Talk:Breast cancer/Archive 1

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Archive 1

Archive 2

Archive 3

Archive 4

Publicity Query

Does anyone have any idea why this particular cancer is so emphasised in the news?

Presumably because, as well as being a very common cancer, it's a very visible cancer (or at least the surgical treatment - mastectomy - is). 81.156.18.164 23:35, 15 May 2006 (UTC)

One word. Feminists.--68.13.59.58 22:30, 31 July 2006 (UTC)

Sexist comments aside, it's the most common cancer in females. Prostate cancer would also get this much publicity, if men were more comfortable talking about it. Unlike other diseases such as lung cancer etc, breast cancer occurs in anybody (well, almost any female) so there is no one to 'blame' and people see it as 'unfair'. Serrin 00:46, 2 September 2006 (UTC)

rewrite

This article badly needs a rewrite, and some of these "risk factors" seem really dodgy, at least the way they're explained.

They may sound dodgy, but those (early menarche, late menopause, late childbirth, late first child, hormone replacement) are well established factors that increase risk of developing breast cancer. Alex.tan 07:21, 12 Feb 2004 (UTC)

They are just risk factors, they are associated, and they are not necessarily causally associated. They are dodgy if you think of causality in a risk factor, rather than a chain of causation and association. What country you live in, how many 1st degree relatives with breast cancer are strong risk factors, but are likely confounders (themselves associated) witht the unknown, underlying cause. Bcameron54 21:42, 5 January 2006 (UTC)

aa

"Overall, it has been estimated that women have about a 1 in 10 lifetime risk of developing breast cancer."

I do not understand this 1 in 10 lifetime risk. Does it not contradict these stats from http://www.breastcancer.org/cmn_who_indrisk.html

From birth to age 39, 1 woman in 231 will get breast cancer (<0.5% risk).
From ages 40?59, the chance is 1 in 25 (4% risk).
From ages 60?79, the chance is 1 in 15 (nearly 7%).

I am not very good with stats so I won't dare edit.

Well, if you sum up those odds, you get a total of a bit more than 10% for the lifetime risk for a woman aged 79. That isn't too far from 10% given that not all women live to that age. Therefore, there is no contradiction. Alex.tan 17:26, 25 Jan 2004 (UTC)

Nope, I am sorry but you can not add percentages up. In fact you can intuitively see that the odds will never go above 7% on an average. The odds for someone 79 years old are already given: 7%, they won't be more then that. In fact these stats make more sense with risk against age - Hence I EDIT. I add I am not good with stats but the change is more clarifying. ank 06:12, 26 Jan 2004 (UTC)

I think you should go read up your mathematics book again. The same article you quote says - "The chance of getting breast cancer over the course of an entire lifetime, assuming you live to age 90, is one in 8, with an overall lifetime risk of 12.5%." - which means, obviously, that the overall lifetime risk is 12.5%. How much more intuitive can you get than that? Alex.tan 06:54, 4 Apr 2004 (UTC)

Also was surprised by the figure. What Alex.tan is saying is that the conditional probability of having had breast cancer, given a person lives to age 90, is 12.5%. Ankur's data would imply that the conditional probability of getting breast cancer if you live to 79 is a bit over 7% (7%+a little bit extra for the previous categories) and lower if you live to a lower age. Since I think average life expectancy is in the 70s this is consistent with an overall lifetime risk of some 6-8%, roughly. I poked a bit on the web and found a figure of 8% at AAFP. They also say the chance of dying of breast cancer is 3.6%.

I think this means the 1 in 10 figure currently in this article is perhaps a bit high, but not too much. I'll leave any other hunting of data and/or editing to regular contributors to this article. Martinp 20:48, 5 January 2006 (UTC)

does someone want to do a writeup on breast cancer screening, mammography, epidemiology, etc. for this? Alex.tan 07:27 18 Jul 2003 (UTC)

- "More than 99% of cases occur in women, but men can also develop breast cancer (the relative risk of developing breast cancer in a female versus a male is more than 100" - isn't this just saying the same thing twice?

- "Breast cancer can be detected by a woman when washing, by her partner during foreplay" - is this serious? I can't tell. Maybe a rewording is in order.

GGano 23:15, 29 Sep 2003 (UTC)

"More than 99% of cases occur in women, but men can also develop breast cancer (the relative risk of developing breast cancer in a female versus a male is more than 100" - isn't this just saying the same thing twice?

No, not exactly. It would be saying the same thing twice given the assumption that there are exactly equal numbers of males and females and that they both have the same life expectancies. It's a given that this is pretty much what actually happens usually but it's not always the case. --Alex.tan 02:36, 30 Sep 2003 (UTC)

Inflammatory breast cancer

Pete attempted to merge the inflammatory breast cancer article, but ended up pasting its whole content. I reverted; while this info certainly belongs in this article, it should be interwoven with the regular breast cancer information. Staging, for example, is no different. JFW | T@lk 23:58, 13 Apr 2005 (UTC)

Staging systems

The clinical TNM staging system is listed here. But operative treatment, adjuvant therapy and prognosis depend on the pathological tumor staging (pTNM). This differs from the clinical TNM system in the N (node) category. To avoid confusion with the rather complicated definitions of clinical and pathological TNM, I would suggest that only stage groups are listed, like here: http://www.usnews.com/usnews/health/cancer/breast/bcancer.test.stage.htm 00:27, 26 September 2005 (UTC)

No need to keep removing link to the "Keeping Abreast" news blog!

InvictaHOG has repeatedly removed an external link, and I have repeatedly added it back, to Keeping Abreast: Dedicated to providing only the most interesting Breast Cancer News links and sumaries. There is no good reason for removing it. This is a legitimate news blog and is quite helpful. It was very helpful to my wife, and many of the breast cancer patients and survivors she interacts with on her BC forums have commented on its quality and relevance.

InvictaHOG initially removed the link with the comment "First page of blog link has article about the mistletoe cure. I'd rather not have this here." That is not only terribly biased, it is reactionary. Yes, that article appeared as the most current post (top of the page) -- on Christmas Day, which added somewhat of a "cute" flavor to it -- but it linked to a legitimate news story, not to some website that offered weird alternative cures or something. Had InvictaHOG read the article, s/he would have seen that. And had InvictaHOG actually looked through a fair sampling of the other news items on the front page and in the archives, s/he would have seen that that article was not in any way common for this blog.

I am adding the link back now, and InvictaHOG will need to provide a reasoned explanation here to convince me not to do so again.

InvictaHOG, I do appreciate your vast contributions to Wikipedia. That is not somehing I can claim for myself. But I think you are being very unreasonable, reactionary, and biased here. - TaintedAzure —The preceding unsigned comment was added by 134.243.210.226 (talk • contribs) .

There is an ongoing debate about whether or not blogs should be included in the external link section; see Wikipedia_talk:WikiProject_Clinical_medicine. In general, the onus is on the editor to prove that a particular blog is noteworthy. Andrew73 20:03, 30 December 2005 (UTC)

I'm not doing this to be spiteful or mean. There are literally hundreds of breast cancer websites out there that people find helpful or interesting. Keeping Abreast is not particularly well-done or insightful. Yes, I did read through the article and I have seen many other popular press articles this holiday season touting mistletoe cures for many other diseases, none with evidence. I read other, better articles on the site but feel that as a whole it was not compelling. I am a relative inclusionist, but it not reactionary to see that not every blog or website needs or deserves to be linked here. This article would benefit from more attention, but not more links. A hundred more well-intentioned links (I know that your goal is to make the article better!) will not make this article more encyclopedic. I hope that you see my side of this! InvictaHOG 23:56, 30 December 2005 (UTC)

I understand your concerns, InvictaHOG, and I understand the concerns about blogs in the discussion Andre73 pointed to. There certainly are hundreds of sites about Breast Cancer out there, and the article wouldn't benefit from links to all of them. To be honest, I'm waffling on this after reading both of your comments, but I still am leaning toward this blog's inclusion, and here is why:

Breast Cancer patients will turn to Wikipedia for information about Breast Cancer. The article itself is very useful and very well written as a beginning educational resource. However, there are a couple of other types of resources breast cancer patients look for, and they do not know where to find them, or even to look for them. For instance, many breast cancer patients would love to find local support groups where they can get together with other patients and survivors. To my knowledge, there is no online resource that attempts to pull info on such local support groups together. However, patients and survivors also benefit from active online forums -- my wife has benefited beyond description from interacting with her "breast friends" at Healing Well's Breast Cancer forum, for example.

And another type of resource sought after by both patients and survivors alike is news related to the disease. "News," of course, can mean a whole lot of things. Most of the sites that pull together breast cancer "news" articles are either very popular-level (with the effect that they can mislead a seeker), are extremely biased in what they report (with the effect that they exclude some important or relevant information because it doesn't promote their agenda), or overly scholarly (with the effect that they are too difficult or inaccessible to the average patient). Yet someone who is dealing with cancer will want to be able to keep up with the goings on in breast cancer oncology. They'll want to know about research that is being conducted, clinical trials that are available, new medicines and procedures that are or may soon be available, old methods that are being supplanted by new ones, and a broad range of other "news" items. The Keeping Abreast news blog seems to do just that. Better than any I've yet found, it links to articles that touch the typical patient where s/he is. It claims to link to the "most interesting" news items, which appears to mean most interesting to the patient. Not all of the links are medical in nature -- it occasionally reports on "social" issues such as the controversy over whether European governments would provide Herceptin to survivors. The blog does not attempt to report news, just alert those interested to new items available elsewhere in a timely fashion. Nor does the blog appear to link to commercial interests. Basically, I'm saying what I already said -- it seems to meet typical breast cancer patients at the right level and with the right topics. It certainly does not attempt to provide much useful to the clinician or scientist in the field.

Does this sort of think belong in Wikipedia? I believe so. The encyclopedia article portion is not the place to include cutting edge or controversial or societal or "news" issues. Rather, it is a place to provide long-established knowledge about Breast Cancer. But in my mind, Wikipedia as a resource benefits greatly from also providing carefully selected external links to other types or resources (such as news) that are tangential to its purpose. -- TaintedAzure

How about linking to a link directory like http://dmoz.org/Health/Conditions_and_Diseases/Cancer/Breast/ instead? It has lots of links to good websites, support organisations and also personal blogs. --WS 15:22, 3 January 2006 (UTC)

Nice resource, but it isn't a source for news. It serves a different purpose than Keeping Abreast. --TaintedAzure

i did i project on breast cancer. it was fun. i am 3 years old. i love juice :) i love you :) go to peteranswers.com :)

male breast cancer

Does anyone know if the ICD-10 code C50 includes both female and male breast cancers? (unsigned comment, 1/3/2005)

Yes. Per this source, under "Differences in ICD-10 neoplasm codes and/or how they are applied", item #4 is "Breast cancer: (C500 - C509) ICD-10 codes for breast cancer are not gender specific." --Arcadian 14:07, 3 January 2006 (UTC)

Is any body else scared of breast cancer out there.

