Breast biopsies in experiment often produced inaccurate results
By Lindsey Tanner ASSOCIATED PRESS
CHICAGO — Here’s another reason for getting a second medical opinion: Biopsy specialists frequently misdiagnose breast tissue, potentially leading to too-aggressive treatment for some women and under-treatment for others, a study suggests.
- The results indicate that pathologists are very good at determining when invasive cancer is present in breast tissue, but less adept at making the right diagnosis with less-serious conditions or when tissue is normal.
The study involved 115 U.S. pathologists and 240 breast-biopsy specimens. Their diagnoses were matched against those of three experts. It was an experiment and might not reflect what happens outside a research setting, but the authors say the results highlight the challenges of interpreting tissue under a microscope.
The study was published in Tuesday’s (17th) Journal of the American Medical Association.
About 1.6 million breast biopsies are performed each year nationwide, typically after radiologists spot something suspicious on a mammogram. Tissue is withdrawn through a needle or from a surgically removed growth and examined under a microscope. Previous research has shown that interpreting mammograms also can be tricky and lead to under- or over-treatment.
Among the new study’s findings:
• Pathologists correctly diagnosed abnormal, precancerous cells about half the time, no better than a coin toss, said lead author Dr. Joann Elmore, a University of Washington researcher. Treatment for this condition typically includes frequent monitoring and sometimes medication. About a third of these cases were misdiagnosed as not worrisome or normal, while 17 percent were deemed more suspicious or cancer.
Because as many as 160,000 U.S. women each year are diagnosed with this condition, the results suggest that many might be getting inappropriate treatment, Elmore said.
• Pathologists mistakenly found something suspicious in 13 percent of normal tissue.
• They had similar trouble with a condition called DCIS — 13 percent of these cases were misdiagnosed as less serious, while 3 percent were mistaken for invasive cancer. DCIS involves abnormal cells confined to a milk duct and is diagnosed in about 60,000 U.S. women each year.
- “As a woman, I would probably want to get a second opinion” with a diagnosis of abnormal pre-cancer or DCIS, Elmore said.
A JAMA editorial notes that the study lacks information on patient outcomes, so there’s no proof that the experts made the correct diagnosis.
Also, pathologists were not allowed to consult with colleagues when they were uncertain about findings — while in the real world those consultations happen frequently, said editorial co-author Dr. David Rimm, a Yale University pathology professor who also interprets biopsies.
Still, he said the results are troubling and highlight that pathology is an imperfect science.
(My comment: Hey, don’t blame me for harping on breast cancer, sometimes the subject matter comes in clumps. Strange. The article speaks clearly enough. . delivering a worrisome message., for any who might be stewing over a recent arrival of an almost pain in one breast or both. . . or maybe a tiny little lump that is hard to palpate. This can start a thunderclap of stress wherein everything around you changes; direction?. . .priorities. . .who to trust – what to do? Been there – done that. . . .
. . .This is of course just an aside, but after weaning my son and drying up, there was a period of nodularity which my doctor assured me was normal, not to worry. Mammary glands operate this way — give it time. He seemed to be right because with time it did seem to go away. Out of mind! After becoming conscious of a tiny discomfort in the upper quadrant of the left breast I began to worry all over again. One of my best friends had discovered a small lump as I had done. Was told that it was nothing. This woman wasn’t hypochondriacal or a worrier. She was a devoted homemaker who could do ‘everything.’ Loving. But shortly, with her continued queries to her doctor, they found the lump and operated. She was gone in less than a year. As this was still fresh in my mind it was difficult to ignore. Doctor insisted on a mammogram over my protestation – so I complied. They found nothing. So I have lived with my not-there lump for over forty years. Of course, I stopped worrying about it long ago. I would say that it hasn’t been noticeable this last 7 to 10 years. My OB/GYN was a trustworthy man – had confidence in him. That of course helps. (How often have you heard me say something like that?) He said it was just a simple mammary nodule which hadn’t emptied in the same manner all the others had; it never caused any harm to me other than emotional, and I didn’t do EFT then, don’t think Gary Craig had dreamed it up yet. I vowed to never have another torturous mammogram and I never have. This is only a useless reflection, nothing else.
Under-wire Bras are universally popular in our land, have worn Bali myself for the comfort and support. . but not in years. The issue is the wire cutting crosswise through an important body meridian (based on old Chinese acupuncture). Have put up an article or two on this (maybe 4 to 6) years ago where the history and reasons are delineated. This is a negative and can affect the lymph from flowing as it should which is and can be deleterious to the breast tissue. Go convince women to buy only non- wired bras! This is Point one I wanted to make on this issue as a means to circumvent trouble before it can happen.
