Talk:Breast cancer/Archive 2

Archive 1

Archive 2

Archive 3

Archive 4

staging vs classification splits

I would be inclined to split out the classification section into a new article, but leave basic detail there and in the staging section. 3 questions: 1) what should the new classification article be called (classification of breast cancer?) 2) can the classification and staging sections be merged? 3) Is this a good idea? -- phoebe / (talk to me) 17:18, 7 September 2008 (UTC)

I originally inserted this long and detailed classification. Since, I found it to be too detailed and technical, not fitting this article. I agree to moving the classification to a separate article. Emmanuelm (talk) 17:46, 7 September 2008 (UTC)

So, um, anyone going to do this? And should it be called Classification of breast cancer or Breast cancer classification or something else? WhatamIdoing (talk) 18:43, 13 October 2008 (UTC)

I vote for split to Breast cancer classification, leaving a short summary in this page. I do not have time to do it. Thanks, Emmanuelm (talk) 13:18, 14 October 2008 (UTC)

Well, I've started, but doubtless there will be things to clean up. All the histology specimens are in the new page's gallery; I removed most, but not all, from this page to reduce the issue to something closer to WP:DUE weight.

While we're on the subject, should Breast cancer staging really be a separate article? It seems to repeat much of Breast cancer classification. WhatamIdoing (talk) 02:06, 15 October 2008 (UTC)

Staging is adequately covered in Breast cancer classification. It doesn't need a seperate article. Mattopaedia (talk) 02:01, 12 February 2009 (UTC)

Could I have breast cancer?

I'm sorry, but the editors of Wikipedia are generally not trained medical professionals, and we can't offer you medical advice. (If you get any here anyway, you probably shouldn't trust it—see the Wikipedia:Medical disclaimer.)

For accurate, comprehensive responses to questions about your own health and symptoms, you should absolutely speak to a physician — some random folks on the Internet are a very poor fallback. TenOfAllTrades(talk) 15:09, 19 October 2008 (UTC)

woman cancer

1)cancer, sounds obusiv but curingor controling the cancers not the best thing to have in ur hole life then maybe u may need a treatment. metastasis is a complex series of steps in which cancer cells leave the original tumor site and migrate. —Preceding unsigned comment added by 208.120.16.10 (talk) 23:19, 20 October 2008 (UTC)

strange sentence to rephrase

"people in less-developing countries reported to have low incidence rate than other in developed countries" What is a "less-developing country", compared to a "developed country"? Which incidence is low? Or is it just lower? —Preceding unsigned comment added by 131.111.176.9 (talk) 12:32, 12 February 2009 (UTC)

Cancerous breast milk

Is breast feeding with a cancerous boob contagiious? —Preceding unsigned comment added by 70.23.223.139 (talk) 01:31, 18 February 2009 (UTC)

Unclear statistics

The section Breast_cancer#United_States quotes incidence rates, but as raw figures (141 and 122). These should be a proportion (e.g. 141 per 1000, or per 1,000,000) of a group (e.g adults, women of a particular age). 86.133.66.18 (talk) 19:01, 22 April 2009 (UTC)

Suggestions

Uhm, sorry for drive by editing, but isn't breast cancer *less* common than both non-melanomatous skin cancer and colon cancer? I'm pretty sure it is. Anyway, can't access the original reference to check up.

Also, the stuff about tamoxifen in the section on etiology on UK is out of place.

Lastly, under etiology, risk factors for male breast cancer should be listed, as they're distinct and different to the ones in female breast cancer.

The sentence "there is no cure for breast cancer" is odd too. Aside from not really being organised there, technically there is-ish; cutting it out, although I know what the editor means.

The section on prevention should probably be deleted and that link placed higher.

The screening section probably needs to be reorganised such that the common screening stuff is at the top, and the rarely used stuff is lower, eg the stuff on MRI. Also, FNAC isn't a screening tool.

The article really needs to be more gender neutral (what I would suggest), or split for a seperate article on men. While the fact that 1.5 (or so) of breast cancer in males may not seem very high, the fact that that leads to a lifetime risk of 1 in 600 makes it more common than many many other diseases which get more of a mention.

