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Among the many difficult decisions women face after receiving a diagnosis of breast cancer is whether to undergo mastectomy, not only of the breast with cancer but, as a preventive measure, of the unaffected breast as well. Cancer detected in one breast has a tendency to spread to the other, healthy breast, and an increasing number of women are choosing to excise the unaffected breast, just to be safe. Numerous studies have documented the reduction in breast-cancer recurrence in women who elect to remove both breasts, but until now, no studies had confirmed that this decision actually increases...
...Whether the findings are sufficient to translate to the clinic, though, is another matter. Some experts are not convinced - yet - that the study results should be part of clinical decisionmaking, pointing out that many factors other than mastectomy may be driving the increase in survival. "Women who undergo a [preventive] mastectomy in the unaffected breast may be different from women who do not," says Dr. George Sledge, president-elect of the American Society of Clinical Oncology and a professor of medicine at Indiana University. "They may be overall healthier in that they see their physician more frequently, and their physicians...
Aware of these concerns, Bedrosian says her team was rigorous in its statistical analysis and feels confident enough in the numbers to begin using the information to help patients decide whether a preventive mastectomy is right for them. "We looked at this in multiple different ways, and we got the same answer every time. And the results make good clinical sense. That adds another level of reassurance," she says. "Our hope is that when women hear the numbers, they will take a second look and decide not to go forward with a preventive mastectomy [in their healthy breast...
...time, Chile was embroiled in an election where voters were to decide whether to grant Pinochet another eight years in office. Cavallaro regularly attended anti-Pinochet rallies, facing the wrath of police water cannons and once even being detained and threatened with immediate deportation...
...whooping cough Americans are going through, policy experts, banks, municipalities, and individuals should form a community advisory board. This panel would consist of respected members of the community—small business owners, local bank executives, parents, teachers, lawyers, etc.—who would strictly advise, not mandate, whether those seeking to buy a home are capable of deciding for themselves what is in their best short-term and long-term interests...