Most of us are, but this page is for discussing the article.Mikereichold 03:38, 2 March 2006 (UTC)

Treatment section

The current section for Adjuvant treatment seems to be a bit dificult to follow. The section almost reads as if some of the treatments (chemo and hormonal) are mutually exclusive. The second statement almost seems to imply that chemo isn't waranted in cases where lymph nodes weren't positive, however my understanding is that chemo depends on the size of the tumor as well as lymph node status. As I am not a doctor I'd like some input before editing this section. A possible rearrangement might include the following changes:

Rename the section from Adjuvant treatment to Systemic treatments. Reason: Chemotherapy can be given as both neo-adjuvant to shrink a tumor and adjuvant to lower the risk of recurrence.

Add 3 subsections for Hormonal (to discuss tamoxifen or aromatase inhibitors), immune system treatments (Herceptin), and Chemotherapy.

Put a statement at the top of the reorganized section stating that any combination of these can be used in treating breast cancer.

Move the first paragraph "At present, the treatment recommendations after surgery (adjuvant therapy) follow a pattern. This pattern may be adapted as every two years a worldwide conference takes place in St. Gallen, Switzerland to discuss the actual results of worldwide multi-center studies. Depending on clinical criteria (age, type of cancer, size, metastasis) patients are roughly divided to high risk and low risk cases which follow different rules for therapy." to the start of the treatment section since it appears to refer to all types of treatment.

Enterkin 01:34, 21 March 2006 (UTC)

Any suggestions here?Enterkin 23:00, 23 March 2006 (UTC)

Go ahead, be bold. JFW | T@lk 07:51, 24 March 2006 (UTC)

Abortion

Presently, the abortion article (Abortion#Breast_cancer) has a section about breast cancer. That and an entire article Abortion-breast_cancer_hypothesis could use some context from breast cancer Wikipedians as opposed to people simply seeking to promote their abortion POV.

I set up talk space for it Talk:Abortion#Breast_Cancer_bias, but feel free to rewrite away.--Pro-Lick 21:35, 21 March 2006 (UTC)

Update: It's improving very slowly, but still in great need of more cancer experts and fewer anti-abortion campaigners. I'd like to do more, but I can only revert so often. The main problem is that the article overemphasizes a single study that has long been considered inferior to studies done after it.--Pro-Lick 04:13, 25 March 2006 (UTC)

Pro-Lick is transparently a pro-choice POV warrior; and as the mention "revert so often" indicates is more interested in getting their way than helping to write an encyclopedia. - Roy Boy ⁸⁰⁰ 15:54, 27 March 2006 (UTC)

And RoyBoy is transparently an anti-abortion POV warrior. Where does that leave us? Apparently for RoyBoy, it leaves us at name-calling instead of article content verification and WP:RS.--Pro-Lick 16:10, 27 March 2006 (UTC)

That's wrong, but that hasn't stopped you yet. Pity. If you would like sources on that – take the time to do the research yourself – preferably before you comment and/or edit articles of an encyclopedia. - Roy Boy ⁸⁰⁰ 16:42, 27 March 2006 (UTC)

And if I was into name-calling I could have labelled you "Pro-Abortion"; but I'll leave it to you to not assume good faith and skip the "Pro-Life" label and go for the extreme. At least you're consistent on going for extremes. - Roy Boy ⁸⁰⁰ 16:49, 27 March 2006 (UTC)

The linkage between abortion and breast cancer is controversial, and while the evidence does not support the association, it's worth mentioning given that this issue has been raised in the lay press. 141.154.227.12 04:29, 28 March 2006 (UTC)

Good point; this indeed has come up in the press and simply cannot be ignored. - Roy Boy ⁸⁰⁰ 18:13, 28 March 2006 (UTC)

Reliable sources

The Daling interview studies and moreover the Howe cohort, and the positive results within the Melbye study are reliable sources; as they are peer reviewed scientific studies. Daling checked for response bias found none; of course bias could exist and remain in her research. The problem is it has yet to be shown response bias is a statistically significant confounding factor in any ABC interview based study. It is a (as yet) unsubstantiated criticism (I'll point out ahead of time I know it response and selection bias exists, but what I'm questioning is its statistical significance); and hence does not magically make positive results in interview based studies ignorable. - Roy Boy ⁸⁰⁰ 02:09, 28 March 2006 (UTC)

The American Cancer Society published a report called Can Having an Abortion Cause or Contribute to Breast Cancer?. It concluded:

Still, the public is not well-served by false alarms, even when both the exposure and the disease are of great importance and interest to us all. At the present time, the scientific evidence does not support a causal association between induced abortion and breast cancer.--Pro-Lick 15:56, 28 March 2006 (UTC)

I couldn't agree more. We have a great deal in common, the problem is you cannot see the forrest for the trees. In this case; I specifically noted ABC was an unestablished factor. Your cites and sources are spot on excellent; but they in no way make reliable sources which indicate a link disappear. Right? - Roy Boy ⁸⁰⁰ 18:11, 28 March 2006 (UTC)

As on Wiki, they do not disappear. They do make them either 1)irrelevant or 2)deserving of far less, if any, weight. They put those sources in context and provide expert perspective from a wider medical community.--Pro-Lick 18:34, 28 March 2006 (UTC)

"As on Wiki"; you talk as if you know what you are talking about. Clearly you do not. The perspective of the wider community is not being ignored in the least (hence "unestablished"); what is being ignored and suppressed by you is the ABC issue. You aren't putting the sources in context, you are attempting to bury them by removing mention of the ABC issue in its entirety from this article. You have no leg to stand on in this instance; and as mentioned above this issue has been covered to some extent in the press. To not have it here, I now realize, is an oversight. - Roy Boy ⁸⁰⁰ 19:55, 28 March 2006 (UTC)

There is a link under External links that links to a detailed guide that links to the risk factors page that, under the section called Factors With Uncertain, Controversial, or Unproven Effect on Breast Cancer Risk lists ABC along with underwire bras. That seems consistent with the WP:NPOV#Undue weight policy.--Pro-Lick 21:09, 28 March 2006 (UTC)

That is a entirely insufficient mention of the issue; and just so you know I've personally sent e-mails to organizations on the matter of their webpages being out of date and/or mischaracterizing the ABC issue. At least one I know of updated their page eventually (removing mention of Daling, as I mentioned her section was out of date) [1] history; poorly I might add as the "Sedish" was put in; but that cohort study only contains 65 breast cancer cases... but hey 49,000 sounds way more impressive doesn't it?

What I am getting at here is those webpages and sometimes associations have no transparency (the NCI workshop did not release the data/studies/and discussion of their workshop); can be partisan and only a handful of people have editorial control over those pages. They are often out of date and inaccurate; I and Wikipedia aspire for a higher standard. Don't get me wrong, your ACS link is good (that's why they are in External links in ABC article); but a "false alarm" is not mutually exclusive to there being an Abortion correlation. Meaning while it could be maintained anti-abortionist are raising a "false alarm" regarding the ABC issue and risks for the vast majority of women that have normal abortions (prior to 12 weeks); at the same time there could still be a minor link between abortion and breast cancer for a minority of women. Science but especially epidemiology and biology is not an all or nothing proposition. And although orginizations have to take firm stands on issues for political purposes and perceived (and real) threats; the science is not so firm and straight forward. It is that scientific ambiguity that is important for Wikipedia to cover.

I spent weeks looking over the primary research; I became uninterested in hearing what organizations opinions on the matter were. I found time and again research that was being ignored by the media (positive results); had very vague and unsubstantiated objections levelled against them by scientists... whereas studies that showed no link or attempted to validate those objections (eg. response bias) were touted by the media and had few objections raised. Despite some of them having serious flaws in their analysis and conclusions. This subject of course is frought with political interferance; but when you dig deep enough you are forced to realize that cuts both ways. Now you want to come along after doing a few Google searches with websites that essentially regurgitate unsubstantiated memes on the issue. Perhaps you can understand how I may not take kindly to that; and at some point you may have to acknowledge I actually know quite a bit about the ABC issue. I could teach you about it, but most of it is already in the ABC article if you read it carefully; and frankly I'm a firm believer in independant learning... so long as the person actually wants to learn about a subject; rather than reinforce their original position.

I would also like to say I really appreciate you ignored my barb; and took the high ground and argued for your case. And when you did bring up policy; you specified it "seems consistent"; a softened position that did not go unnoticed by me. I am happy you seem to appreciate policy isn't always exactly applicable as you see it. In this instance; despite the latest link(s) you've found; it does not change the reality abortion is an alleged factor with a significant amount of conflicting epidemiological research examining the issue. That simply cannot be ignored or thought "irrelevant" because a partisan website did poor job of researching the issue and/or updating their website. I am very confident a one sentence mention of the ABC issue is not "undue weight". Writing an entire paragraph or section would be, but mentioning the issue is actually required make the article more comprehensive and neutral (since not mentioning it implies "Wikipedia" considers there to be no ABC issue whatsoever... almost like it doesn't exist; but of course it does); being comprehensive and up-to-date is something we always strive for at Wikipedia. - Roy Boy ⁸⁰⁰ 22:37, 28 March 2006 (UTC)

Robustness of study and ABC hypothesis

Hiya Andrew73. Thanks for your edits there, but I don't agree with them.

Firstly, to promote one source as robust is a little POV. I understand it has been present as such by some organizations; but to examine its robustness is an issue that should be handled in the ABC article rather than a one sided mention here. Moreover what you unintentionally did was promote a study over others. Unless it is the most important and highly regarded study (that would be the Melbye (Denmark) study in 1997) we shouldn't be referring to it outside the ABC article. But even then that would require a back and forth analysis that would bloat the ABC mention; and repeat material already in the ABC article.
As to "medical community in general feels abortion link not robust"; I entirely agree... but that is why I described it as "unestablished and controversial" and we could go a step further and expand the name of the article. (that way "hypothesis" would be seen right away by the reader, I see you put hypothesized in the article, that's good too)
"Based on the observation that early full-term pregnancy is associated with a reduced risk of breast cancer"... that implies the ABC hypothesis is an increased risk in relation to having children. The increased risk in scientific studies is almost always relative to women of same parity (child bearing). So that is misleading and likely factually incorrect on how the ABC issue was first hypothesized; and it is certainly incorrect on how it is currently presented.
"subsequently"... subsequently to what? That is confusing.

Also expanding the ABC mention itself in this article; makes it seem more important than it currently is. If we go back to my version, it is a minor side note. Maybe changing unestablished to hypothesized would be best. Is that alright with you? - Roy Boy ⁸⁰⁰ 03:08, 31 March 2006 (UTC)

I've tweaked out the misleading and confusing parts. I'm okay with this version. - Roy Boy ⁸⁰⁰ 05:24, 31 March 2006 (UTC)

Looks better. I guess the specifics in terms of the studies are better amplified in a separate article, rather than in the main breast cancer article. Andrew73 18:12, 31 March 2006 (UTC)

I think we need to add a section like "Breast Cancer Myths" in which we list various causes/links/effects that are known to be false or very weak. Combining ABC in a section with other confirmed causes/links seems misleading and potentially even dangerous if it's taken as a sign that the section can be used to add anything that has had 15 minutes of breast cancer fame.--Pro-Lick 16:50, 6 April 2006 (UTC)

ABC has been around longer than you. I've added a section, unproven. - Roy Boy ⁸⁰⁰ 02:50, 7 April 2006 (UTC)

The reference provided in support of the claim that recent large studies support an association between breast cancer and abortion says exactly the opposite: "Several studies have provided very strong data that induced abortions have no overall effect on the risk of breast cancer. Also, there is no evidence of a direct relationship between breast cancer and spontaneous abortion (miscarriage) in most of the studies that have been published. Scientists invited to participate in a conference on abortion and breast cancer by the National Cancer Institute (February 2003) concluded that there was no relationship. A recent report of 83,000 women with breast cancer found no link to a previous abortion, either spontaneous (stillbirth) or induced." Perhaps the original text was a typo - I've amended it. If not, another source is needed. --203.97.252.91 00:08, 10 March 2007 (UTC)

Indeed, it was simply vandalism that feel through the cracks. Good catch. - Roy Boy ⁸⁰⁰ 00:43, 10 March 2007 (UTC)

Artificial Light a cause?