Anyway, I'll start working on fixing up screening. 128.250.5.246 (talk) 14:47, 29 April 2009 (UTC)

Done work on screening and diagnosis, still need sources, but a little better now. Cut the section on mammography not showing a mortality benefit, there's undue weight to that study and far more powerful studies have demonstrated the advantage to mortality. The section on CT US is undue weight to an thing that is not in common use. 128.250.5.246 (talk) 15:24, 29 April 2009 (UTC)

A Section on the Abortion-Breast Cancer link MUST BE ADDED

This article sucks! How can you call this a balanced, encyclopedic article about breast cancer when no mention is made of the definitive and indesputable link between abortions and breast cancer. Most doctors agree that the majority of breast cancer cases appear in women who have had abortions. Mention must be made of this, and equal space and effort devoted to discussing it. If sutible changes aren't made, I'll have to add a NPOV tag. 69.122.133.58 (talk) —Preceding undated comment added 21:16, 31 July 2009 (UTC).

If any proof or evidence exist for this "definitive and indesputable" link please provide it here. I myself disagree that most doctors agree on this and think it is only a few that shouldn't have any mention in order to comply with NPOV policy. For now I am removing the tag as there is no overall neutrality problem. Biofase ^flame| stalk  17:20, 14 August 2009 (UTC)

Here is a link to a thesis by a well known and credible source.

http://www.columbia.edu/cu/augustine/arch/frear/brind.htm 69.122.133.58 (talk) 14:53, 17 August 2009 (UTC)

Here is one more http://www.suewidemark.netfirms.com/bcchart.htm 69.122.133.58 (talk) 14:55, 17 August 2009 (UTC)

Here is an article on the link between feminism and breast cancer

http://news.bbc.co.uk/2/hi/health/6214655.stm 69.122.133.58 (talk) 15:01, 17 August 2009 (UTC)

Why does Dr. Susan Love ("Dr. Susan Love Breast Book") not have an article in Wikipedia? —Preceding unsigned comment added by 98.217.209.143 (talk) 16:32, 28 August 2009 (UTC)

How can a statement of fact be removed? Under "Causes", I wrote: Abortion: A peer-reviewed study published in the 2009 World Journal of Surgical Oncology found a statistically significant 66% increase in breast cancer risk: "Conclusion: These findings suggest that age and induced abortion were found to be significantly associated with increased breast cancer risk" That this study took place fits the definition of a fact. Is the World Journal of Surgical Oncology not a reputable source? Please explain. —Preceding unsigned comment added by 209.148.89.134 (talk) 13:05, 30 August 2009 (UTC)

I was not involved in that removal, but it is sensible based in part on WP:MEDRS. The WJSO paper is a primary source supporting a non-consensus hypothesis. That, in itself, is not a big problem, but this hypothesis should be discussed in context of prevailing views on the topic. More problematic is the study design, which is a retrospective survey in a hospital setting with a convenience sample as control group, among the least-convincing scientific designs. In addition, the biological basis of this hypothesis is lacking, and the data appear distorted (smoking was protective in univariate analysis?). Overall, this is a weak source for a non-consensus hypothesis. A nuanced discussion would be needed. This is not my primary area of interest - someone else would be needed to do this. --Scray (talk) 13:46, 30 August 2009 (UTC)

Scray is right. This is not what most resources conclude and this is covered in another article I didn't even know about. What is problematic is that it is a selective sample relying on circumstantial evidence where a scientific approach would include a more random sample from wider backgrounds and even multiple countries. Not to mention using such a specific study to support a worldwide conclusion is a misuse of it.

Granted it is a relatively new study and there may still be other studies done in future that will confirm it but from what I have seen no scientific study has ever concluded a confirmed link and the agreement on the issue has drifted between a non-existent link and an ambiguous one at best. There may still be a link between the chemicals and methods used in abortion and cancer in general but it wouldn't be much greater than the link between hormone replacement and cancer (less than 1% I think) and centainly not near what this "study" concludes. Biofase ^flame| stalk  18:43, 30 August 2009 (UTC)

I removed it, for the reasons described above. I replaced it with a link to the detailed WP article discussing the subject, which is where that link belongs. We're not eliminating the discussion from WP. The evidence for the abortion-breast cancer link is so weak that under WP:WEIGHT it doesn't deserve more than a brief mention in this article and a link to the detailed article. If you could find a review article in a major journal, then I'd be interested. See Evidence based medicine.

