It was announced this past week that, for women not at high risk, self-examination and mammography before age 50 are ineffective methods for preventing the morbidity and mortality of breast cancer. The news reverberated across the media like a bomb exploding in a temblor fault. The American Cancer Society is contesting this. Is it possible? Can less truly be more? 

Years ago I read that studies had shown that fetal monitoring (electrodes snaked into the uterus to give real-time data on the status of the soon-to-be-born) did not reduce complications or fetal death. Over the years I asked several obstetricians if this was true and they confirmed that, yes, the studies showed this. Then why is it still being done? In essence, because it has become standard of care and should there be a complication and the fetus wasn’t monitored, the doctor would be raked across the legal coals. 

Ignoring scientific data isn’t new in the legal arena. You may recall the brouhaha over silicone breast implants years back and their alleged role in the development of chronic fatigue and immune syndromes. Epidemiologic studies refuted the relationship, but this didn’t stop juries from granting huge monetary awards. Science is sometimes an inconvenience. 

To be fair, clinical studies often contradict one another and scientific fact can sometimes be a moving target. Still, it pays to follow the money when a person or institution makes or decries a claim. It can be very enlightening.


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