It has been said on an online forum (via email) that breast cancer is caused by exposure artificial light. True or false?-- 陈鼎翔 ^说!贡献 Chat with Tdxiang on IRC! 10:09, 13 April 2006 (UTC)

It is a speculative theory, the proposed mechanism is that artificial lights confuse the body clock and alter the hormonal balance. Increased artificial light might also be correlated with other behaviors, such as LESS exposure to sunlight. There is also a theory that the potent vitamin D from sunlight is particularly good a preventing cancer. The proponents of this theory argue that while sunlight increases the risk of skin cancer, that increase is far outweighed by all the other cancer mortality it prevents.Technicaltechy 17:53, 18 April 2006 (UTC)

Non-expert blogs...

This section doesn't seem notable enough to belong in this article...it seems to serve as a repository for link spams and attempts at self-promotion of blogs. Andrew73 17:39, 16 April 2006 (UTC)

Agree. Most of the blogged material is regurgitated from other, more professional resources anyway and hence secondary. JFW | T@lk 19:49, 16 April 2006 (UTC)

Everything in Wikipedia is "regurgitated from other, more professional resources anyway and hence secondary." No one is posting original research on Wikipedia. Respectable, responsible blogs and other websites can pull together disparate resources (such as news) in a single location. I believe the usefulness of the article decreases if such resources aren't included as an appendix. -- TaintedAzure

prevention?

The new prevention section for high risk patients, reminded me that some high risk patients even opt for propholactic mastectomy. If someone knows a good reference, it might add to the completeness of the article.--Technicaltechy 20:50, 20 April 2006 (UTC)

unreferenced article and contradictory passage

See WP:V, WP:CITE and WP:RS. Yesterday I putted a "unreferenced" tag which was immediately deleted. So, this is supposed to be a scientific article addressing a wide audience. We certainly need references for statistics and for almost everything. Since I'm sure pretty much of the editors here have a scientific background, this shouldn't be too difficult to provide. And it would make the article something on which we could rely on. If references are not introduced, than just any crack-head can put whatever he want, and we will just have to trust other editors struggles against silly or outlandish claims. I don't trust Wikipedia on sight, so I do think this article is totally unreferenced. Furthermore, without moving the passage here, I find this quite strange:

"Some ethnic groups have a higher risk of developing breast cancer - notably, women of European and African descent have been noted to have a higher rate of breast cancer than women of Asian origin ^[1]. However, these apparent racial differences diminish when geography is altered, as Asian women migrating to the western world, gradually acquire risk approaching that of western women."

I assume that this means that it is wrong than Asian ethnic groups have a higher risk of cancer! So why put it in the first place? Isn't it rather about food diet and such different mores, that are lost when they live in an Western environment? Then we could write this. Sorry for asking for sources, but if you look at political articles or even things like the Chernobyl disaster, you will see how sources are provided. I remind you that if no sources is provided, any editor, including me, has the right under Wikipedia policy to delete it on sight. Why should I believe things on race, alcohol, or percentages that come out of thin air? Unreferenced statistics is just... too much! Lapaz 17:39, 27 April 2006 (UTC)

ps:Please don't take offense, this is totally normal. Again, see WP:RS. Lapaz 17:41, 27 April 2006 (UTC)

Lapaz, if you look at {{unreferenced}}, it is quite clear this template should be either at the bottom of the article or on the talkpage (There is currently no consensus about where to place this template; most suggest either the bottom of the article page (in an empty 'References' section), or on the article's talk page). This is why I removed it.

I totally agree that this article needs sources. Google is your friend. Unreferenced statistics are indeed absolute evil&tm;. I would not disagree with their targeted removal. Alternatively, you can put {{fact}} behind the more outrageous claims, so readers will understand that no source has yet been made available for them. JFW | T@lk 23:19, 27 April 2006 (UTC)

Moved paragraph on race issue

I changed the citation tag to the fact that it was backing up, and therefore put this strange and contradictory passage here, till source provide back-up and explanation (see also comments on section immediately above):

"Some ethnic groups have a higher risk of developing breast cancer - notably, women of European and African descent have been noted to have a higher rate of breast cancer than women of Asian origin. However, these apparent racial differences diminish when geography is altered, as Asian women migrating to the western world, gradually acquire risk approaching that of western women."

This means that it is wrong than Asian ethnic groups have a higher risk of cancer! isn't it rather about food diet and such different mores, that are lost when they live in an Western environment? In any cases, either this is true, and source can be found, either it's whatever, and i don't think whatever goes about race issues. Lapaz 01:45, 28 April 2006 (UTC)

History of breast cancer

I was looking for some history remarks on the diagnosis, treatment, and discoveries for breast cancer. For example, the earliest known cases of breast cancer I know of is from the Etruscans who used votives to ask the gods for mercy on health issues. They formed body parts from terracotta illustrating the health problem, and many breasts, complete with visible tumors, were found in votive pits (I saw these at the Allard Pearson Museum in Amsterdam) Jane 20:22, 10 May 2006 (UTC)

GA nomination

This nomination is on hold for 7 days for these issues: Reference section is ABOVE two article text sections, references are not properly formatted--they need to be in a single (cite php) format, refernces are a mix of external jumps and inline citations--all should be in inline citations, and the citation tags need to be taken care of with proper references. Rlevse 21:29, 9 July 2006 (UTC)...There are also several fact tags.

GA failed due to the only fix done was to move the ref section. Rlevse 23:41, 16 July 2006 (UTC)

External links

There see to be quite a lot. Any that are particularly valuable per the guideline? - brenneman ^{L} 11:54, 17 July 2006 (UTC)

flax

it's not exactly "preclinical"--please note that the research being done in toronto is not "nutritional prevention"--what they are finding is that flax has treatment potential, as it not only shrinks extant tumor tissue but enhances effect of tamoxifen. Cindery 21:11, 21 August 2006 (UTC)

Agree with treatment potential. However, most of the papers though mention its effect in vitro and only one of the papers talks about using it in people and tumor markers. Andrew73 22:15, 21 August 2006 (UTC)

so? the artificial light study is still at preliminary stage but was worth including. (also--i think there have been two more human studies--sweden, maybe? will look it up.) i agree obviously it needs more study, but should definitely be mentioned/not quite exactly "pre-clinical." Cindery 23:15, 21 August 2006 (UTC)

One in 7? 12? (13?)

At the top of the article, it states the incidence as "one out of twelve or thirteen". Under "Age", it states it as "one in seven". In both places, it says that this statistics is for women who live to be 90. I have added a contradiction tag to the "Age" section. --Strait 23:49, 31 August 2006 (UTC)

bad statistic that should not be in wikipedia

This statistic seems like one make to try to confuse and distort the truth. First off percentages are much more common than fractions and easier to understand and why does it only count women that reach 90 in the western world?. I also checked the reference and it does not seem to support this statistic either.

Worldwide, it is the most common form of cancer in females, affecting, at some time in their lives, approximately one out of nine to thirteen women who reach age ninety in the Western world. This statistic is just bad, why not make it 100% of women and men that get breast cancer get breast cancer? --222.152.90.4 22:25, 17 October 2006 (UTC)

Moved from the article

I have moved the following from the section on male breast cancer: Since the psychological effects of this surgery are just as great for males as for females, experimental surgery has been started to introduce the lumpectomy for males. This looks highly doubtful. The psychological relevance of the breasts is very different among the sexes. Unless properly referenced, this should not stay. 91.64.30.198 12:17, 8 November 2006 (UTC)

Vandalism in "Screening" - what was meant originally??

Under 'Screening' I read (emph. mine):

Magnetic resonance imaging (MRI) has been shown to detect cancers that are not visible on mammograms, but it has several disadvantages. For example, although it is 27-36% more sensitive, it is im hot age that is 10 years less than the age at which the relative was diagnosed with breast cancer.

I'm pretty sure that's Vandalism! I've been thinking about what the original text was but I was actually coming to this page to look for info, so I have no idea! Anybody know? Also, who put that in there - Wikibot hasn't spot it?

breast cancer

---BREAST CANCER--- breast cancer is a really bad thing.If you havr breast cancer and you don't go to a doctor you may died or something migth happend to you.the way that you will know if you are in risk of breast cancer if you are around 62 years old,if you are a women(men are still able to get breast cancer), if you are a tall women,and if you are an alcohol person.A way to prebent breast cancer is by not being over weight.this a lot of stuff you can know about breast cancer if what to know more information you can go to yahoo,google,wikipedia,or to ask.com and they will answer all your questions. —The preceding unsigned comment was added by 216.165.217.197 (talk) 21:04, 5 February 2007 (UTC).

This page is an archive of past discussions. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page.

Obesity

Why does it say gaining weight after menopause can increase a woman or man's risk of contracting breast cancer? Surely men don't go through menopause...

checked the study referenced and fixed this Sfmammamia 18:02, 17 April 2007 (UTC)

mentions of men

I don't want to get into an edit war over mentions of breast cancer in men. I removed the phrase "which can occur in both men and women" in the article's first sentence, and it was re-inserted. I have left it there, but changed the order to "women and men". There have been numerous additions to this article over time mentioning breast cancer in men--some of these have clearly been vandalism, others were likely well-meaning, but were removed because they appeared to over-emphasize or over-state the risk and prevalence in men. If anyone disagrees, could we please discuss it here before making wholesale changes? Sfmammamia 23:06, 28 April 2007 (UTC)

I agree that the main focus of the article should be female breast cancer.--Dr.michael.benjamin 06:13, 23 May 2007 (UTC)

Why? Is female breast cancer differant than male breast cancer? Is it necessary to focus primarily on one? What is really being said here? That all information pertaining to females should be included and that informaion about men should only be included sparingly? Does one subtract from the other? I can't help but wonder how this discussion would go if someone were trying to focus on men and was deleting referances to the fact that women can get a certain type of cancer. I think it's ridiculous that this is even being disscussed who cares if it says "men and women" or "women and men"? Is breast cancers womens turf now? If someone vandalises the page then delete it. But otherwise what is the problem with recognizing that both sexes can suffer from this cancer? How will women seeking information about breast cancer sufer more if information about men is included? I can't see how they would unless the concern is that they may have to sift through a few sections or sentances that mention scenarios unique to men suffering with breast cancer. But don't men have just as much a right to be able to find info about breast cancer and how it may affect them? really, what is going on here?--Matt D 16:12, 9 October 2007 (UTC)

