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Originally posted by drmgj... false positives will lead to many healthy people getting unnecessary surgery...
From age 30 to 39, absolute risk is 1 in 233, or 0.43%. This means that 1 in 233 women in this age group can expect to develop breast cancer. Put another way, your odds of developing breast cancer if you are in this age range are 1 in 233.
From age 40 to 49, absolute risk is 1 in 69, or 1.4%.
From age 50 to 59, absolute risk is 1 in 38, or 2.6%.
From age 60 to 69, absolute risk is 1 in 27, or 3.7%.
A randomised trial was conducted comparing modified radical mastectomy with lumpectomy and breast irradiation at 7 years follow-up. The trial included 206 patients with breast cancer stage I and II - 84 cases with mastectomy and 122 cases with lumpectomy followed by radiotherapy. Results: The risk of local recurrence and distant metastases was lower during the first 7 years after lumpectomy (24,5%) compared to mastectomy (35,7%) with no statistical significance in the number of total events between the two groups. Local recurrence rate was lower in the lumpectomy group 1,6 % compared to the mastectomy group 5,9%. The same trend was observed for distant metastases, which were the most frequent events- 23% in the lumpectomy group compared to 29,7% in the mastectomy group with no statistically significant differences. There was no significant difference in overall survival among the two treatment groups: 94,4% for patients assigned to mastectomy and 98,3% for patients assigned to lumpectomy. Conclusions: After 7 years of follow-up our findings indicate that lumpectomy followed by breast radiation is an appropriate therapy for women with stage I or II breast cancer; breast conserving surgery and mastectomy demonstrate similar survival rates at 7 years after surgery.
Among women ages 40-50, African American women have a higher incidence of breast cancer than white women. African American women also have the highest death rate from breast cancer; Chinese American women have the lowest death rate.
Supporting Research into Women's Health: Heart disease is the leading cause of death among women, accounting for nearly 39 percent of all female deaths. Studies show that after a first heart attack, women are less likely than men to receive diagnostic, therapeutic, and cardiac rehabilitation procedures, and are more likely to die or have a
second heart attack
From 2001 to 2004, breast cancer incidence rates in the U.S. decreased by 3.5% per year. One theory is that this decrease was due to the reduced use of hormone replacement therapy (HRT) by women after the results of a large study, called the Women’s Health Initiative, were published in 2002. These results suggested a connection between HRT and increased breast cancer risk.
About 40,480 women in the U.S. are expected to die in 2008 from breast cancer, though death rates have been decreasing since 1990. These decreases are thought to be the result of treatment advances, earlier detection through screening, and increased awareness.
About 90% of breast cancers are due not to heredity, but to genetic abnormalities that happen as a result of the aging process and life in general.
Doctors, Medical Centers, Former Patients Reject New Guidelines
By JOSEPH BROWNSTEIN
ABC News Medical Unit
Nov. 18, 2009
New guidelines saying women between the ages of 40 and 50 should not receive mammograms to screen for breast cancer have met a groundswell of rejection from many medical centers, breast cancer survivors and numerous doctors -- some of whom have advised their patients to ignore the recommendation.
Meanwhile, doctors' offices and hospitals have been fielding calls from women wanting to know what these new guidelines will mean for them.
One of these calls came not from a woman concerned about getting breast cancer but one who has already had it. Beth Thompson, 44, a mother of four who lives in the suburbs of Baltimore, Md., was first diagnosed with breast cancer following a mammogram at the age of 40.
"I had no risk factors and no family history," Thompson told ABCNews.com. "Under the new guidelines I wouldn't be screened. That's why I'm so upset about this. I firmly believe I would not be here today if I had not had a screening mammogram at 40."
"[Some] women don't understand how screening can cause problems," said Dr. Bob Crittenden, an associate professor in family medicine at the University of Washington. "Personally, I think this is symptomatic of many in people in medicine promising good health if you get screened. As we know with PSAs and other screenings of asymptomatic people, we have only a few things we can do that actually help extend life and then usually only marginally."
