Wednesday, May 13, 2015

Are You Sure You Have Cancer?



If you’ve been told you need a breast biopsy, you need to read this first
It’s what every woman fears the most – your mammogram or ultrasound turned up something suspicious.

Now you’re waiting for a biopsy result that has the power to give you a clean bill of health – or sentence you to painful surgery or sickening chemo and radiation.

We’ve been told the biopsy is the gold standard of tests. That it’s the fool-proof final word on whether we have cancer.

But according to a frightening new study in JAMA, that may all be a myth.

Because it turns out botched biopsy results could be forcing thousands of healthy women a year into aggressive breast cancer treatment they never needed. And if you’re one of 160,000 women a year with a common breast condition, your biopsy results may be no more reliable than the flip of a coin.

Shades of gray

“As a surgeon, I only know what to do based on the guidance of my pathologist,” said Dr. Elisa Port. And she should certainly know, being the chief of breast surgery at Mount Sinai Hospital in New York City.

But if breast cancer surgeons are in the dark without their pathologists, then we may be looking at a case of the blind leading the blind.

A group of researchers from prestigious hospitals all around North America found that breast biopsies are often misdiagnosed by pathologists.

The lead author of the study said that most patients believe that getting a biopsy will give you “definitive answers”– but that’s far from the truth.

The researchers asked a panel of top pathologists – including experts who have written textbooks on diagnosing cancer – to examine slides from breast biopsies and give their opinions. Then a group of practicing pathologists reviewed the slides to see if they got the same results.

When it came to “invasive” cases of cancer, both groups reached the same conclusion 96 percent of the time.

That’s the good news. It’s the only good news.

The pathologists wrongly diagnosed women with ductal carcinoma in situ (D.C.I.S.) — which is often treated with aggressive surgery and radiation.

In fact, if you had perfectly healthy breast tissue, there was still a one-in-seven chance that a pathologist would tell you your biopsy results were abnormal.

And when you enter the “gray zone” called atypia — which are abnormal, but not cancerous cells in breast ducts — the results were even more frightening. The two groups came to the same conclusion only about half the time.

There are about 160,000 women a year who are diagnosed with atypia and given the heartbreaking news that they’re at a heightened risk for cancer. And thousands of these women may be worrying and suffering needlessly right now, thanks to a botched biopsy reading.

Doctors are calling the findings “disconcerting.” How’s that for an understatement?

But the thing to remember here is the comment made by Dr. Port. You may go to a lot of trouble to find the very best doctor or surgeon, but it’s actually someone behind the scenes – some pathologist you may never meet — who will dictate which treatments you receive.

That’s why being a knowledgeable patient is so important these days.

So here’s how to help protect yourself. I know this is something you’ve heard before, but you may not think it applies when you’re talking about a biopsy:

Get a second opinion

If your breast biopsy shows abnormalities – especially those vague and hazy ones called atypia or D.C.I.S. — don’t let a doctor hustle you into surgery or radiation.

Get a second opinion.

A second opinion does not mean another biopsy must be taken. All you’re doing is asking additional pathologists to look at your slide under the microscope.

And it won’t be an insult to your doctor or anyone else. In fact, that’s exactly what all the doctors who commented on the new JAMA study suggested patients do.

Because if there was ever a case of something being worse than having breast cancer, it’s getting breast cancer treatments when there was nothing wrong with you in the first place.
Source:

“Breast biopsies leave room for doubt, study finds” Denise Grady, March 17, 2015, The New York Times, nytimes.com

Cancer
President's Cancer Panel is an advisory panel for the National Cancer Institute.

Note: National Cancer Institute is a division of the National Institutes of Health.
Harold Varmus is a director National Cancer Institute, was a director at the National Institutes of Health, an advisory board member for the Earth Institute, and the president & CEO for the Memorial Sloan-Kettering Cancer Center.
Ezekiel Emanuel was a founding chair of the Department of Bioethics for the National Institutes of Health, the health care policy adviser for the Barack Obama administration, and is a senior fellow at the Center for American Progress.
Open Society Foundations was a funder for the Center for American Progress, the Bill, Hillary & Chelsea Clinton Foundation, the Carnegie Endowment for International Peace (think tank), and the Human Rights Watch.
George Soros is an advisory board member for the Earth Institute, the founder & chairman for the Open Society Foundations, a director at the Brain Trauma Foundation, Daisy M. Soros’s brother-in-law, was the chairman for the Foundation to Promote Open Society, a supporter for the Center for American Progress, a benefactor at the Harlem Children's Zone, and a benefactor for the Human Rights Watch.
Foundation to Promote Open Society was a funder for the Center for American Progress, the Roosevelt Institute, the Children's Defense Fund, and the Aspen Institute (think tank), the International Rescue Committee, the Sundance Institute, the Robin Hood Foundation, the Carnegie Endowment for International Peace (think tank), the Brookings Institution (think tank), the Harlem Children's Zone, and the Human Rights Watch.
Edgar M. Cullman Jr. is a director at the Brain Trauma Foundation, a trustee at the Mount Sinai Medical Center (New York), and Edgar M. Cullman Sr’s son.
Edgar M. Cullman Sr. was Edgar M. Cullman Jr’s father, and a trustee at the Mount Sinai Medical Center (New York).
Susan W. Rose was a director at the Brain Trauma Foundation, and is a trustee at the Hospital for Special Surgery.
Anne B. Ehrenkranz is a trustee at the Hospital for Special Surgery, and married to Joel S. Ehrenkranz.
Joel S. Ehrenkranz is married to Anne B. Ehrenkranz, a trustee at the Mount Sinai Medical Center (New York), and an advisory board member for the Wheelchair Foundation.
Mikhail Gorbachev is an advisory board member for the Wheelchair Foundation, was the general secretary for the Communist Party of the Soviet Union, and the president for the Union of Soviet Socialist Republics (USSR).
Anna Eleanor Roosevelt is an advisory board member for the Wheelchair Foundation, the chair for the Roosevelt Institute, and was a director at the Brain Research Foundation.
Barbaralee Diamonstein-Spielvogel  is a governor for the Roosevelt Institute, a leader’s council member for the Breast Cancer Research Foundation, and was a funder for the Bill, Hillary & Chelsea Clinton Foundation.
American Cancer Society was a funder for the Bill, Hillary & Chelsea Clinton Foundation.
Jonathan Soros is a senior fellow at the Roosevelt Institute, the vice chairman for the Open Society Foundations, George Soros’s son, and was the vice chairman for the Foundation to Promote Open Society.
Daisy M. Soros is a leader’s council member for the Breast Cancer Research Foundation, and George Soros’s sister-in-law.
Leslie Cornfeld is a trustee at the Hospital for Special Surgery, and a director at the Children's Defense Fund.
Robert K. Steel is a trustee at the Hospital for Special Surgery, and the chairman for the Aspen Institute (think tank).
David H. Koch is a trustee at the Hospital for Special Surgery, a trustee at the Aspen Institute (think tank), and an overseer at the Memorial Sloan-Kettering Cancer Center.
Mortimer B. Zuckerman was a trustee at the Aspen Institute (think tank), and is an overseer at the Memorial Sloan-Kettering Cancer Center.
Lynda R. Resnick is a trustee at the Aspen Institute (think tank), and an advisory board member for the Breast Cancer Research Foundation.
Princess Firyal is a leader’s council member for the Breast Cancer Research Foundation, and an overseer at the International Rescue Committee.
Karen J. Lauder is a leader’s council member for the Breast Cancer Research Foundation, and was a trustee at the Sundance Institute.
Jo Carole Lauder is a leader’s council member for the Breast Cancer Research Foundation, and a trustee at the Mount Sinai Medical Center (New York).
Glenn R. Dubin is a trustee at the Mount Sinai Medical Center (New York), and a director at the Robin Hood Foundation.
Jeff Zucker is a director at the Robin Hood Foundation, the president of CNN Worldwide, and an overseer at the Memorial Sloan-Kettering Cancer Center.
Evelyn H. Lauder was an overseer at the Memorial Sloan-Kettering Cancer Center, and the founder & chair for the Breast Cancer Research Foundation.
Josephine Robertson was an overseer at the Memorial Sloan-Kettering Cancer Center, and a director at the Breast Cancer Research Foundation.
Christine Schwarzman is a leader’s council member for the Breast Cancer Research Foundation, and married to Stephen A. Schwarzman.
Stephen A. Schwarzman is married to Christine Schwarzman, an advisory board member for the Russian Direct Investment Fund, and a founding member of the Core club.
Russian Direct Investment Fund is a state fund for Russia.
James F. Collins was a U.S. ambassador for Russia, a senior advisor for Akin, Gump, Strauss, Hauer & Feld, LLP, and is a senior associate at the Carnegie Endowment for International Peace (think tank).
Jessica Tuchman Mathews was the president of the Carnegie Endowment for International Peace (think tank), a director at the American Friends of Bilderberg (think tank), and a 2008 Bilderberg conference participant (think tank).
