammography to hyper-detect lesions of concern. Taking this to politics, some women refuse treatment, others refuse screening and/or biopsy on these or related grounds. e.g., "Well, I will agree to a physical exam, but, if you find anything, that does not mean I am going to agree to a mammogram or a diagnostic test - as those are not without risk to me."

In the context of "Is every lump...?" there are two unstated questions, "Is every lump an indication of cancer?" (No.) Is every lump something that should be brought to attention of medical provider?" ("Every lump of xyz characteristics...." - or, if uncertain, "Yes.") Again, this is a place to indicates (with statistics) the high percentages of different types of evaluations and surgeries indicate "no evidence of disease." This promotes debate of, "It this good or no? - with differing opinions.

Someone could add a section like this, worded more appropriately, and annotated, perhaps placed within historical and clinical context. --KnowLimits (talk) 15:05, 4 December 2011 (UTC)

A paragraph or two on overdiagnosis would probably be appropriate. WhatamIdoing (talk) 23:00, 3 January 2012 (UTC)

A paragraph or two on overdiagnosis sourced to a peer-reviewed journal would be appropriate. --Nbauman (talk) 05:27, 12 February 2012 (UTC)

Review

• Harris, SR (2012 Apr 15). "Clinical practice guidelines for breast cancer rehabilitation: syntheses of guideline recommendations and qualitative appraisals". Cancer. 118 (8 Suppl): 2312–24. PMID 22488705. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)Doc James (talk · contribs · email) 12:34, 12 June 2012 (UTC)

Screening

Another good review [1] Doc James (talk · contribs · email) (please reply on my talk page) 00:03, 9 July 2012 (UTC)

Cochrane meta is much better. Note how OLD your review is. Not relevant now.32cllou (talk) 00:25, 9 July 2012 (UTC)

Yes 8 months old.Doc James (talk · contribs · email) (please reply on my talk page) 01:24, 9 July 2012 (UTC)

Info improves as more data comes in from the trials. Same trials over time = better data. 2009 USPSTF narrows the age rec and screen frequency, 2011 rec becomes moderate, and they say maybe screen biannual at this interval not sure of value. ECU is 2011 also and says only every 3 years (down from USPSTF 2). 2012 more data comes in, find treatments improve making screening less import, and they find more harm from early treatments. Same trials more data finding 'do not recommend at any age. I understand that the U.S. Preventive Services Task Force is updating their (only moderate) recommendation to the new data.

If you must add "nat'l orgs" recs include old data from the same trails you can't be vague. You must name each org, date each rec in order of date / data set, state the strength, age range, and interval of each rec, the fact that they all are using the same trials, and the fact that the 2012 current data set finds DO NOT RECOMMEND AT ANY AGE. Do it right instead of reverting old data set recs as though they were valuable. The most and only value is to the best / longest / largest meta which is the 2012 Cochrane.

Reference the first sentence in the last para or remove as misleading. My understanding is that it's not supported and not factual using 2012 data.32cllou (talk) 03:36, 9 July 2012 (UTC)

These are the most current recommendations. And they remain the national recommendations until these bodies change them. If they accept the conclusions of the 2012 Cochrane handout than they will change them soon. Until they change them however we leave the current conclusions here. Doc James (talk · contribs · email) (please reply on my talk page) 08:37, 9 July 2012 (UTC)

I know you should include natl org recommendations, but you have to list who, dates, and exactly what they recommend. Your vague sentences are misleading, simplistic, and will be reverted. Your picture is a fraud (marketing picture from GE?). Please present suggested sentences and picture here before you degrade wiki with such vague misleading historical or marketing info.32cllou (talk) 16:32, 9 July 2012 (UTC)

That comment is a concentrated example of what not to do in addressing a content dispute. Please make at least a token effort to engage the substance of the question instead of making off-handed and far-fetched accusations against other editors. It's not just a good idea; it's policy.

This isn't a zero-sum game. The Cochrane Library review is a good source, and the Canadian Task Force review is a good source. I really think that the goal of writing a good article is getting lost in the battleground mentality you're displaying here. Is your argument seriously that major national guidelines published 8 months ago are "too old" to use as a source? Or am I missing something? MastCell ^Talk 16:56, 9 July 2012 (UTC)