As many as 60,000 American women each year are told they have a very early stage of breast cancer — Stage 0, as it is commonly known — a possible precursor to what could be a deadly tumor. And almost every one of the women has either a lumpectomy or a mastectomy, and often a double mastectomy, removing a healthy breast as well.Cancer diagnosis and treatment have reached, it seems to me, a very bad stage. Doctors are capable of detecting tiny tumors long before they cause symptoms, but can't tell which ones are potentially dangerous. By the time we are fifty, all humans have cancer somewhere in our bodies, but most of us die of something else before those cancers become dangerous. Removing every tiny node of rogue cells is a waste of time and also dangerous-- all surgery is dangerous, something we often forget.
Yet it now appears that treatment may make no difference in their outcomes. Patients with this condition had close to the same likelihood of dying of breast cancer as women in the general population, and the few who died did so despite treatment, not for lack of it, researchers reported Thursday in JAMA Oncology.
Instead of learning to scan for ever smaller lumps, we should put our efforts into genetic testing that might reveal which tumors are potentially life-threatening. That way we could ignore the harmless ones, saving billions of dollars and untold worry.
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