In contrast, there is overwhelming evidence for the hormone replacement therapy/breast cancer link, in the form of randomized, controlled trials published in major medical journals. The issue is not the magnitude of the effect or the percentage, but the study design and strength of the evidence. --Nbauman (talk) 04:18, 31 August 2009 (UTC)

)Forgive my wiki formatting ignorance, I don't have time to learn all the conventions, tags, etc.)

> centainly (sic) not near what this "study" concludes. Biofase

> The issue is not the magnitude of the effect or the percentage, but the

> study design and strength of the evidence. --Nbauman

Yes, all three of you felt qualified to critique the "study", I wonder

though:

- How then did this so-called "study" pass the "peer review" process? Or

are all of you sufficiently "qualified" (credentials please) to have

participated in (and doubtless improved) the study design and review process?

- Does your dismissal of the World Journal of Surgical Oncology's

content and review process therefore include BioMed Central and PubMed

Central (where it is reviewed, published and archived, as well at the US

National Library of Medicine's repository of life science literature,

and also at INIST in France and in e-Depot, the National Library of the

Netherlands' digital archive of all electronic publications)

- Do you still stand by your replacement text "The scientific community

has found no evidence for abortion causing breast cancer." None? The

study and all the scientific expertise it represents constitute NO

evidence???

209.148.89.134 (talk) 00:36, 1 September 2009 (UTC) (Martin Pearl)

Let me just run through a few points:

• I never said I have a problem with the high percentage concluded in the study. I do not see that in the study itself though so it is likely to be an interpretation of the results that may require a ternary source. If it is a basic math calculation then anybody here should feel free to correct me. I have to say that with incredible claims come incredible sources, and 66% would need more than one study. I do not have a problem with the percentage itself, I have a problem that the majority of sources do not support it.
• Peer-review is a necessary evil to get reliable results but is meaningless for individual studies. The only requirement to pass the peer-review process is a review by qualified individuals in the relevant field. Whether or not the reviewer(s) agrees with the process or conclusion is irrelevant to having it published and even a completely wrong conclusion must be given peer-review recognition if it was peer-reviewed. So to sum it up a peer-reviewed article is no better for me than one written by the local newspaper reporter if I don't have the comments from the process.
• Nobody is dismissing the World Journal of Surgical Oncology's content. They are merely publishing something that was reviewed whether or not the conclusion or process used is correct. Something like the WHO would be more credible as they have to look at the conclusions and consider the different views.
• I have never claimed to be a qualified scientist. That does not mean I can't interpret the results of scientists based on accepted scientific methods, methods which are claimed to be followed but in most part usually are not. I can even tell them they are flat out wrong when I think they are. This is still a world dominated by ordinary people so I don't have to accept what any scientist say especially when there are conflicting views.

Do I stand by the current text? No. I have always maintained that evidence is neutral without exception so it's simply stating something that would be impossible in any case. The same evidence that convict people also prove them innocent with a different interpretation. Something can only be proven or unproven and in this case it is the majority view that it's unproven. Biofase ^flame| stalk  17:55, 1 September 2009 (UTC)

Suggested External Link

I would like to add a link to the American Cancer Society's Detailed Guide for Breast Cancer to this page.

• American Cancer Society's Detailed Guide: Breast Cancer

karen7673 (talk) 18:30, 18 September 2009 (UTC)

I agree with Karen 7673 - Please the add the ACS link. RobinSM23 (talk) 17:47, 14 November 2009 (UTC)

About semen and breast cancer

I was horrified to see someone referring to a 20 year-old single study suggesting that exposure to semen is somehow protective of breast cancer. This observation was never reproduced. But many other studies suggested a much smarter explanation for what this French team observed: in 1989, the vast majority of their non-barrier contraceptive users used "the pill". It is now well known that any intervention that decreases the number of ovulations will decrease breast cancer risk. Bottom line: besides the non-modifiable genetic risks, most, if not all, known modifiable risk factors for breast cancer cause an increased exposure of the body to oestrogen. In fewer words, genes and oestrogen cause breast cancer. Emmanuelm (talk) 17:46, 4 October 2009 (UTC)

