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Two noteworthy breast cancer articles: women who turn down mammography…and questions about precision medicine

Women’s magazines are often not the place to go for hard-hitting, evidence-based health care stories.  That’s not just my opinion.  That’s what I’ve heard through the years from many women who try to write such pieces for women’s magazines.

But here’s an exception to that pattern:  Laura Beil’s piece in O, The Oprah Magazine, entitled, “The Truth About Mammograms (and Whether You Should Get One).”

There’s much to applaud in the story:

  • interviews with two health care professionals – an MD and an RN – who articulate rational decisions to decline mammography.  The RN is quoted: “I’ve been made to feel like I’m nuts for turning down the test.”
  • an interview with Dr. Susan Love, who discusses “an approach that’s gaining traction called informed choice.”
  • a dismantling of the over-used and misunderstood statistic that a woman has a 1-in-8 chance of getting breast cancer in her lifetime:  “But if you’re 50, your chance of a cancer diagnosis in the next decade is actually closer to 1 in 42.”
  • the ending, quoting the MD who declines mammograms:  “There isn’t one right answer.  What matters is that each woman makes the best decision for herself and her body.”

It will be interesting to see the reactions of O‘s readers to the piece.

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Former three-time Pulitzer Prize nominee Michael Millenson – from his days at the Chicago Tribune – is now a health care consultant.  His column on the Forbes website, “Breast Cancer Tests Betray ‘Precision Medicine’ Branding,” deserves a look. You need to read his entire piece to understand his concerns, but these excerpts give you a taste:

Yes, President Obama’s new $215 million Precision Medicine Initiative supports important science, but it also bolsters biotech branding in a way the science doesn’t always support.

To understand why clinical genomics (a more neutral descriptor) isn’t quite as reliably precise as backers like to boast, consider three tests meant to determine whether a certain type of breast cancer will recur. …

(But) The lack of agreement on biomarkers among breast cancer recurrence tests brings to mind the caveat of the carnival barker at the amusement arcade: “Ya pays your money and ya takes your chances.”

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