The Orginial Women Have Likely Passed On, But We Still Think of Them With Great Love

Meadowbrook Park Flower by WS
Research trials protect the names and identities of the individuals who enroll. But none the less, like the grave of the unknown solider, we think of the some of the women who participated in trials in some of the same way. In 1963 over 60,000 women, most of whom surely are no longer with us, but were moms, and grandmothers and great grandmothers of some of our most at risk women, enrolled in what was the first massive trial using mammography as a screening tool to see if lives could be saved. The women were followed for over a decade before the results were published in the Journal of the National Cancer Institute in 1982. It was recognized from this early trial that screening did decreased death from breast cancer. As we celebrate advances in the diagnosis and treatment of this disease in breast cancer awareness month, we need to think of these women with love. As we think of them, what would we want to talk to them about those early, so important studies. We are very grateful for those studies, and we do live by the principals we have learned from them even today.  But as we have moved into the generations beyond these original courageous women we have discovered other unexpected consequences of the wide spread application of the hunt for cancers. Statisticians tell us what was once revered data, memorized and dutifully repeated on medical school examinations, is now felt to be just the beginning of a quest for better information. We cannot view successes by magnifying lenses with side blinders on. In the past studies looked at what was called "disease specific mortality". So if the study looked at breast cancer, death from breast cancer was the important outcome. But if in fact other cancers or other diseases were increased by the process of the testing or the treatments, that was not considered in the formula of success in the evaluation of a treatment or a test. Confusing it is. There are other aspects of testing that have now come under fire since those earliest days. What the early studies suffered from, was a great deal of overdiagnosis. Early ductal carcinomas, many we have discovered may pose no threat to life. This has become one of the most difficult cases to treat, because there is a suggestion, by even some well regarded experts, that it might be better to not treat. Or perhaps if you are going to treat  you could treat these very earliest cases less aggressively so that less harm is done. Prevention is still going to be the best 'treatment of all.' Something that generation those 50+ years ago never had any chance of. We have some chance at that. So speak to your gyno about how to prevent. As detection and treatment still has flaws, but whatever you do this month, spend a moment in silence to thank those early research participants who have passed on.

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