Discussion of text regarding bras

This was recently added. The only link which is easily accessible is not a published study but looks like someone blog. Therefore I have moved it here to discuss in more detail. The references do not seem to relate to the topic at hand.Doc James (talk · contribs · email) 00:23, 2 December 2009 (UTC)

Clothing Factors

In a two year "Bra and Breast Cancer Study" including 5000 women in the United States, it was discovered that women with breast cancer had a history of sporting tighter and longer bra-wearing than did the women who had not (yet) developed the disease. Since this time many studies have independantly verified the connection between cancers and tight fitting clothing. in particular bras and that wearing a bra significantly correlates with cancer rates. One hypothesis is that restriction of lymphatic flow by bras could, by several possible mechanisms, cause breast disease.

Some types of fibrocystic lumps are correlated with higher breast cancer rates. Hormones that affect bra-fit have been related to breast cancer risk

Some people might think that women who do not wear bras would be smaller breasted and therefore have lower cancer rates because of size. However, cup size has been shown to not be significant.

Local hypoxia (lack of normal oxygen levels) can happen when circulation is compromised through wearing a bra (as in a heart attack or stroke). Hypoxia can reduce the effectiveness of cellular antioxidant mechanisms and has been related to altered gene expression and DNA damage.

The myth that bras prevent the breast ptosis has no scientific support. Medical research actually shows that weight-bearing and movement is necessary to the maintainence of healthy ligaments. And, ligaments are responsible for supporting and giving shape to the breasts

Thanks for removing this WP:SYNTH violation. It is also not WP:DUE, as 'bras cause breast cancer' is an unsupported fringe theory.

I admit that I'm surprised to see it being added from a UK address instead of from the same Hawaiian IP that usually spams this idea. WhatamIdoing (talk) 19:01, 22 December 2009 (UTC)

Pink ribbon

I think the pink ribbon in the infobox is too big and crowds the infobox information out of the screen. Perhaps it belongs below in the discussion of the pink ribbon? --Nbauman (talk) 20:39, 17 December 2009 (UTC)

It does symbolize breast cancer so I think it should stay. You could try making it small but this is the default size.Doc James (talk · contribs · email) 20:43, 17 December 2009 (UTC)

The image should really go in the disease box. It does not look particularly good below it. The image on Chron's disease is twice as large. Doc James (talk · contribs · email) 23:36, 20 December 2009 (UTC)

Well what do you think? Better? Doc James (talk · contribs · email) 21:25, 21 December 2009 (UTC)

I am taking the liberty to replace the pink ribbon with a picture of real breast cancer for the info box. The pink ribbon is an advertising gimmick that really should not be featured so prominently for NPOV issue. Difu Wu (talk) 21:53, 21 December 2009 (UTC)

(edit conflict) The ribbon is a much better symbol of breast cancer than a patho specimen. People recognize it well a yellow lump they do not. The ribbon is much more than an advertising gimmick.Doc James (talk · contribs · email) 21:59, 21 December 2009 (UTC)

I made a good edit and got reverted so quickly. Just look at the info box for Lung Cancer, a featured article showing a patho specimen. The pink ribbon is an abominable marketing gimmick. Quoting from the Pink Ribbon page: "Promotion of the pink ribbon as a symbol for breast cancer has not been credited with saving any lives. Wearing or displaying a pink ribbon has been denounced as a kind of slacktivism, because it has no practical positive effect. Business marketing campaigns, particularly sales promotions for products that increase pollution, have been condemned as pinkwashing (a portmanteau of pink ribbon and whitewash). Such promotions generally result in a token donation to a breast cancer-related charity, while exploiting the consumers' fear of cancer and grief for people that have died to drive sales." The pink ribbon may be a symbol for breast cancer awareness, but it most definitely is NOT a symbol for breast cancer itself. Difu Wu (talk) 22:16, 21 December 2009 (UTC)

I too had just made a good edit a few minutes before it was removed :-) I see many problems with the breast cancer movement from screening having questionable benefits ( as per a Cochrane review ) and people loving to ally themselves with breast cancer research because breast are nice clean and wholesome ( colon cancer research btw does not get them same attention, no ribbon for colon cancer awareness ). Still I prefer this pink ribbon whos history is not as bad as it more recent usage. It is tarnished yes...

