With better adjuvant therapy, does breast cancer stage still matter?
BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h5273 (Published 06 October 2015) Cite this as: BMJ 2015;351:h5273
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This editorial and accompanying paper sends out a very optimistic message about breast cancer survival. This is good news for those affected and screened and treated in the early stages of this cancer. The level of screening at 80% is high in Netherlands, and the accompanying anxiety and preoccupation with breast cancer must also be high - pointing to the enormous burden of not only getting this disease but also of the worry of possibly getting it. This focusses on prevention and why the need for all the screening and publicity around this particular cancer.
Why do young women get so much invasive cancer and why is the incidence increasing? Why is the prevalence of breast cancer increasing in the underdeveloped world? Why do the graphs of breast cancer, reducing child birth and use of hormonal contraceptives mirror each other in every country where these data are available? Why do young women get twice as much invasive cancer as young men? Why is there no female animal model that has a similar high incidence of breast cancer to that in women? I have looked at the research and found no animal studies for the pill. I also couldn't find an alternative cause for young women becoming ill with breast cancer except for their exposure to hormonal contraception.1 Anyone who can explain breast cancer aetiology without blaming iatrogenic hormonal exposure please respond.
1. Breen EG. The Screech Owls of Breast Cancer. Authorhouse 2013.
Competing interests: I have written a short book called "The Screech Owls of Breast Cancer" describing the increasing incidence of breast cancer world wide.
Re: With better adjuvant therapy, does breast cancer stage still matter?
I wonder why an editorial so well chosen - as is the habit of the BMJ - does not even mention *overdiagnosis* when dealing with a subject like this: the benefit of a medical procedure. There is a lack of equipoise. A balanced analysis requires consideration of a medical intervention's drawbacks too. It is not possible to make an entirely dispassionate analysis on this issue without comment on the thorny issue of *overdiagnosis*.
Competing interests: No competing interests