Good Science, Bad Conclusions

Of course, today we have medications that effectively treat breast cancer by blocking estrogens or significantly reducing the amount of estrogen in the body.

Unfortunately, I am going to have to take a wait-and-see attitude about what is going on here as a result of these new reports. I don't believe we have the explanation in hand as to why the incidence of breast cancer dropped so dramatically in 2003.

I suspect that what we are seeing is a combination of factors, including fewer women getting mammograms, which in turn means fewer breast cancers are being diagnosed.

I suspect that there is indeed some positive benefit from the decreased emphasis on combination HRT, which years from now will contribute to a true decline in the incidence of breast cancer.

I do not believe the sudden drop in breast cancer incidence is because 11 percent of breast cancers in some of the post-menopausal women have suddenly disappeared or no longer exist.

Which brings me to my concluding comments:

The greatest tragedy here is if women and their doctors become complacent about ordering and receiving mammograms.

We recommend that a woman at average risk aged 40 and over should have a mammogram and clinical breast examinations annually.

If you are a post-menopausal women who either stopped taking hormones or never took hormones, please do not delude yourself into thinking that you don't need a mammogram.

If my contrarian viewpoint is correct, and that discontinuation of HRT simply slowed down the growth of breast cancers that already existed, then not getting a mammogram every year could be the worst decision you make for your health.

Dr. Len Lichtenfeld is deputy chief medical officer of the American Cancer Society. Read a longer version of this commentary, as well as comments on other ongoing cancer news, at his blog.

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