BTW we already know how to cure 50% of cancer and that is by prevention. Aggressive measure with respect to smoking would do wonders but of course that is not nearly as sexy as high tech research.Doc James (talk · contribs · email) 22:26, 21 December 2009 (UTC)

Thanks for replying. While I am no fan of the pink ribbon, it has its place within the article under the Society and culture section, as Nbauman alluded to. I just don't think that the breast cancer awareness movement should in any way be confused with the disease breast cancer itself. The patho specimen is breast cancer. A pink ribbon is not. Why does editing on wikipedia have to be so combative? >:( (but I can understand your point...) Difu Wu (talk) 22:39, 21 December 2009 (UTC)

By the way, I was initially going to make some improvement to this article, but this whole pink ribbon business is making me feel so depressed about editing on wikipedia. I'm going to edit somewhere else :( Difu Wu (talk) 22:43, 21 December 2009 (UTC)

All pathology specimen look so similar. The only one who would identify with the image you propose is maybe a pathologist :-) The image is in the public domain rather than being an owned gimmick. In Canada it is reserved for use by charities even though we do get the propaganda from the US on cable.

I am not one to shy away from gory images but often I feel they do not belong in the lead. The image on the lung cancer page is well associated with lung cancer in the minds of the general public as here in Canada anyway half the cigarettes packages are covered with a very similar image.Doc James (talk · contribs · email) 22:45, 21 December 2009 (UTC)

Part of the issue is I had just spent 15 minutes figuring out how to format the ribbon in the lead to make it smaller when you came along and replaced it with the patho specimen :-) Doc James (talk · contribs · email) 22:47, 21 December 2009 (UTC)

I hate to spoil all the enthusiastic work that you've done, but I basically agree with Difu Wu. The Pink Ribbon campaign is a commercialized promotion, and it's become controversial; a lot of people think it's had its day. I tried to compromise by putting a small Pink Ribbon image down by the discussion of the Pink Ribbon, but I don't think it's important enough to go in the infobox. Ideally, I'd prefer to have a drawing illustrating the lobules and ducts (which I think is unclear). If you really like the Pink Ribbon, and it makes you happy, I'll go along, but if you're taking a head count, my vote is against it. --Nbauman (talk) 01:41, 22 December 2009 (UTC)

(undent) If we had something better I would go with it. I do not see anything better on the page right now. The illustrating sound interesting..Doc James (talk · contribs · email) 01:46, 22 December 2009 (UTC)

I was thinking of a great illustration I saw in Curetoday.com, but it's not public domain (in fact it's a flash illustration that you can't even download for personal use).

A lot of people actually find the Pink Ribbon and the Pink Ribbon campaign annoying or offensive, and not just for the reasons discussed in Pink Ribbon.

One of them was Barbara Ehrenreich, the writer, who wrote about it extensively. (Ehrenreich btw seldom mentions it but she was a PhD researcher at Rockefeller University before she dropped out of science in favor of political organizing.) She said it was a feel-good campaign for breast cancer patients which promotes naive optimism. Maybe denial is good for some patients, but other patients don't like it.

The Pink Ribbon is tangled up in a lot of politics, a lot of commercial tie-ins, and a lot of naive policy advocacy. Do you really want the National Cancer Institute to move money from basic research into "prevention"? I'd like to know a little bit more about it before we essentially endorse it by putting it on our breast cancer page.

All that money they collect in the Pink Ribbon campaign -- who gets it? What do they do with it? Maybe all that money just goes to keep promoting the Pink Ribbon campaign. It might violate WP:ADVERTISING or the WP prohibition on promoting self-help organizations.

And I'm the second person who has objected to it, so we really don't have a consensus.

If you can't tell me where the money goes that they collect from the Pink Ribbon campaign, I think you should take it down. --Nbauman (talk) 16:47, 22 December 2009 (UTC)

Yes however when I added the image to the page there was nothing in the lead. This picture did appear like the best candidate IMO. I have heard and read much of what you speak of. The cuddly breast cancer movement is hated by many with the disease. As I mention here in Canada it does not seem to be as commercial as in the USA.