Matt D, if you see a problem with the current version of the article and how it deals with breast cancer occurrence in men, please make suggestions here to improve it or a bold edit in the article. My concern is with the article's overall accuracy, lack of bias, and credibility. If the article were to over-state or over-emphasize the risk of breast cancer in men, that could introduce inaccuracy and bias and could jeopardize the entire article's credibility for all readers. -- Sfmammamia 16:52, 9 October 2007 (UTC)

As of Oct 21, 2007, there is absolutely no recognition or reference to the fact that men can also have breast cancer in the article at all. I see this as a major problem because people are often mislead to believe that breast cancer can only happen to women, which is no the case at all. The fact that men can also have breast cancer should at least be mentioned in the beginning of the article without going into the specifics or better yet, have a seperate section about it in the artcle. --Stoppedcode12 07:03, 21 October 2007 (UTC)

Several sections of this article which had grown too large were split out on there own recently, including Epidemiology and etiology. This detailed risk factors including but not limited to sex. While this is not addressed in detail at the moment,[2] it is mentioned in the line "The primary risk factors that have been identified are sex, age, childbearing, hormones, a high-fat diet, alcohol intake, obesity, and environmental factors such as tobacco use and radiation.". Several sections of the article still need rewrites to include the data, while not being as lengthy and detailed as before. Feel free to make edits in Wikipedia mainspace and actually correct this yourself. - Optigan13 07:39, 21 October 2007 (UTC)

Stoppedcode12, did you miss the last sentence of the lead? It does exactly what you said and includes a reference: "Because the breast is composed of identical tissues in males and females, breast cancer also occurs in males, though it is less common." --Sfmammamia 20:42, 21 October 2007 (UTC)

I would like to make a case for expanded consideration of breast cancer in men. It is not my intent to obscure the fact that breast cancer is primarily a women's health issue. In a nutshell, the problem comes from three facts. First, breast cancer is much more common in women. Secondly, breast cancer is still a significant issue in men. Finally, the disease is not distinguishable between men and women such that an interested person can simply add a "Breast Cancer in Men" article. The disease is the same; the gender differences lie in the epidemiology, social context, screening recommendations, etc.

The article is well-written with regards to the issue of breast cancer in men. With this issue, I think there are two important points. First, that breast cancer is much more common in women, and that hormonal influences over the person's life, as opposed to innate anatomic differences between males and females, likely plays the major role in this discrepancy. Secondly, breast cancer in men is still a serious issue. Although I don't object in general to the use of the term "rare" in reference to male breast cancer, especially in comparison to the female incidence, it should be noted that, by NIH criteria, breast cancer in men actually occurs too often to be considered a rare disease.

Although breast cancer is primarily a disease of women, and there are many women-specific issues (screening mammography, advocacy groups, etc.), the disease itself has no gender. This is in contrast to cancer of the cervix, prostate, etc. Breast cancer in men, although very uncommon in comparison to women, is not insignificant. It is certainly not some sort of bizarre medical anomaly, like a case from the TV show House; it is not even a rare disease by the epidemiological definition. —Preceding unsigned comment added by 71.61.185.126 (talk) 18:22, 9 March 2008 (UTC)

Actually, according to the definition of rare disease cited in Wikipedia, breast cancer in men IS rare. Rare is defined here as less than 5 cases per 10,000. ACS statistics indicate that the incidence rate for breast cancer in the U.S. is 1.08 per 100,000 population, or .1 per 10,000, and the ACS calls it a rare disease. Expanding treatment in the overview article, to me, would clearly be a case of undue weight. Perhaps treatment in the article on Epidemiology and etiology of breast cancer could be expanded with global statistics, if any are available. --Sfmammamia (talk) 18:54, 9 March 2008 (UTC)

I just wanted to make a comment about it being a "rare" disease, note that the definition you are using refers to prevalence, as in less than 5 people per 10,000 have the disease, which is different than the incidence, as is how many new people get the disease each year. TKuca (talk) 04:21, 7 August 2008 (UTC)

The article seems very messy to me, it could be more consice, more layman friendly. In relation to male breast cancer the article says "Because the breast is composed of identical tissues in males and females...", breast tissue in males isn't the same as in females post-puberty (at risk of carcinoma). Male breast tissue has ducts but no lobules/acini. Nkosi69 (talk) 01:23, 4 May 2008 (UTC) Nkosi69 02:21 4th May 2008

I would suggest a separate wikipedia article on male breast cancer ala http://www.breastcancer.org/symptoms/male_bc/index.jsp. 24.8.37.91 (talk) 03:57, 3 July 2008 (UTC)

The subject of the article is "Breast Cancer". The point of this website is to convey information. A piece of information regarding the subject "Breast Cancer" is that men get it. The benefit of withholding that information from people researching the subject "Breast Cancer" does not appear to me. When my mother told me she had been diagnosed with breast cancer I came here to discover information about the disease. If my father told me he had been diagnosed with breast cancer I would come here to discover information as well. If in the article titled "Breast Cancer" I found no information pertaining to males I would be dissatisfied. Chances are I would dig deeper and come across this thread of argument. I would be appalled to find what is written above. I would be even more appalled to find that people admittedly actively removed factual information from the article because, in their opinions, that information negatively impacted its flavor. Facts are facts. A commensurate omission would be: failing to mention Washington D.C. in an article titled "The United States of America" because Washington D.C. is only one small feature of the entity "The United States of America" and studies indicate that the percentage of land area it occupies is slight in comparison to other states. A commensurate thread of argument to follow such an omission would be a conversation about how California is more important because it's one of the REAL United States of America. —Preceding unsigned comment added by 24.186.187.251 (talk) 17:33, 10 August 2009 (UTC)

Wikipedia isn't exactly known for objectivity. People are actively trying to keep policy from changing in a way that would prevent them from furthering their own agendas. I find that most people actually mean well but there are the few bad apples that keep any real progress from happening. The people in charge need to take lead and stop hiding behind "community consensus" and make the necessary changes or else somebody will do it for them and wikipedia will fall to the sideline. Biofase ^flame| stalk 03:15, 14 August 2009 (UTC)

I'm not an active editor in this article, but I noted the question about neutrality and so I read through the article. I think it's properly balanced. Men are mentioned in appropriate places, and the language is quite appropriate in making it clear that most of the statistics (and knowledge) address women, in part because so little is know about male breast cancer. So, I disagree with the claim that this article suffers from a non-neutral point of view. For what it's worth, I'm a man, and have substantial professional experience with cancer. --Scray (talk) 12:30, 14 August 2009 (UTC)

Just to make this clear the NPOV tag was added after a threat (non-legal) made here. I have already removed it once as it is clear to me this IP is furthering an anti-abortion agenda and not providing any support for the claim. I do not think the article suffers from any overall neutrality issue atm. Biofase ^flame| stalk 17:12, 14 August 2009 (UTC)

NBR2

I excised this portion from the epidemiology:genetics section. It's too technical for this article.

A recent publication in the Journal of Nucleic Acids Research shows that the ’BRCA1 and ’NBR2’’’ genes are directly connected by a bi-directional promoter. The promoter is found in a CpG island that is constitutively methylated as a means to silence the gene(s). In addition to being methylated, these genes have specific methyl binding domain proteins that they are associated with - namely MBD2. Through Western blots, ChIP analyses, and siRNA knockdowns, it was determined that MBD2 binds specifically to the BRCA1-NBR2 locus. In addition, if MBD2 is removed and unable to bind to the BRCA1-NBR2 promoter, no other methyl binding domain proteins will bind to this locus. There is no "rescue" by other MBD proteins. The high fidelity of binding and the specificity of MBD proteins have important implications in understanding the mechanism of breast cancer, and subsequent treatment approaches.

--Dr.michael.benjamin 06:36, 23 May 2007 (UTC)

Prevention of environmental causes

I cut this section off the main page. It appears to have been written by this breastcancerfund.org, and is POV and unsubstantiated. It should live on the discussion page, if at all, or consider a separate page entirely.

Fewer than 20 percent of breast cancers are genetic. When all known risk factors and characteristics are added together, including family history, genetics, smoking and obesity, more than 50 percent of breast cancer cases remain unexplained.^[2] According to State of the Evidence 2006 - What Is the Connection Between the Environment and Breast Cancer?”, a report which reviews and analyzes nearly 350 journal-published scientific studies on environmental links to breast cancer:

Over 100,000 synthetic chemicals are registered for use today in the United States, with an additional 1,000 new chemicals added each year, yet less than 10 percent of these chemicals have been tested for their effects on human health. Large numbers of these chemicals are found in products we come into contact with every day and compelling scientific evidence points to these chemicals as contributing to the development of breast cancer, either by altering hormone function or gene expression
Many toxic chemicals are now credibly linked to serious chronic diseases including breast cancer. Furthermore, new science demonstrates that even very small amounts of some chemicals can have adverse health effects, particularly in pregnant mothers, infants and small children. (See State of the Evidence)

The Breast Cancer Fund suggests the following environmental prevention methods:

Practice Healthy Purchasing: Don’t bring toxic chemicals home from the store. Choose chlorine-free paper products to reduce dioxin, a carcinogen released when chlorinated products are incinerated. Read food labels, and choose pesticide-free, organic produce and hormone-free meats and dairy products. Replace harmful household cleaners that contain bleach with cheaper, nontoxic alternatives like baking soda, borax soap and vinegar. Look for alternatives to chemical weed and bug killers— many contain toxic chemicals that accumulate in our bodies.

Use Caution with Plastics: Some plastics leach hormone-disrupting chemicals called phthalates into the substances they touch. Polyvinyl chloride (PVC) plastics release carcinogens into our air and water during the production process. PVC plastics are especially dangerous in toys that children put in their mouths, so keep an eye out for nontoxic toys. Further, never put plastic or plastic wrap in the microwave, as this can release phthalates into food and beverages.

Advocate for Clean Air: The soot and fumes released by factories, automobiles, diesel trucks and tobacco products contain chemicals called polycyclic aromatic hydrocarbons (PAHs) that are linked to breast cancer. Indeed, breathing these compounds from secondhand tobacco smoke may increase your risk for breast cancer more than active smoking. Stay away from secondhand smoke, and advocate for stronger clean air protections.

Avoid Unnecessary Radiation: Ionizing radiation is a known cause of breast cancer. Radiation damage to genes is cumulative over a lifetime—thus many low doses may have the same effect as a single high dose. Mammograms, other X-rays and CT scans expose you to radiation. While mammography screening may benefit postmenopausal women, mammography for women in their 30s and 40s remains controversial. Whenever you have an X-ray or scan, request a lead shield to protect the areas of your body not being X-rayed.

Explore Alternatives to Artificial Estrogens: Women who have prolonged exposure to estrogens are at higher risk for breast cancer, and major studies continue to show an increased risk when postmenopausal women use hormone replacement therapy (HRT). Women who use both birth control pills and—later in life—HRT face an even greater risk of breast cancer than those who use neither. Explore your options with healthcare professionals.

