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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