In response to your personal question about how I beleive money should be allocated for prevention and treatment. I do not think the issue in prevention is lack of money it is lack of political will. Smoking on my hospitals grounds was only banned a year ago after much push back. The pharmacies as of this year are no longer allowed to sell cigarettes. How did there consciously allow them to do so for this long? THe tobacco companies realize they are losing in the global north and thus are moving to the global south. Were are those who are supposed to protect the poor and powerless? Craking down on cigarettes does not take money just ingenuity and will. This applies to many cancers. This of course has little to do directly do with this page.

Except of course the cancer research has a great deal to do with politics. This is part of the reason why I like the pink ribbon with all it negative connotations. In that 1) it does not save lives ( but than again what is the evidence for mammograms and for cancer research overall? ) 2) it is covered in commercialism and politics like much of cancer research ( remember the war on cancer? ) 3) many people hate it. I am not that adverse to having it removed if we have something better to replace it with.Doc James (talk · contribs · email) 17:39, 22 December 2009 (UTC)

I tried to find out where the money goes. If they had been funding Elizabeth Blackburn, it would be OK with me.

But the more checking I do on this, the worse it looks. I looked up the sources for the Pink Ribbon page. All of the sources I read were balanced articles, discussing the reasons behind the Pink Ribbon campaign and the (many) critics of its commercial ties, its feel-good naivite, and its vague goals. But the Pink Ribbon page selectively quoted the supporters and ignored the critics. I'm not sure I agree with all the anti-corporate arguments, but the Pink Ribbon is unquestionably controversial, WP:POV, and not a neutral symbol. I think it's interesting that the Canadians are regulating it better than we are.

The Pink Ribbon page has problems that I don't want to get into; I'm more interested in biology and clinical medicine. However, I now feel even more strongly now that the Pink Ribbon doesn't belong at the top of this page, because among other things it's not a neutral symbol and it violates WP:PROMOTION.

I think graphics do a great job of conveying information. I'd like to have an appropriate graphic. But I think it's better to have no graphic than a graphic which conveys the wrong idea. I agree that nobody but a pathologist would know what the path sample was. But it's better than a pink ribbon. --Nbauman (talk) 18:03, 22 December 2009 (UTC)

I have asked if anyone else has any comments from WP:MED. Maybe someone can come up with something better...Doc James (talk · contribs · email) 18:15, 22 December 2009 (UTC)

• Two cents Nbauman, your comments about Pink ribbon (the article) relieve my mind considerably, because I was worried that my work on it had pushed it very much too far the other way. I personally dislike the pink ribbon advertising industry and go out of my way to avoid buying products that are promoting it.
  However, Wikipedia isn't written for people like me. The pink ribbon, like the red ribbon for AIDS (which article also uses a riboon in the infobox), is a very widely recognized symbol -- the "corporate logo" for the disease itself, if you will, and not just for the advertising campaigns. Regular readers will know, instantly, that they're at the 'right' page when they see this symbol. While I'd rather that it were even smaller than the current 130px width, I think that it is a better choice than a lump of tissue because it is recognizably associated with breast cancer.
  As an alternative, we could perhaps consider something like the image in the lead at mammography, although I think that the pink ribbon is a broader symbol. WhatamIdoing (talk) 19:19, 22 December 2009 (UTC)

Mammography is however equally controversial if not more so than the pink ribbon. A recent publication commented on it as part of the " Breast terror industry " [1] BTW this was also published in the Medical Post. And the Cochrane review concluded that it is unclear if it causes more harm than good. Breast cancer screening Doc James (talk · contribs · email) 19:26, 22 December 2009 (UTC)

This 2003 Cochrane review states "It is possible that increased breast awareness may have contributed to the decrease in mortality from breast cancer that has been noted in some countries." Kösters JP, Gøtzsche PC (2003). "Regular self-examination or clinical examination for early detection of breast cancer". Cochrane Database Syst Rev (2): CD003373. doi:10.1002/14651858.CD003373. PMID 12804462. Just a curiosity rather than something we should base our decision on though. Doc James (talk · contribs · email) 20:18, 22 December 2009 (UTC)

The problem is that the Pink Ribbon is not a universal symbol of breast cancer. It's the symbol of a particular approach to breast cancer, and it's an approach a lot of serious scientific people are uncomfortable with and think is flawed. It's a packaged advocacy campaign that you can take off the shelf and use for any purpose you want -- even if, as Ehrenreich says, those purposes are actually harmful to women with breast cancer individually, and advocate for some self-defeating ends, like politicizing the science behind breast cancer policy. Anti-abortion congressmen can wear a pink ribbon (as Alfonse D'Amato did). Hayley's original advocacy was that "only" 5% of the NCI's budget went to "prevention," and she wanted it to be more. How do you prevent breast cancer -- by encouraging women to have children earlier and more often? (Screening isn't prevention.)