Dr. Gary Lyman, a breast cancer oncologist at Duke University who researches comparative effectiveness, says guidelines like those issued by the USPSTF may cause a great deal of harm.
"This is a reversal of the position they took in their previous recommendations, and this flies in the face of previous guidelines from other groups in the U.S.," he said. "[While] the risk of breast cancer is less in the younger age group, 40 to 50, mammograms save lives in those age groups."
"I'm puzzled why, when the evidence hasn't really changed, when the estimate in benefit and risk hasn't really changed, why they reversed their position," he said.
While many have said the new recommendations are part of a bid to lower medical costs, Lyman said he does not believe there was an economic motive.
Instead, he said, the issue could be that the panel does not include a breast cancer specialist.
"There's no breast cancer expertise on that panel, and I think it's hard to develop guidelines with the data as it is without understanding breast cancer," he said. "It's certainly not a change in the evidence. Something else is at work."
While false positives may create problems for some patients, many seem to feel that those are outweighed by the deaths that can result if the screening is not done, something that will present a challenge to any desire to change screening guidelines.
"At the Methodist Breast Center, we diagnose and/or treat about 500 patients with breast cancer every year," said Dr. Luz Venta, medical director of the Methodist Breast Center in Houston and fellow of the Society of Breast Imaging, in a statement. "And about 21 percent of these are women under age 50. Should these women be sent away and told the cost of screening for breast cancer is not justified in the number of lives that can be saved?"
By Paul Goldberg
House and Senate conferees last week reconciled the differences in the
economic stimulus bill that will give NIH $10 billion over two years and
put $1.1 billion into comparative effectiveness research at the Agency of
Healthcare Research and Quality.
The $789-billion measure has been sent back for action by the House
and Senate, and insiders expect that it will be passed and signed by President Obama.
The bill would give NIH $8.2 billion to fund research over two years.
Another $1 billion would pay for construction on campuses of grantee
institutions, $500 million would pay for on-campus construction and $300
The compromise bill gives $1.1 billion to AHRQ for assessment of comparative effectiveness research. Of this money, $400 million would be transferred to NIH to start such studies. NCI-sponsored clinical trials
cooperative groups are well positioned to conduct such work.
Several groups have been applying the A-word— accountability—to NCI, not a gratuitous dig, considering that one of its recent directors, Richard Klausner, ended up under Congressional investigation.
The Congressional investigation suggested that Klausner had steered grants to associates, questioned his acceptance of awards and lecture fees, and alledged that he engaged in negotiations with potential future
employers without proper recusal.
In its continuing investigation into how the National Institutes of Health (NIH) awards research grants and contracts, the House Energy and Commerce Committee is seeking to determine whether Richard D. Klausner steered a $40 million contract to Harvard University while director of the National Cancer Institute (NCI) and during the time he was a candidate to become the school's president.
Dr. Richard Klausner, global health director for the Bill & Melinda Gates Foundation, resigned yesterday, saying he is launching a new venture in Seattle. He would not reveal details.
Both Klausner and Joe Cerrell, director of Global Health Advocacy for the Gates Foundation, said Klausner's resignation had nothing to do with a Friday Seattle Times story that the Government Accountability Office has begun looking into conflict-of-interest guidelines and Klausner's role in a lucrative contract awarded to Harvard University when he was National Cancer Institute (NCI) director.
CHICAGO, IL, January 23, 2009 --/WORLD-WIRE/-- President Barack Obama is the first President to develop a comprehensive cancer plan. While the plan reflects strong emphasis on oncology, the diagnosis and treatment of cancer, no reference is made to prevention. Yet, the more cancer that can be prevented, the less there is to treat.
In March 1998, in a series of questions to then NCI Director Dr. Richard Klausner, Congressman David Obey requested information on NCI’s policies and priorities. He asked, “Should the NCI develop a registry of avoidable carcinogens and make this information widely available to the public?” The answer was, and remains, no.
Klausner’s responses made it clear that NCI persisted in indifference to cancer prevention, coupled with imbalanced emphasis on damage control - screening, diagnosis, treatment, and clinical trials.
