The idea of "watchful waiting" already exists in prostate treatment. Should it be considered with other cancers?
Overall, your chances of dying of breast cancer are lower if you get regular screening mammograms. But a new study points out that an unadvertised cost of screening includes the possibility that you'll be diagnosed with, and treated for a cancer that was not going to hurt you.
Despite the appeal of early detection, some mammograms may locate some cancers that would have otherwise regressed, according to the study, which appeared in the Archives of Internal Medicine.
In four Norwegian countries, breast cancer rates increased significantly after women there began undergoing mammography every two years.
But the rates among regularly screened women remained higher than rates among women of the same age who were screened only once after six years, suggesting that some of the cancers detected by mammography may have spontaneously regressed had they not been discovered and treated, the researchers said.
"Perhaps the most important concern raised by the study is that it highlights how surprisingly little we know about what happens to untreated patients with breast cancer," wrote Robert M. Kaplan of the University of California, Los Angeles, and Dr. Franz Porzsolt, of Clincal Economics University of Ulm, Germany, in the accompanying editorial "The Natural History of Breast Cancer."
"In addition to not knowing the natural history of breast cancer for younger women, we also know very little about the natural history for older women," they wrote. "We know from autopsy studies that a significant number of women die without knowing that they had breast cancer (including ductal carcinoma in situ). The observation of a historical trend toward improved survival does not necessarily support the benefit of treatment."
11-28-2008, 05:26 PM
Can cancer vanish naturally?
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