I was following Gøtzsche and I had a subscription to The Lancet at that time. Mammography is not controversial the way the Pink Ribbon is. There's a broad consensus for mammography. The USPH service recommended mammograms. The only controversy is at what age. Gøtzsche is still saying that we don't have class I evidence showing that mammography saves lives, and he's right on that -- we don't have prospective randomized trials.

Here's an image http://www.dhss.mo.gov/BreastCervCancer/index1.jpg from a U.S. government document http://www.dhss.mo.gov/BreastCervCancer/ that should be free for reproduction. I think we should use that until something better comes along. --Nbauman (talk) 23:48, 22 December 2009 (UTC)

"Screening is likely to reduce breast cancer mortality. As the effect was lowest in the adequately randomised trials, a reasonable estimate is a 15% reduction corresponding to an absolute risk reduction of 0.05%. Screening led to 30% overdiagnosis and overtreatment, or an absolute risk increase of 0.5%. This means that for every 2000 women invited for screening throughout 10 years, one will have her life prolonged and 10 healthy women, who would not have been diagnosed if there had not been screening, will be treated unnecessarily. Furthermore, more than 200 women will experience important psychological distress for many months because of false positive findings. It is thus not clear whether screening does more good than harm. To help ensure that the women are fully informed of both benefits and harms before they decide whether or not to attend screening, we have written an evidence-based leaflet for lay people that is available in several languages on" 2009 Cochrane review [2] Well the pink ribbon page says "The pink ribbon is an international symbol of breast cancer awareness." Doc James (talk · contribs · email) 02:59, 23 December 2009 (UTC)

Here is some stuff on prevention [3] Doc James (talk · contribs · email) 04:50, 23 December 2009 (UTC)

I agree with Difu Wu and Nbauman. A promotional charity symbol should not be the main illustration to the article "Breast cancer". Have a look at the (FA) article "Lung cancer". In my opinion, the pathological specimen is a better representation of an encyclopedia article about this disease. Axl ¤ [Talk] 13:40, 23 December 2009 (UTC)

Thanks Nbauman and Axl for your great reasoning. The pink ribbon needs to go. It pains me to see this marketing gimmick on this page on wikipedia. Just look at pages for other cancers, such as testicular cancer, ovarian cancer, kidney cancer, prostate cancer, just to name a few --- all use actual pictures of the disease. Lay persons may not immediately recognize the path specimen as breast cancer, but they will appreciate the explanation. Moreover, they will appreciate not being confused into thinking that the pink ribbon is breast cancer itself. Sorry Doc James for my bad timing. I really appreciate all the efforts you put into it, but when I see something this bad like the pink ribbon, I cannot help but change it.Difu Wu (talk) 14:14, 23 December 2009 (UTC)

The vote looks more like 2 (pink): 2(patho):1(neither) :-) An important discussion none the less.Doc James (talk · contribs · email) 15:40, 23 December 2009 (UTC)

Thanks for the courteous, respectful debate. I'm sorry everybody couldn't get what they want. But I can't stand that pink ribbon. --Nbauman (talk) 21:30, 23 December 2009 (UTC)

Never realized people hated this ribbon this much... Will see if I can figure out something better. A google search is bleak [4] but there is this one at Wikimedia commons? [5] Could crop a bit and indicate with arrows the changes associated with cancer like retraction, skin changes, nipple discharge, etc? These are a little less gory and I think in the CC. [6] Doc James (talk · contribs · email) 22:17, 23 December 2009 (UTC)

Frank Netter has such great images [7] only another 51 years before they are in the public domain! Doc James (talk · contribs · email) 22:39, 23 December 2009 (UTC)

James, thanks for your open-minded approach towards achieving consensus. