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My BIL, who is a doctor and my SIL who is an oncology nurse both advise against routine mammography.
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Eight out of every 1,000 women have breast cancer. Of these 8 women with breast cancer, 7 will have a positive mammogram. Of the remaining 992 women who don’t have breast cancer, some 70 will still have a positive mammogram. Imagine a sample of women who have positive mammograms in screening. How many of these women actually have breast cancer?
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OK, but this is a problem with all tests of all kinds.
Every kind of test has some probability of false-positives and false-negatives.
So it is always a matter of RISK vs BENEFIT
BENEFIT of having the mammogram:
Dx leads to treatment and longer survival
(
7 women in the example)
RISK of having the mammogram:
First, does the test CAUSE any problems ? (a mammogram = finite, but
very low probability)
False Positives cause anxiety/expense until further testing is done
False Negative may lead to
early death
(
1 woman in example)
RISK of NOT having the mammogram:
High probability of
early death due to lack of treatment
(
all 8 women in example)
Being male, I can't make the decision.
But for my wife and daughters and G-daughters, a few days of anxiety vs early death:
"No matter how much it hurts, Go get the damn mammogram !"
My wife's reply: OK, but no matter how embarrassing, Go get your damn prostate exam !"