Ed Griffin’s interview with Norman Dodd in 1982
(The investigation into the Carnegie Endowment for International Peace uncovered the plans for population control by involving the United States in war)
Roger W. Ferguson Jr. was a trustee at the Carnegie Endowment for International Peace (think tank), and is an overseer at the Memorial Sloan-Kettering Cancer Center.
Akin, Gump, Strauss, Hauer & Feld, LLP is the lobby firm for the Memorial Sloan-Kettering Cancer Center.
Vernon E. Jordan Jr. is a senior counsel for Akin, Gump, Strauss, Hauer & Feld, LLP, an honorary trustee at the Brookings Institution (think tank), married to Ann Dibble Jordan, Valerie B. Jarrett’s great uncle, a director at the American Friends of Bilderberg (think tank), was the president of the Economic Club of Washington, and a 2008 Bilderberg conference participant (think tank).
Ann Dibble Jordan is married to Vernon E. Jordan Jr., an honorary trustee at the Brookings Institution (think tank), and an overseer at the Memorial Sloan-Kettering Cancer Center.
David M. Rubenstein is a co-chairman for the Brookings Institution (think tank), the president of the Economic Club of Washington, and an overseer at the Memorial Sloan-Kettering Cancer Center.
Cyrus F. Freidheim Jr. is an honorary trustee at the Brookings Institution (think tank), and a member of the Commercial Club of Chicago.
Valerie B. Jarrett is Vernon E. Jordan Jr’s great niece, the senior adviser for the Barack Obama administration, and a member of the Commercial Club of Chicago.
Rahm I. Emanuel is a member of the Commercial Club of Chicago, the Chicago (IL) mayor, Ari Emanuel & Ezekiel Emanuel’s brother, and was the White House chief of staff for the Barack Obama administration.
Ari Emanuel is Rahm I. Emanuel & Ezekiel Emanuel’s brother, and a founding member of the Core club.
Stephen A. Schwarzman is a founding member of the Core club, an advisory board member for the
Russian Direct Investment Fund, and married to Christine Schwarzman.
Russian Direct Investment Fund is a state fund for Russia.
Christine Schwarzman is married to Stephen A. Schwarzman, and a leader’s council member for the Breast Cancer Research Foundation.
Daisy M. Soros is a leader’s council member for the Breast Cancer Research Foundation, and George Soros’s sister-in-law.
George Soros is Daisy M. Soros’s brother-in-law, the founder of the Soros Fund Management, an advisory board member for the Earth Institute, the founder & chairman for the Open Society Foundations, a director at the Brain Trauma Foundation, was the chairman for the Foundation to Promote Open Society, a supporter for the Center for American Progress, and a benefactor at the Harlem Children's Zone.
Open Society Foundations was a funder for the Center for American Progress.
Foundation to Promote Open Society was a funder for the Center for American Progress, and the Harlem Children's Zone.
Stanley F. Druckenmiller was a managing director for Soros Fund Management, is the chairman & benefactor for the Harlem Children's Zone, and an overseer for the Memorial Sloan-Kettering Cancer Center.
Harold Varmus was the president & CEO for the Memorial Sloan-Kettering Cancer Center, an advisory board member for the Earth Institute, a director at the National Institutes of Health, and is a director National Cancer Institute.
Ezekiel Emanuel was a founding chair of the Department of Bioethics for the National Institutes of Health, is Rahm I. Emanuel & Ari Emanuel’s brother, a senior fellow at the Center for American Progress, and the health care policy adviser for the Barack Obama administration.
National Cancer Institute is a division of the National Institutes of Health.
President's Cancer Panel is an advisory panel for the National Cancer Institute.
Michael R. Bloomberg was a benefactor for Harlem Children's Zone, and is the founder of the Bloomberg Family Foundation.
Bloomberg Family Foundation was a funder for the CDC Foundation.
CDC Foundation is a foundation for the Centers for Disease Control and Prevention (CDC).
CDC- Cancer Prevention and Control
National Cancer Programs
Amy Robbins Towers is a board member for the CDC Foundation, a director at the Human Rights Watch, and was a director at the Millennium Promise.
Open Society Foundations was a funder for the Human Rights Watch, and Bill, Hillary & Chelsea Clinton Foundation.
George Soros is the founder & chairman for the Open Society Foundations, Daisy M. Soros’s brother-in-law, Andrea Soros’s father, was a benefactor for the Human Rights Watch, and the chairman for the Foundation to Promote Open Society.
Foundation to Promote Open Society was a funder for the Human Rights Watch, and the Millennium Promise.
Daisy M. Soros is George Soros’s sister-in-law, and a leader’s council member for the Breast Cancer Research Foundation.
Barbaralee Diamonstein-Spielvogel  is a leader’s council member for the Breast Cancer Research Foundation, a governor for the Roosevelt Institute, and was a funder for the Bill, Hillary & Chelsea Clinton Foundation.
American Cancer Society was a funder for the Bill, Hillary & Chelsea Clinton Foundation.
Andrea Soros is George Soros’s daughter, and a director at the Acumen Fund.
Joel Ackerman was a senior portfolio fellow at the Acumen Fund, and is the CEO for the Champions Oncology, Inc.
Champions Oncology, Inc.
Creating Greater Certainty in the Fight Against Cancer
Champions Oncology is engaged in the development of advanced technology solutions and services to personalize the development and use of oncology drugs.

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