It should be further emphasized that the costs of new biotech cancer drugs have increased more than 100-fold over the last decade. Furthermore, the U.S. spends five times more than the U.K. on chemotherapy per patient, although their survival rates are similar.
The Obama Cancer Plan is subject to Congressional authorization, and funding approval by the House and Senate Appropriations Committees. These committees will be in a position to require that major priority should be directed to cancer prevention rather than to oncology. Clearly, the more cancer is prevented, the less there is to treat. This will also be of major help in achieving Obama’s goal “to lower health care costs.”
Because Klausner had the unfortunate circumstance of announcing his resignation on the same day as the terrorist attacks, Sept. 11, few people paid much heed to those who praised his leadership as he left the cancer institute.
He moved on to serve briefly as president of the Case Institute of Health, Science and Technology, part of the Case Foundation started by AOL Time Warner Chairman Steve Case and his wife, Jean. But because of Sept. 11, Klausner was asked to head a National Academy of Sciences task force to make recommendations on how to use science and technology to fight terrorism, and the new institute never got off the ground.
Developing a vaccine against HIV, the AIDS virus, is also one of the top-funded priorities of the foundation. Klausner has a lot of experience in that arena, noting that the study of AIDS-related cancers at NCI made his institute the second-largest AIDS research program (in terms of funding) worldwide. He also helped launch a center at the National Institutes of Health devoted to the search for an HIV vaccine.
He thinks his work as chairman of the National Academy's task force on terrorism will dovetail nicely with his new position.
Dr. Richard Klausner, former director of the National Cancer Institute, now managing partner of The Column Group, a venture capital company:
The plan has been developed with funding from the Gates Foundation of Seattle. The foundation's director for global health, physician Richard Klausner, says the proposal follows the example of the Global Alliance on Vaccines and Immunization, a grouping of governments, drug companies, and private institutions that buys existing vaccines for global distribution. Dr. Klausner says the Alliance's efforts have expanded hepatitis B vaccine suppliers from one to about 10 companies and the price has dropped 20 percent. He says the Center for Global Development idea could provide the same incentive for new vaccines. "This specific report presents a convincing argument that we may now have one more specific tactic, a new tool, for pulling vaccine development," he said.
A new biotechnology venture-capital firm launched by Richard Klausner, the former director of global health at the Bill and Melinda Gates Foundation, has raised at least $132 million in funds and begun investing in startup companies, according to one of the firm's managing partners.
Svennilson declined to discuss The Column Group's investments in any detail but did confirm two investments: NGM Biopharmaceuticals and 3-V Biosciences. Neither company has a website but both appear to be based in California.
Novavax and Bharat Biotech announce a pandemic influenza vaccine development alliance
10 Mar 2006 - Novavax, Inc. and Bharat Biotech International announced a strategic alliance to pursue the rapid development of pandemic influenza vaccine for India and other ASEAN markets. Under the terms of the Agreement, Bharat Biotech will fund all preclinical and clinical development, work with Novavax on optimal manufacturing processes, and be responsible for the commercialization of the vaccine. In return Novavax will receive unrestricted access to all preclinical and clinical data, and a royalty on all sales.
Novavax's Virus Like Particle Technology uses recombinant protein technology to imitate the structure of a virus to provide protection without the risk of infection or disease. Virion proteins can self-assemble into virus-like particles (VLPs) when over-expressed in certain cells. Novavax's proprietary VLP technology produces safe and effective vaccine products through an aseptic process that reduces contamination risk and produces high, cost-effective yields. A key advantage of the technology is the ability to rapidly respond to emerging threats or new strains.
The alliance will be overseen by a steering committee chaired by Dr. Richard Klausner, eminent scientist and Former Executive Director of the Bill and Melinda Gates Foundation and Former Director of the US National Cancer Institute. Dr. Klausner is a special advisor to the Government of India and to Novavax, Inc.
Originally posted by ~Lucidity
Originally posted by drmgj... false positives will lead to many healthy people getting unnecessary surgery...
hardly. additional mammograms, ultrasounds, and needle biopsies maybe, but that is standard BEFORE ANY SURGERY. this is a flat out crock.