Advocate for Safe Cosmetics: Chemicals linked to cancer and birth defects do not belong in cosmetics, period. However, some popular brands of shampoo, deodorant, face cream and other everyday products contain these dangerous chemicals. The Breast Cancer Fund demands safer products and smarter laws by letting cosmetics companies know they need a makeover. The public can join BCF in asking cosmetic companies to sign the Compact for Safe Cosmetics, a pledge to substitute chemicals linked to birth defects, infertility, cancer, brain damage and other serious health consequences with safer alternatives.^[3]

--Dr.michael.benjamin 20:54, 25 May 2007 (UTC)

Molecular Diagnosis of Breast Cancer

I am also removing this section, since it doesn't report any existing information. Like Jimmy says, it may be reportable at some point, just not right now. Wikipedia is not a forum for news per se; it's a repository of knowledge. There are a lot of studies right now describing the genomic differences between cancer and no cancer, but there aren't a lot of products on the market for doctors and patients. We should focus on what's actually out there, rather than what a company says they might do at some point.--Dr.michael.benjamin 05:44, 26 May 2007 (UTC)

OncoDetect (www. oncodetect.com) is an early-stage biopharmaceutical company focused on the development of a diagnostic assay for cancer. Preliminary research has shown the potential to use a combination of markers as a breast cancer diagnostic tool. The company is seeking to develop a molecular diagnostic assay. This assay will identify the presence or likelihood of breast cancer through measurement of markers in blood that are also expressed in malignant tumors to identify individuals at high risk to develop breast cancer. OncoDetect will develop molecular technique based diagnostic assay kits to accurately diagnose the presence and/or likelihood of breast cancer by determining the unique pattern of expression using a variety of gene markers. Research by Dr. Khanna has demonstrated the following results significant to the development of breast cancer diagnostic assays: Application of standard PCR techniques to malignant and non-malignant tissues from 50 human breast tissue pairs has confirmed the statistically significant difference in expression of molecular and protein markers between diseased and non-diseased states. (Results for Mammaglobin B, PPAR-alpha, PPAR-gamma, MMP-9, Skp2, TNF-alpha and TIMP-2.) Correlation of Mammaglobin B in breast tissues and lymphocytes of patients known to have malignant breast cancer (based on 25 tissue/lymphocyte pairs) indicates that mammaglobin B levels can be detected in blood samples, not only tissue samples requiring biopsy. Low concentrations of Mammaglobin B in the lymphocytes can be amplified using 10 to 40 PCR cycles, greatly lowering the detection threshold. Correlation of multiple molecular markers with in tissue and lymphocytes demonstrates the feasibility of a non-invasive blood based molecular diagnostic test for breast cancer

Symptoms

I beefed up the symptoms section and took out the "expand-me" tag. The symptoms section is exhaustive now, but not all that relevant, since probably 90% of breast cancers are diagnosed by mammography at this point, not symptoms.--Dr.michael.benjamin 04:27, 29 May 2007 (UTC)

Linkspam

Please don't post linkspam in the links section. This article should be based on evidence based medicine, not quackery.--Dr.michael.benjamin 04:53, 3 June 2007 (UTC)

TOC and MEDMOS

The Table of Contents of this article is quite large and rambling, with some stubby sections; it may be instructive to review WP:MEDMOS and recent featured articles like Tuberculosis, Influenza, and Tourette syndrome. SandyGeorgia (Talk) 05:04, 27 June 2007 (UTC)

I tried to re-organize the article to be a little less difficult. See my diff for the changes. I tried to follow the both the medical and general manual of style as well as the Prostate cancer article for guidelines. I tagged of the more lengthy sections for splitting. Also for splitting I saw that there is a Breast cancer chemotherapy stub. Would someone please review where I moved the sections to make sure they fall under the corrected subheadings. Also the diet, soy intake, and folic acid intake are all spread across multiple sectiosn which causes some overlap. I didn't change that since I couldn't make up my mind on how to characterize them as either a risk or a preventative factor. I also did some citation and other more minor changes as part of this edit. Optigan13 02:49, 7 October 2007 (UTC)

I've split some major sections out and created a navigation template so they don't get lost. So the article may read disconnected now because large sections are out on their own. I've left the recently revised tag on and left this comment to make sure no one misses these edits. Optigan13 08:00, 13 October 2007 (UTC)

Review

The article is a strange one: it has 87 (!) references in the list, yet many paragraphs and sections don't have them at all. The lead doesn't provide a meaningful summary of the article, it only discusses cancer rates. The article is patchy and difficult to read. It should be focused on the main causes, treatments,etc. All other short subsections should be grouped in ones like "Other causes", "Other treatments". The authors shouldn't attempt to write something about everything and instead try to select the core knowledge about the breast cancer and write a well sourced shorter article. Ruslik 13:22, 29 June 2007 (UTC)

I agree, the reference section is a too large; heck it is large enough to be it's own article. There are several statements that have more than one reference, is this really necessary? I also think that Ruslik's comment about grouping the shorter subsections is a good idea. Markco1 20:31, 12 October 2007 (UTC)

Actually this article is still light on references. The main problem is that it is unevenly referenced. Medical articles need to be heavy with references, or "dense". See the Medical Manual of Style section on citing sources. Medical articles need to be careful especially since people may come to this for personal medical questions, even though they shouldn't. It also provides verifiability and protects against copyright violations. - Optigan13 23:42, 14 October 2007 (UTC)

Diet in secondary prevention

While it is recognised that a healthy diet may prevent breast cancer, this study finds that once cancer has developed, adopting such a diet does not alter prognosis. JFW | T@lk 21:51, 17 July 2007 (UTC)

Technical sections

I addded the technical tag to this article because, a couple of sections in particular are quite dense. Selective Estrogen receptors under prevention is quite bad, and shows that it was pulled from very technical sources, and doesn't give context for a broad audience. Treatment also has several sections that become quite dense. For example, under indications for radiation the lines Patients with <4 LN involved, but extension out of the substance of a LN and Inadequate numbers of axillary LN sampled are quite difficult. Optigan13 02:49, 7 October 2007 (UTC)

Interesting interview

I read an interesting interview with an artist who had a mastectomy in an online magazine. Her way of dealing with this was to not have reconstructive surgery but to have a tattoo where the breast was removed. It is an extremely touching story. lovely magazine I thought about posting this to external links but did not want to do so without the ok from the group. The issue has other breast cancer stories in it as well. Markco1 —Preceding signed but undated comment was added at 22:12, 7 October 2007 (UTC)

I wouldn't include that in external links, instead you should check out that and other articles about the psychological and social impacts of mastectomy, then rewrite the Prognosis section including that as well as other information about breast prosthesis and other responses to Breast cancer. - Optigan13 23:42, 14 October 2007 (UTC)

Leading cause of death

In my area, there's a common belief that breast cancer is the leading illness affecting and/or the leading illness killing women. Some reading I did on the issue indicated that it's heart disease, not breast cancer, that both affects and kills the most women. Is the above-mentioned belief common? Am I right that such a belief would be mistaken? And is this worth noting in the article? — NRen2k5 13:47, 12 October 2007 (UTC)

I added a study that quantifies breast cancer as the most feared disease among women in the U.S. as well as a reference with comparative statistics to other frequent causes of death, indeed heart disease is a much more frequent killer -- I suspect this would be true in other industrialized countries as well but I don't have a source yet for this. Death rates from breast cancer in the U.S. have been declining in the last decade; I suspect this would also be true in other industrialized countries but lack a source for global trend data. I think it would strengthen the lead if such trend data could be added. --Sfmammamia 22:52, 15 October 2007 (UTC)

Does anybody else think that it's confusing to have the lead discussing whether breast cancer is the fifth, third, or second most common cause of cancer death among different population groups? Is it really that important? That discussion belongs further down. I would simply say in the lead that breast cancer is the most common cause of cancer death among women worldwide, that it's increasing, and use the lead to summarize a few other important points from the body. Nbauman 17:55, 16 October 2007 (UTC)

I agree that perhaps some of the details could be simplified in the lead, but I think I disagree that it could be simplified as much as you say. Here's what I see as the problem with that approach: It is true that breast cancer is the leading cause of cancer death among women worldwide. However, both the incidence and death rates from breast cancer are declining in the U.S., not increasing, according to study results published just yesterday [3]. I suspect the same may be true in other industrialized countries. Some of the currently provided detail helps to correct common misperceptions, such as the belief that breast cancer is a greater killer than it actually is. If we generalize too broadly or make the lead too short, I'm concerned we will feed fears and misperceptions rather than correct them. Do you have access to international trend data that could help us refine the current approach? --Sfmammamia 18:49, 16 October 2007 (UTC)

You’re missing the point. That breast cancer is a leading cause of death and a leading disease affecting women are myths, and apparently common ones at that. And this isn’t addressed in the article. I recommend creation an entire “controversy” section to address this and some other issues. One other such issue off the top of my head is “pinkwashing.” — NRen2k5 19:08, 23 October 2007 (UTC)

Myths according to whom? My main concern with your characterization is that it be attributed to reliable sources and not original research. With regard to "pinkwashing" it seems to me more relevant in articles about those accused of its practice, not necessarily here. This article has recently undergone effort to reduce its size, with major subtopics split out, so any new sections should be highly relevant and appropriately condensed. I added mention of pinkwashing months ago to the article on Susan G. Komen for the Cure, where it seems more relevant to me. --Sfmammamia 23:44, 23 October 2007 (UTC)

Myths according to the facts. If reading the data (not collecting it) is original research, then I have to confess, I don't know what isn't. — NRen2k5 12:15, 2 November 2007 (UTC)

What you are suggesting sounds exactly like synthesis of published material serving to advance a position to me. Find a reliable source. --Sfmammamia 17:28, 2 November 2007 (UTC)

More women die of lung cancer than breast cancer in the U.S. According to Harrison's Internal Medicine, there are 40,000 deaths from breast cancer every year, and 80,000 cases of lung cancer among women (Which I think they mean to be interpreted as eventual deaths). It would be difficult to get worldwide statistics, because it's hard to collect accurate statistics in third-world countries. In fact, the most accurate cancer statistics in the U.S. are from a few states in the SEER reporting system, and deaths from non-SEER states aren't as reliable. One of the big problems is that most elderly people have many diseases, such as cancer, lung disease and heart disease. The problem is figuring out which one caused the death. Nbauman 18:46, 2 November 2007 (UTC)

The stat you mention for deaths in the U.S. is already in the article lead, although the cited source, the American Cancer Society, predicts slightly different numbers of deaths for women in 2007 -- roughly 71,000 for lung cancer and 40,500 for breast cancer. The lead also already states that breast cancer is the leading worldwide cause of cancer death among women, using the World Health Organization's statistics, but places the disease as a killer within the wider context by stating that breast cancer causes roughly 1% of all deaths worldwide. The only addition to context that I have been able to find is this one [4], also from WHO, that ranks the top 10 worldwide causes of death by income groups. Breast cancer is ranked 8th, but only for high income countries. This analysis groups men and women together, so I'm uncertain whether adds much to what's already in the lead. So again, my question is, what is missing from what's already stated? --Sfmammamia 19:58, 2 November 2007 (UTC)

That WHO fact sheet No. 297 says that breast cancer is the most frequent cancer among women in order of deaths, but it doesn't give the numbers. Neither does it give the source of that claim, so you can't look it up and drill down, and the lack of a source makes it not reliable. I wonder how accurate it is, and I wonder if it's just a rough estimate. How do you get accurate numbers on breast cancer from China and India?