Next, let’s agree that our immune system is our greatest, single asset and we should do all that we can to protect it. For example, the body doesn’t make vitamin C, so every single one of us should be taking about a 1,ooo mg daily on good days – can double or take massive amounts more when under viral or germ attack of any kind. Vitamin C alone has cured cancer, tho that is done intravenously where many multiples of it are injected. [I take vitamin C in the powdered crystal form which works best for me as I hate swallowing pills]. 1/4 teaspoon = 1K mg. Taking too much at a time will produce diarrhea, so one must take to bowel tolerance. I can take 2 K, but more will give me runs. Must spread it out over multiple dosage – even 1-2 K ea hour. Our immunity is housed primarily in the gut, so much thought should go into protecting it – keeping it healthy.
We need to understand that if our digestion is off, putrefying foodstuff is sent to the intestines wherein the process of assimilation ain’t gonna happen. Instead, we have gas, pain and slow starvation going on. [hugely over-simplified]. Not going to describe the content of this entire blog – each subject has been covered often. We need to understand why and what “Food Combining” is because using it assures we digest our food which allows the gut to process and send it on to be assimilated for body sustenance. Our body is a temple, not a garbage can. . .we have to do these things, know about them or accept disease as a way of life we have allowed. Our bodies communicate, we should listen and try to understand. So don’t eat stuff in boxes, cans or bags – anything prepared for you to ‘make life easier and cheaper’. . .it is so not worth it. Drink best water you can muster (I distill my own, my latest unit is an H2O brand. Cheaper than any I’ve bought before and easier to clean (- that’s important). Use fresh stuff, organic as you can afford. Free-range, grass-fed cattle are so expensive as is fresh-caught Alaska Salmon – but that’s my preference or I do without. Did you know that small mouthed fish [also smaller in size], are better for us than say cans of Salmon and/or other large mouthed fish? Why? It’s the mercury and other contaminants – far less in tiny fish like sardines and anchovies. Use more plant protein – nuts, seeds, flax, chia, hemp and so on. . in easy ways like sprinkle on salads or use in morning shakes with some green stuff like kale or spinach, etc., so don’t worry, can get plenty of protein animal protein is to costly for the budget.
For the best idea to heal your unhappy gut so that it can serve you and get your immunity way up where it should be, My #1 piece of advice is FERMENTED VEGGIES. I have my own method – way back and repeated again later for someone who couldn’t find it and many others who do a great job with this all somewhere on the site. It’s not hard to do; chop, cut and slice some cabbage, carrots, maybe some onions, garlic or hot peppers into this big bowl — mess it around squeezing and lifting til its pretty and stuff into big jars and tamp down firmly using fist or round tool to help. Lay on some reserved big outer leaves of cabbage, folded to cover the veggies for they must be covered in liquid. Pour over some liquid [I generally blend few stalks of celery in mixer with close to a quart of distilled water and pour over veggies in each jar — must cover the veggies. Then I lay on top of those leaves a few corks saved over the years from wine bottles. Then secure the lids on top. I bring up my Coleman Cooler from the basement and place all the big jars in the cooler and place in the pantry, out of the way. My first time I had put on a top shelf in there and they leaked big time. Mess. That’s when I started with the cooler. This chemical reaction happens, it’s just part of the process. Many use salt in their veggies – I don’t, read that salt inhibits the growth factor so why do it? Also, many use a starter to make cultured foods. I don’t, tho I have and don’t see any difference. This is nature at work and the way (kinda) that it was always done. It’s still cold here, so could take 7 to 12 days til done. Summer, maybe 4 or 6 days. The food is juicy, pretty and quite tart. IT DOES TAKE SOME GETTING USED TO. After all that effort – I was dumbstruck with disbelief! But I’m one who liked chocolate, ice cream and sweets, so I thought I’d croak if I had to eat that stuff! But I learned to eat it in only a few days; used by dipping some chips into it, hiding in salads, putting in baked potato. Truly in less than 3 days – it was acceptable to me, then I loved it. Didn’t even notice that I wasn’t eating chocolate anymore. It changed the flora in my intestinal tract. It helped change my taste buds. (I’d heard they could be trained, but then I knew it.).
Just another reason to use fermented foods; there is no pill made by anyone which can deliver the quality and potency of B Vitamins as ingesting this (even a few smallish dollops) at your meals. 1/4 cup is a good serving, maybe 1 to 3 times a day. It can do much to heal the gut and in time, give you the assurance of knowing that you will not have to succumb to disease because you have a fully functioning immune system. That’s a good way to live. Stay well, Jan)