Tag Archives: breast cancer

Survival Outcomes After Contralateral Prophylactic Mastectomy

The practice of contralateral prophylactic mastectomy (CPM) has increased in woman with unilateral breast cancer. This highly invasive approach to the management of breast cancer has been done without hard evidence that it conveys a survival benefit. Survival Outcomes After Contralateral Prophylactic Mastectomy: A Decision Analysis by Pamela R. Portschy, Karen M. Kuntz, and Todd M. Tuttle just published in the Journal…


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Mammography Screening in Switzerland

The May 22, 2014 issue of the New England Journal of Medicine has a perspective piece that is even more instructive than its authors and the journal’s editors realized: ‘Abolishing Mammography Screening Programs? A View from the Swiss Medical Board’. It describes the process that the Swiss used to evaluate the scientific foundation for the…


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Head Start as an Heuristic For Medical Students, Treatment of Strokes, and the Law of Unintended Consequences

For more than 25 years I have used the Head Start program to teach medical students data analysis, how to evaluate the therapeutic efficacy of treatment regimens, and how belief commonly trumps evidence. This process usually followed the recommendation of a course of treatment by a consultant to a patient who was on a general medicine service…


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Reform School

If you would understand why reform of our medical system is so difficult consider the case of the angiogenesis inhibitor Avastin. The drug had been used in combination with other therapies to treat metastatic breast cancer. “The FDA notified healthcare professionals and patients that it is recommending removing the breast cancer indication for bevacizumab (Avastin)…


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New Data on the Treatment of Breast Cancer

Axillary node dissection has been the standard of care for patients with breast cancer who have early metastatic disease as indicated by a positive axillary lymph node biopsy. In other words, an axillary lymph node is biopsied; if it contains  cancer cells the axilla on the affected side is dissected and its lymph nodes are removed. A new…


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