The 10 leading causes of death document also gives more deaths from lung cancer than breast cancer in high-income and middle-income countries, and doesn't list lung or breast cancer at all for the low-income countries. So how do they get breast cancer as a more frequent death than lung cancer among women? Nbauman 05:02, 3 November 2007 (UTC)

The feminist POV slant here is astounding. I don’t even know where to start editing. On the other hand, I wouldn’t trust them not to try to drag my name through the mud once I get started. — NRen2k5, 20:03, 11 February 2008 (UTC)

Current article status and splits

Optigan13 has done some very good work bringing this article down to a manageable length. I'm starting a discussion session to encourage further comment on the article's current state. My own comments: Regarding further splits, I don't think it's necessary to split the Classification section, as it's fairly short. Ditto the Staging section -- this is pretty basic information for a cancer article and is pretty compact. I think the Screening section, now that the split has been done, could benefit from further summarizing and condensing in this overview article. Other comments? -- Sfmammamia 18:20, 13 October 2007 (UTC)

Most of the splits were either going from size or what sub-pages Prostate cancer has. After the split it is noticeable how many sections need a full rewrite, because they are both unreferenced and very technical. The page still needs some restructuring to make it more manageable, so take a look at the medical manual of style for that. I haven't been able to properly rephrase treatment so it is still a duplicate of the subpage, so that and its subpage should be first up. Also with respect to the words sex vs gender, the article should use sex since their is a technical difference between the two. I understand what you were trying to accomplish by changing it, but I think we should just stick to reverting, and possibly having the sites blacklisted if the same articles are added. Also some of the language this article uses will inevitably attracts vandals, but it is still more important to be direct then to tiptoe around. - Optigan13 23:42, 14 October 2007 (UTC)

I think there should be more detail in the staging section. People are interested in learning more about the staging, and it has a place in a reference piece.--Dr.michael.benjamin 16:05, 22 October 2007 (UTC)

Accuracy - diet and prevention

The National Breast Cancer Coalition seems to think the idea that eating fruits and vegetables will prevent breast cancer is a popular myth not supported by scientific evidence.[5] The sources in the Folate section are not strong; they are journal articles describing individual studies, which are not necessarily a good indication of whether or not there is scientific consensus to support the results of the studies. Can anyone reconcile these competing claims? -- Beland 02:13, 28 October 2007 (UTC)

Hi Beland- I think you're correct that the evidence is clearly very mixed and contradictory with regard to whether or not folic acid reduces breast cancer in general. There does appear to be, however, good evidence that folic acid can reduce the effects of alcohol on raising the risk of this type of cancer.

The National Breast Cancer Coalition may have been referring to breast cancer in general rather than that associated with drinking. In addition, it was apparently referring to folates from fruits and vegetables in the diet rather than from supplements. I don't think any responsible organization or researcher would ever claim that folates or anything else in a diet can prevent breast cancer, but only reduce the risk. So the Coalition's position is not necessarily inconsistent with the fact that folate can reduce the risk of breast cancer associated with drinking, especially if taken as a supplement.

The following studies have found folate to reduce or eliminate the effects of alcohol on breast cancer:

Ulrika Ericson, Emily Sonestedt, Bo Gullberg, Håkan Olsson and Elisabet Wirfält. High folate intake is associated with lower breast cancer incidence in postmenopausal women in the Malmö Diet and Cancer cohort. American Journal of Clinical Nutrition, Vol. 86, No. 2, 434-443, August 2007

A Tjønneland1, J Christensen1, A Olsen1, C Stripp1, S B Nissen1, K Overvad2and B L Thomsen. Folate intake, alcohol and risk of breast cancer among postmenopausal women in Denmark. European Journal of Clinical Nutrition (2006) 60, 280–286.

Laura Baglietto, Dallas R English, Dorota M Gertig, John L Hopper, Graham G Giles. Does dietary folate intake modify effect of alcohol consumption on breast cancer risk? Prospective cohort study. British Medical Journal, 2005;331:807.

Sellers TA, Grabrick DM, Vierkant RA, Harnack L, Olson JE, Vachon CM, et al. Does folate intake decrease risk of postmenopausal breast cancer among women with a family history? Cancer Causes Control 2004;15: 113-20.

Shrubsole MJ, Jin F, Dai Q, Shu XO, Potter JD, Hebert JR, et al. Dietary folate intake and breast cancer risk: results from the Shanghai breast cancer study. Cancer Res 2001;61: 7136-41.

Sellers TA, Kushi LH, Cerhan JR, Vierkant RA, Gapstur SM, Vachon CM, et al. Dietary folate intake, alcohol, and risk of breast cancer in a prospective study of postmenopausal women. Epidemiology 2001;12: 420-8.

Negri E, La Vecchia C, Franceschi S. Re: dietary folate consumption and breast cancer risk. J Natl Cancer Inst 2000;92: 1270-1.

Rohan TE, Jain MG, Howe GR, Miller AB. Dietary folate consumption and breast cancer risk. J Natl Cancer Inst 2000;92: 266-9.

Zhang S, Hunter DJ, Hankinson SE, Giovannucci EL, Rosner BA, Colditz GA, et al. A prospective study of folate intake and the risk of breast cancer. JAMA 1999;281: 1632-7.

Ronco A, De Stefani E, Boffetta P, Deneo-Pellegrini H, Mendilaharsu M, Leborgne F. Vegetables, fruits, and related nutrients and risk of breast cancer: a case-control study in Uruguay. Nutr Cancer 1999;35: 111-9.

Freudenheim JL, Marshall JR, Vena JE, Laughlin R, Brasure JR, Swanson MK, et al. Premenopausal breast cancer risk and intake of vegetables, fruits, and related nutrients. J Natl Cancer Inst 1996;88: 340-8.

Graham S, Hellmann R, Marshall J, Freudenheim J, Vena J, Swanson M, et al. Nutritional epidemiology of postmenopausal breast cancer in western New York. Am J Epidemiol 1991;134: 552-66.

However, this study did not:

R. Stolzenberg-Solomon, S. Chang, M. Leitzmann, et al. Folate intake, alcohol use, and postmenopausal breast cancer risk in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Am J Clin Nutr; 83:895-904 (April, 2006)

David Justin 00:29, 29 October 2007 (UTC)

A quick note concerning folate & cancer risk - it has been suggested by studies examining the relationship between folate supplement consumption and colon cancer that perhaps folate only reduces the risk up to a certain level of folate use; since we now supplement so many foods with folate, as long as you're not overwhelming your system with alcohol, additional folate might not make a difference. I'm off to look for the citations both from the colon cancer study, and for any I find on breast cancer. I'll post them here when I find them.~~Ruth Feb 12 2008

Merge: Racism in diagnosis and treatment section

I think this would fit better in the Epidemiology and etiology of Breast cancer article, but could we at least keep one sentence in this main article? futurebird 19:35, 28 October 2007 (UTC)

It does deserve a mention in the article in both ~~risk factors in treatment~~ epidemiological risk factors and in treatment, since race does play a factor in treatment in a addition to being a risk factor. So yeah please refactor the section to go into the sub-articles, and to get a mention in the main one (this article). The other problem is that it isn't only race, but also culture, socio-economic status, and a myriad of other factors that create health disparities. Check out the National Cancer Institute's articles on women of color. That one has several studies across multiple populations cited. The other problem is that this is still focusing on an American audience. So we need some way to expand on race as a factor, while still keeping it global. - Optigan13 21:32, 28 October 2007 (UTC)

The section isn't about "risk factors" it's about racism in the way people are screened and diagnosed. Take a look at Race and health, there may be some info there on race being a risk factor... although that article is also US focused. futurebird 21:39, 28 October 2007 (UTC)

Sorry, I meant to say it deserves a mention in both risk factors and in treatment. When I say risk factors, I'm talking about epidemiological risk factors, and referring to the epidemiology and etiology section. The race and health article does covers this in general. But that article also mentions what I'm talking about in that direct racism isn't the only factor affecting treatment. The section right now just mentions direct racism towards African-American women in treatment. It needs to include how the other factors mentioned in the race and health articles 3rd line that begins with Many explanations for such differences affect risk (epidemiology), screening, and treatment. I'm favoring a line in those three sections and a section in each one's article. Saying that direct racism is the only factor is too narrow a focus. It also doesn't give examples of how race affects treatment (such as higher rates of full mastectomy). It doesn't mention any other women of color. I'm not arguing against including race in treatment, it just needs to be part of a broader look at race and how it relates to breast cancer. - Optigan13 22:52, 28 October 2007 (UTC)

I think the section is relevant to a general article on breast cancer. I also thought the section was very poorly worded and documented, so I fixed a few things and added some references. There was a lot of POV, and I corrected that. The disparity issue is either related to cultural or biological factors, or both. There is active research (i.e., over 200 PubMed citations) on both of these factors.--Dr.michael.benjamin 06:43, 29 October 2007 (UTC)

I am continuing to remove the POV quote in the section by the scholar in Wisconsin, as I think it's too inflammatory, and not really supported by the substantial literature suggesting that there is a possible biological reason why breast cancer disproportionately affects the African American community, not just racism.--Dr.michael.benjamin 01:05, 30 October 2007 (UTC)

I agree with you about the quote, but in the process of getting rid of it, you removed other changes that had made the section clearer and more neutral. I'm restoring those changes. --Sfmammamia 01:26, 30 October 2007 (UTC)

The issue of racism is raised in a number of papers published in peer reviewed journals. Of course, it is still an open question, but there's nothing inflammatory about discussing exactly what is meant by "racism," as the quote does.

There are good data supporting the concept that inherent or genetic differences are not the reasons that blacks have higher breast cancer mortality rates than whites. The most obvious evidence is the fact that there was no disparity in mortality between blacks and whites in the United States before 1980. It is distressing that Bradley and colleagues (2) found that, after adjusting for age, socioeconomic status, and insurance coverage, black women diagnosed with breast cancer were less likely to receive surgical removal of their tumors than white women.... It is a sad statement that race influences one's chances of obtaining adequate medical care. In the United States, it is bad to have cancer; it is worse to be poor and have cancer; and it is even worse to be poor, black, and have cancer....Results of several breast cancer clinical trials demonstrate that equal treatment yields equal outcomes among equal patients (14–16). Other institution-specific treatment series demonstrate that outcomes are similar among the races when there is equal treatment (17–19). These findings, taken together with the fact that the racial disparity in mortality began in 1981, are consistent with the hypothesis that as we have learned how to treat breast cancer, a larger proportion of one segment of the population (the middle and upper class, which is primarily white) is receiving better (or more effective) treatment than are other segments of the population. Disaggregating the Effects of Race and Poverty on Breast Cancer Outcomes by Otis W. Brawley. ( JNCI Journal of the National Cancer Institute 2002 94(7):471-473; doi:10.1093/jnci/94.7.471 )

Others:

I don't disagree with Dr. Brawley; while I was at Emory he and I wrote a paper about the racial disparity issue in multiple myeloma, which I reference in the breast cancer disparity section. I think the problem has a largely social explanation, but there are researchers who, even now, are trying to discover a biological explanation for the disparity issue. The fact that it is being studied at all is worthy of mention. I think the Brawley citation should be included as a standard reference.--Dr.michael.benjamin 04:34, 30 October 2007 (UTC)

JCI

Targeted review on the origins and evolution of breast cancer: doi:10.1172/JCI33295 JFW | T@lk 00:29, 4 November 2007 (UTC)

Breast Cancer in men

Can I ask why the segment about breast cancer in men was deleted, it should remain in the article because it is a fact. --88.108.100.139 (talk) 02:12, 19 December 2007 (UTC)

As I explained in the edit summary, the addition was completely uncited. Also, this degree of detail needs to be added to the main article, Epidemiology and etiology of Breast cancer, not here. We need to keep this article a summary level, because it is already too long. This article already mentions men further down in the lead and in a couple other places. There's no consensus for increasing the emphasis. --Sfmammamia (talk) 02:42, 19 December 2007 (UTC)

death numbers

it is known by all with some form of intelligence that prostate cancer kills more men a year than breast cancer kills women..so why does the page state that it is the fifth most common cause of cancer death .. breast cancer is not exclusive to women so we simply cant make this page exclusive no matter what the statistics. —Preceding unsigned comment added by PotentiallyMensa (talk • contribs) 16:06, 27 December 2007 (UTC)

According to the cited source, the World Health Organization, breast cancer ranks fifth globally in total cancer deaths, inclusive of both men and women. Do you have a reliable source that states otherwise? --Sfmammamia (talk) 17:33, 27 December 2007 (UTC)

Ultrasound, gamma imaging

Breast ultrasound and gamma imaging aren't screening techniques, they're used for surgical guidance. They've been marked as not having sources since October 2007. Isn't it time to delete them (unless someone can supply sources)? And Miraluma has even weaker justification. Nbauman (talk) 15:32, 10 January 2008 (UTC)

Nbauman, here is a grand idea: search Medline for sources and improve the article yourself. Emmanuelm (talk) 15:56, 10 January 2008 (UTC)

Emmanuelm, (1) Wikipedia doesn't work that way. The person who added the sections on ultrasound and gamma imaging should have provided a WP:RS when they first added it.

(2) I don't have to search Medline. I have a bookshelf of oncology books and I read the medical journals, so I already know what Medline will say.

The American Cancer Society's textbook Clinical Oncology, for example, says that ultrasound is used after a mammogram to tell whether lesions are solid tumors or cysts. US is not a screening test.

Unless anyone has a good reason to the contrary, that section should be removed, because it's inaccurate, misleading, confusing, and unsourced. The best way to improve the article is to remove it. Nbauman (talk) 06:47, 11 January 2008 (UTC)

Nbauman, one of the five pillars of Wikipedia is to be bold!. You seem far more educated than the average editor. Go ahead, edit the article. Emmanuelm (talk) 14:39, 11 January 2008 (UTC)

Psychological aspects

I think this section should be pruned. Some of it isn’t relevant or specific to breast cancer. — NRen2k5, 20:22, 11 February 2008 (UTC)

Copyright problems with Image:BCtimeline.jpg (Sources for new pic please)

Image:BCtimeline.jpg, has been listed at Wikipedia:Copyright problems because it is a suspected copyright violation. The source listed is http://carcin.oxfordjournals.org/, but no specific journal is listed. I tagged it as possibly needing to be converted to an SVG, which is why someone noticed the licensing issue. In order to create a new image without it being a pure reproduction of that image. Can anyone provide similar images or references so if someone creates a new image that isn't derivative of that specific work alone. I've done a quick try on google, but haven't done an exhaustive search myself.

Also, reliable overview references for some sections of this article would probably help for citations and to trim more language back out into the sub-topic articles. I had initially planned to do a proper lit review for overview sources to help reduce the screening article into something of an abstract of the sub-article, and also to better source the treatment section and its article, but I've yet to follow through with that. I think the longer these two spend without the short sections here the higher the chance of differing data/information. -Optigan13 (talk) 18:42, 28 February 2008 (UTC)

Bras and Breast Cancer

I posted this comment on the Talk:Epidemiology and etiology of breast cancer page a couple of days ago, but no one responded. So, I thought I'd try this page.

One very plausible theory that explains the world-wide epidemiology of breast cancer has to do with the use of bras. Please see this link as well as the long discussion on the brassiere talk page. I know this is controversial but I think it deserves to be mentioned in the article. --Jonathan108 (talk) 01:41, 18 March 2008 (UTC)

I've responded at Talk:Epidemiology and etiology of breast cancer. -Optigan13 (talk) 00:42, 21 March 2008 (UTC)

"Alternative" treatment.

Assuming that that this breast cancer page is of particular interest to women with breast cancer, it seems to me that this is not the place to have a section on what is basically quackery. Women with breast cancer have enough to deal with already and the last thing they need is to have to contend with this sort of false and misleading rubbish. I propose removing this section on Alternative Treatment, perhaps leaving flax seed in a newly titled section Experimental or New Treatment Undergoing Assessment.--Kenneth Cooke (talk) 12:38, 15 May 2008 (UTC)

I have concerns about WP:WEIGHT on the 'alternative' treatments as well. I don't think that mention of them should be eliminated completely from this article, however. Many of the treatments mentioned have some historical significance (they may have represented the state of the art in the patent medicine era) to the treatment of breast and other cancers, others deserve mention simply because they are significant quackery (the craven, the gullible, and the true believers continue to prey on the desperate and the helpless to this day).

Since a large number of these alternative treatments (are claimed to) 'treat' many or all cancers, it strikes me as sensible to move the bulk of discussion about these treatments to a central article (perhaps Unproven cancer therapy) and leave only a summary here. Something similar is already done for the real cancer therapies, which have their own article at breast cancer treatment. Incidentally, I've just noticed that that article needs a bit of work and quackectomy as well. TenOfAllTrades(talk) 13:53, 15 May 2008 (UTC)

I wondered when you two would recommend this. Yes, this section has too much weight due to Kenneth's pedantic insistence on trying to debunk each and every one ad nauseum, even when the information he cited wasn't directly relevant to breast cancer. This section wasn't supposed to become a point of view area, but rather a summation of alternative treatments that are available, are specifically relevant to breast cancer patients, and are currently being used by many breast cancer patients, either as alternative or complementary therapies. From my own recent experience, I know that many breast cancer patients would like to know this information, even if they automatically reject it as a matter of principle. Any responsible alternative practitioner will advise finding a medical professional to monitor and give advice, even if choosing to pursue this route. While these methods may rely on largely testimonial evidence (given the lack of research support for anything not patentable by a major drug company), there is a large amount of this for certain of them. Cancell stands as an example of something that should have been researched, with efficacy easily eclipsing most chemotherapy agents in the NCI's own trials (look into this if you don't believe me - get the results). The Budwig Diet should also have been investigated years ago, if only for it's ability to substantially reduce breast tumours - it remains "alternative" even while many medical professionals are aware that it works. Yes, there is quackery as well, but these are two examples of methods produced by qualified scientists. I think the more information about choices available the better. The 2-3% survival rate for established chemotherapy is hardly inspiring.Aristillus (talk) 00:25, 16 May 2008 (UTC)

You've mentioned suppression (by the NCI) of positive results for Cancell before, Aristillus. I asked on Talk:Cancell for references to those studies; as far as I know, those references still haven't been provided. The NCI's own reports indicate that while the Cancell formula may kill cancer cells at high doses, those doses would be too toxic for human consumption. Similarly, you assert that the Budwig diet has the "ability to substantially reduce breast tumours" while in the same sentence you seem to indicate that it hasn't been the subject of investigation. Which is it?

I'm afraid that you may have some misunderstanding of what it means to be a "qualified scientist". Holding a PhD, an MD, or both doesn't protect a person from pride, hubris, and wishful thinking. A concept that looks good on the blackboard can fail in the test tube, or in an animal test, or fall down on human trials. A convincing story is damn near useless in medical research without having evidence to back it up. In the words of Thomas Huxley, it is "The great tragedy of Science — the slaying of a beautiful hypothesis by an ugly fact."

Meanwhile, I'm not sure where you're getting your 2-3% survival rate. Even left totally untreated, the five-year survival rate for breast cancer runs about 18% (based on 19th and early 20th century data where a significant proportion of cancers actually were left untreated: [6]). Recent studies of high-risk non-metastatic breast tumours (with or without lymph node involvement) treated with surgery and chemotherapy put the five-year disease-free survival rate at better than 80% and the five-year survival rate at about 90%: [7].

To the question of 'relevance' – either of particular treatments or discussions on their efficacy – I note that none of the alternative treatments listed appears to claim to be exclusively for the treatment of breast cancer; it strikes me as an unnecessary duplication of effort to discuss all of them in every article on every cancer when we have a perfectly good article on unproven cancer therapy that can house them all. TenOfAllTrades(talk) 01:31, 16 May 2008 (UTC)

Cancell is definitely not toxic at high doses, as thousands of users would attest (there are plenty of books and websites dedicated to personal accounts, as it is illegal for the manufacturers or sellers to mention any possible efficacy with cancer - a good example is Pamela Hoeppner's The Breast Stays Put and one Protocel formula is specifically recommended for breast cancer). The point of alternative treatments is that there is no limitation on repeat or continued usage, as with radiation and chemo. You make a good point that a similar section is relevant to many cancers. Entelev (Protocel/Cancell) wasn't tested according to Sheridan's guidelines (longer term, oral not injected) but the results - as opposed to the report - are still diverting. You'd need to request them from the NCI yourself. The manipulation of breast cancer statistics is a subject of some debate, with increased five year (only) survival rates increased due to the inclusion of more efficiently detected early DCIS - technically a precancer. The 2-3% refers to chemotherapy only. This is very relevant if you have breast cancer, given the downside of chemo. There are official obstacles to the testing of "alternative" remedies, so double-blind studies on most of these aren't possible, even if research funds were available (these are dedicated to the pursuit of patentable drugs and the promotion of "early detection"). It's also illegal for professional physicians to mention them. It would be good to know the real truth about certain non-toxic alternative treatments, but it can't happen as the official channels for this don't exist (a kind of "Catch-22"). Unfortunately, anything not tested by a drug company is automatically "alternative" putting it in a bracket with real quackery (which also exists). This doesn't alter the fact that it is both objective and informative to post a summary of alternative treatments that have been, or are being used, by patients with breast cancer.Aristillus (talk) 02:21, 16 May 2008 (UTC)

I'm afraid that you're continuing to misunderstand or misrepresent the statistics. The study that I cited (with 90% five-year survival) looked at patients with node-positive and high-risk node-negative malignancies. Ductal carcinomas in situ were excluded from the recruitment criteria: [8]. (Am I wasting my time supplying sources for you here?) I have doubts about your 2-3% survival figure for chemo alone – even when DCIS and other nonaggressive lesions are excluded – but it's a moot point. Chemotherapy is rarely used as the sole treatment modality—most often it is used to (markedly) enhance the benefit of surgical resection and/or radiotherapy.

