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...seeing their lesions, whether they are cancerous or not, by having their entire breast removed rather than just a portion of the tissue. "I just saw two patients who both had MRIs done at an outside institution, and both came in wanting mastectomies based on the MRI findings," says Dr. Anthony Lucci, a surgical oncologist at M.D. Anderson Cancer Center in Houston. Neither of the MRIs showed cancer, just abnormalities, says Lucci, but more and more patients are requesting an MRI not as a diagnostic screening tool but as a prognostic one. And in those situations, "they are much more...
While there is no doubt that MRIs are more sensitive than mammograms, says Dr. Daniel Hayes, clinical director of breast oncology at the University of Michigan Comprehensive Cancer Center and a co-author of the commentary, it's not clear that the technique is more specific than mammography. Studies of each diagnostic screen have shown that compared to mammograms, MRIs can pick up additional cancer lesions 16% of the time. "But," says Hayes, "the question is whether they are biologically important...
According to the studies that Hayes and his co-author, Dr. Nehmat Houssami, analyzed, such mastectomies are often unnecessary; earlier studies have shown that many of the small cancers that a lumpectomy may leave behind are in the same region as the surgery site, and therefore will most likely be destroyed by the radiation treatment that follows. "Radiation is very good," says Dr. Larry Norton, a breast-cancer specialist at Memorial Sloan Kettering Cancer Center in New York City. "We do know that if you don't irradiate a breast after surgery, you get local recurrence." (Read "The Year...
Some medical professionals question the value of such stringent measures. This late in a pandemic, they say, the spread of H1N1 is inevitable. "They are not effective at all in my opinion," says Dr. Lo Wing-lok, a Hong Kong?based infectious-disease expert. "By picking up these few cases, there isn't any real impact in control of the flu." Hugh Pennington, a microbiologist at the University of Aberdeen, puts it more bluntly: "We are already in a pandemic. There's no containment option now." (See the 5 things you need to know about swine...
...Dr. Ezekiel Emanuel, the medical ethicist and oncologist who advises President Obama, does not own a television, and if you catch him in a typically energized moment, when his mind speeds even faster than his mouth, he is likely to blurt out something like, "I hate the Internet." So it took him several days in late July to discover he had been singled out by opponents of health-care reform as a "deadly doctor," who, according to an opinion column in the New York Post, wanted to limit medical care for "a grandmother with Parkinson's or a child with...