Questions that keep me up at night

Recently, the headlines seem full of breast cancer news. “Conflicting Breast Cancer Studies Creating Unsettling Uncertainties”, “Study Sets Off Debate Over Mammograms’ Value”, “Cancer Study Finds Support Groups Do Not Extend Life”, “Marin has highest breast cancer rate in U.S.--20% rise in cases in one year a mystery”

Every time new research results are released, they seem to conflict with what we thought we already knew. How are we to make decisions and act? Should I have gotten a mammogram last year because everything I read told me that early detection was the key to survival? Should I not get one this year because I read that mammograms do not save lives? If I don’t get one and next year am diagnosed with advanced breast cancer, will I be told that, if only I had had a mammogram, I’d have a much better prognosis? Or that maybe if I did not live in Marin County, I might not even have developed breast cancer?

These are not new questions, yet research still hasn’t given us clear answers. Maybe the answers are not clear because the questions are not clear. For example, if breast cancer is not a single disease, but rather a group of very different conditions that only look similar, the question “does mammography prevent deaths from breast cancer?” makes as much sense as the question “does sunscreen prevent all skin redness (including blushing, rashes, rugburns)?”

Maybe the answers are not clear because we are asking the questions in the wrong way or are using the wrong tools to solve these mysteries. These questions keep me and all of us at the California Breast Cancer Research Program up at night.

The reality is that headlines, and even most full articles, summarize research in a simplistic manner, which obscures the uncertainty that lies in any single study’s results. What you think we know is, in fact, not “known” as certainly as it would appear from most of what we read.

BCRP aims, through this newsletter and other publications (such as “Advances in Breast Cancer Research 2002”, – coming soon!), to provide a clearer picture of what our research does, and does not, tell us. And we continue to search for ways to find answers better, faster, and with more certainty.

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Mhel Kavanaugh-Lynch, M.D., M.P.H
CBCRP Director

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