Reports from the NCI are generally works of the federal government and not subject to copyright. If the NCI is suppressing information in their web-based reports, then scan the damning documents and put them up, or point me to a link where someone's already done it. If you're not prepared to support your arguments with sources, then please don't waste my time. TenOfAllTrades(talk) 03:38, 16 May 2008 (UTC)

The study you just linked to is a classic example. The original taxol was discovered in its natural form in 1967, but the Paclitaxel is a patentable synthetic (ie: expensive) version, developed by a pharmaceutical company. That text itself was comparing survival rates of Paclitaxel administered every week, rather than every three weeks. And it only took them 40 years to get to doing this. I am reading your links for what its worth.

Results As compared with patients receiving standard therapy (paclitaxel every 3 weeks), the odds ratio for disease-free survival was 1.27 among those receiving weekly paclitaxel (P=0.006), 1.23 among those receiving docetaxel every 3 weeks (P=0.02), and 1.09 among those receiving weekly docetaxel (P=0.29) (with an odds ratio >1 favoring the groups receiving experimental therapy). As compared with standard therapy, weekly paclitaxel was also associated with improved survival (odds ratio, 1.32; P=0.01). An exploratory analysis of a subgroup of patients whose tumors expressed no human epidermal growth factor receptor type 2 protein found similar improvements in disease-free and overall survival with weekly paclitaxel treatment, regardless of hormone-receptor expression. Grade 2, 3, or 4 neuropathy was more frequent with weekly paclitaxel than with paclitaxel every 3 weeks (27% vs. 20%). Conclusions Weekly paclitaxel after standard adjuvant chemotherapy with doxorubicin and cyclophosphamide improves disease-free and overall survival in women with breast cancer."

I'm hardly going to take your advice on Copyright (an area I know plenty about), but nice try. If they're in the public domain, why aren't they up anywhere?Aristillus (talk) 03:56, 16 May 2008 (UTC)

Perhaps you are unfamiliar with the provisions of United States copyright law, under which works produced by the United States Government are automatically part of the public domain and not protected by any copyright. You keep telling me that there are suppressed studies. Have you actually read any of them? Got one on your shelf? I'm not going to go on a wild goose chase on your say-so.

The study I linked to above was just the first study I hit with a Google search on "breast cancer chemotherapy five-year survival". The point was to show that chemotherapy forms a key part of modern cancer treatment and generally leads to much higher survival rates than your 2-3% figure.

We're getting way off topic here, though. I'm not here to argue with you about your personal and deeply-held convictions. We're supposed to be discussing ways to improve this Wikipedia article. TenOfAllTrades(talk) 14:37, 16 May 2008 (UTC)

I actually don't have any personal or deeply-held convictions about alternative breast cancer treatments, beyond thinking natural progesterone (non-patentable) supplementation is a good idea and synthetic progestins appear to present an increased risk - I notice this information has also been removed.

It's evident that there is a group of Wikipedians dedicated to making sure that "Alternative treatments" are not included in this (and other) entries - even as a summary, with no claims as to efficacy, just that such alternatives exist (which was my point). At present, no facility exists for testing any of these treatments scientifically and resistance from the pharmaceutical industry and medical community is a given (just good business for the former, and a legal requisite for physicians). Whether effective or not - and certainly in the cases of Cancell and the Budwig Diet, there are reasons to suspect that they may have some efficacy - these treatments must ultimately disappear untested, which is not a good thing. The problem is that "alternative" is a catchall for anything not properly tested, and research funds are currently dedicated to expensive pharmaceutical developments only. Why the NCI chose to dismiss further testing of Cancell is mysterious, and it seems likely that the average reader would find their report misleading (as opposed the actual 48 hour results, which were excellent). I'm generally a natural skeptic, but looking into this really made me wonder about our existing systems (not about double-blind testing, rather the mechanisms of FDA approval). I do think current medical regimes (beyond surgery) aren't for everyone and I thought this summary was useful - it's a pity it can't at least be included here.

On the other point, breast cancer statistics have "improved" largely due to earlier diagnosis, with five year survival rates hence beginning at an earlier point. That five year survival rate is a whole other issue in itself. One revelation is that conventional medics will advise their patients to resist "alternatives" even when the prognosis is the worst it could be, conventional therapy has failed and remaining quality of life can only be made more difficult. I hope you don't personally ever have to think about these issues, and I'd be interested to know what you'd decide.

No point flogging a dead horse - have it your way.Aristillus (talk) 01:56, 20 May 2008 (UTC)

You're confused on a couple of points. Lead-time bias due to earlier diagnosis is a well-known phenomenon; survival in metastatic breast cancer has improved even when it's taken into account. See, as a starting point, PMID 16149088, PMID 17647245, PMID 14692023. It's also become much easier to get funding to study "alternative" treatments since the establishment of the NCCAM; additionally, many "alternative" treatments generate substantial revenues; the producers of such remedies could reinvest some of that into studies of safety and efficacy, as the evil pharmaceutical firms do, but they generally choose to pocket the change instead. I don't think there's anything mysterious or sinister about the NCI deciding to abandon a treatment which was found too toxic for practical human use - it happens all the time. I think your generalization about "conventional medics" relies on a number of incorrect assumptions. As to Wikipedia, it is based on verifiable information from reliable sources. Given such sources, alternative treatments can and should be described. However, if the level of sourcing is "zOMG the NCI doesn't want you to know about Cancell!", then it's probably not appropriate for Wikipedia. MastCell ^Talk 18:35, 20 May 2008 (UTC)

Classification - Pathological types.

The Subsection "Pathological types" of the "Classification section is too long, inappropriate and misleading. It is not in fact a list of pathological types of breast cancer; rather it is a list of breast tumours. Tumour means any sort of lump and this term includes breast cancers (malignant breast tumours), or non cancerous lumps (benign breast tumours such as fibroadenomas). This list also includes benign and malignant tumours or cancers which are not particularly unique to the breast and which are more likely to occur elsewhere in the body such as most sarcomas, leimyomas( more often found in stomach or intestine), neurofibromas(usually in skin or spine) and lipomas(found almost anywhere). I suggest it be replaced by a list including only cancers (malignant tumours) which are either unique to the breast or more commonly found in the breast than elsewhere. I suggest a short list such as at Cancer Reasearch UK or at US National Cancer Institute.--Kenneth Cooke (talk) 11:51, 20 May 2008 (UTC)

DVS: Dose verification system

User:Smg2008 has done nothing but create an article DVS: Dose verification system, about a proprietary system by Sicel Technologies. See Special:Contributions/Smg2008.

Shortly after, Special:Contributions/96.234.60.75 linked to DVS: Dose verification system from Breast cancer and prostate cancer.

DVS: Dose verification system doesn't cite a single published study, or even a meeting report; it merely links to the company's web site, which gives preliminary data from a non-published study which doesn't even identify a single investigator. The rest of the entry is padded with generic bullshit about breast and prostate cancer.

I would bet money that DVS: Dose verification system was created by someone with the company (the tipoff is the ® sign; company lawyers require companies with registered products to use the registration mark every time they mention the name).

DVS is a clever device, but it has no clinical use right now. It certainly doesn't belong in a general article about breast cancer for the non-specialist. I wonder why DVS: Dose verification system belongs in Wikipedia at all. I don't think it meets WP:NOTABLE, unless every clever gadget is notable.

I don't want to piss on somebody else's parade, but I am annoyed at the covert way they created an article in apparent violation of WP:COI and several other WP good-faith rules. We've had enough of that lately.

My first inclination is that DVS: Dose verification system is about a non-notable product, created by the company itself, and should be deleted, along with the references to it in Breast cancer and Prostate cancer. How do other people feel about it? Nbauman (talk) 00:09, 5 June 2008 (UTC)

Absolutely agree. --Sfmammamia (talk) 00:22, 5 June 2008 (UTC)

I agree emphatically. I've removed what amounts to ad copy from the prostate cancer and breast cancer articles, and I've {prod}ed the article on the DVS device itself. At best, it's a tool (or part of a class of tools) that ought to be mentioned in our article on dosimetry. TenOfAllTrades(talk) 01:12, 5 June 2008 (UTC)

Proposed merger of inflammatory breast cancer

I see that someone has proposed merging inflammatory breast cancer into this article. I would tend to argue against such a merger. This (main) article should offer an overview of breast cancer (diagnosis, types, treatments, etc.), and subarticles should exist – or be created – to expand on concepts introduced here. (See Wikipedia:Summary style). In the same way that we have subarticles on topics like ductal carcinomas, inflammatory breast cancer is a reasonable, interesting, and well-documented type of breast cancer on which we ought to (continue to) grow a separate, more-detailed article. TenOfAllTrades(talk) 01:17, 5 June 2008 (UTC)

Yeah that was me, I had initially hoped to follow up on some restructuring and splitting of topics I did, only to stall. I've removed the tag as I haven't followed and their doesn't seem to be any interest at this time. This article, especially the screening section still needs to be summarized, merged, but the tag doesn't need to be there. -Optigan13 (talk) 02:54, 5 June 2008 (UTC)

Breast Cancer in men

Why is there little or no mention of this, it's supposed to be an encyclopaedic article so it should mention more about the thousands of men that get diagnosed worldwide with it. In any case- the article should be better gender neutralised. I myself am male and had a breast cancer scare 2 years ago and finding this article in this state is very demeening to the men that are suffering from it - please sort it out. --88.108.34.230 (talk) 22:16, 15 June 2008 (UTC)

Staging

Breast cancer staging would be better in its own article, particularly as is is comprised mostly of lists. Have a look at non-small cell lung carcinoma staging. Ditto pathological sub-types. Axl (talk) 13:37, 17 June 2008 (UTC)

Bad Infomation

There is misleading information...... In the US, both incidence and death rates for breast cancer have been declining in the last few years.[10][9] Nevertheless, a US study conducted in 2005 by the Society for Women's Health Research indicated that breast cancer remains the most feared disease,[11] even though heart disease is a much more common cause of death among women.[12]

It states that there is a decrease in incidence and death rates etc. in the last few years. But the article to back it up only covers (or atleast to my attention span) American Indians and Alaska Natives. Not for nothing the sources states American Indians? To my understanding its Native Americas. —Preceding unsigned comment added by Mikesta21 (talk • contribs) 20:53, 17 August 2008 (UTC)

Messy

This article is kind of a mess -- too technical for a general article, but not split well (the information from the splits was also left in the main article). I'm going to do my best to work on it section by section to make it a useful reference for the casual reader as well as medically accurate -- and don't worry, I'll add back in references. It would probably also help if we had some broad, general references for a "further reading" section -- most patients can't be expected to track down, or understand, many of these medical articles. -- phoebe / (talk to me) 06:33, 4 September 2008 (UTC)

The problem with External links is that, after you collect a good sample of links, there are WP editors who come along, delete it, and replace it with the Open Directory, which is an indiscriminate collection of links, some of them commercial.

Check the past versions of this article and see if somebody collected links already that were deleted. Nbauman (talk) 13:44, 4 September 2008 (UTC)

Yeah, I was also thinking books (!) and such, not just links -- phoebe / (talk to me) 17:38, 7 September 2008 (UTC)

[1] ures from breastcancer.org

[2] Madigan MP, Zielgler RG, Benichou J, Bryne C, Hoover RN (1995). Proportion of breast cancer cases in the United States explained by well-established risk factors. Journal of the National Cancer Institute 87: 1681-85.

[3] Campaign for Safe Cosmetics

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