I'm not an organized person. In the morning, I tend to bumble around my apartment getting ready, the corporate news in the background, morning routine even more difficult, because of my obsessive tendency to bound over to the laptop and hit F5 at even the most inopportune moments.
Yesterday, going through all that, I heard in the background something that took on more and more prominence in my mind in the past 24 hours: MRIs may offer new way to detect breast cancer very early or prevent it.
Detect breast cancer very early or prevent it?
Essentially, the study suggested that for certain kinds of cancer, the MRI had a detection rate of 92% vs. 56% for traditional mammography.
Pretty stunning, huh? So should MRIs become the standard early detection technology, as some experts suggest?
Dr Carla Boetes and Dr Ritse Mann, from Radboud University Nijmegen Medical Centre in the Netherlands, wrote: "MRI should thus no longer be regarded as an adjunct to mammography but as a distinct method to detect breast cancer in its earliest stage.
"A large multicentre breast-screening trial with MRI in the general population is essential."
Not here in the U.S., most likely, as I heard CNN wafting in the background of my morning routine saying: "The reason is that MRI is expensive -- $1,000 to $1,500 per scan -- and has a high rate of false positives, meaning it detects lesions that are harmless." Actually, the study seems to contravene this claim of an inordinate amout of (costly) false positives:
In addition, despite picking up more high grade cases, MRI did not result in a larger number of false positive diagnoses.
Still, the message from CNN's reporting was clear:
It's literally not worth the extra cost to save women's lives.
Of course, wealthy women will be able to pay for an MRI out of pocket, so the value and cost of each life is wildly and unjustly uneven.
(Btw, it's very interesting to compare the way this story is being reported in different outlets, some downplaying the findings, and highlighting the costs, some reporting it with a sense of true hope for the future, some being more circumspect.)
This had gotten me so angry by this morning that I decided to click around the tubez and see if I could find some data about the costs of breast cancer treatment, and see in the main if MRIs that helped with early detection could prevent not just the suffering of later detection, but also (puke) be cost efficient. I say "puke," because it chafes to even think of such things in business terms.
Well, mostly all I discovered was that the ways of estimating and evaluating costs of early detection vs. later treatment is practically impossible for a lay person like me ...
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The total cost of illness for breast cancer has been estimated at $3.8 billion, of which $1.8 billion represents medical care. Since treatment costs are considerably lower when a tumor is discovered at an early stage, screening programs have economic value ... Source
- The cost of cancer care in the U.S. (and other countries) is skyrocketing: "Cancer prevention may be the best way for these countries to save money as costs continue to rise." Atlas of Cancer (PDF within)
I leave it to experts here to provide the kind of cost-benefit analysis I wish I could provide. Although, frankly, I think that even if it turns out to be much more expensive in the beginnning of moving toward MRI as the standard of early detection, eventually the costs of technology will come down as it becomes more and more deployed, no? Beyond that, f*ck it! ... even if it is more expensive, women's lives are worth it.
For me the crucial point remains that there are other ways of measuring success and prosperity than sheer economic calculations. There are other meaningful economies in this life. Protecting women's lives and the quality of those lives is one of them.
Sisters, if you are part of a high-risk group, demand an MRI instead of a mammogram. Let's fight for our right to the best medical technology for early detection!
Free registration at The Lancet to read the study. And listen to a podcast there, an interview with the lead researcher on the study, Dr. Christine Kuhl.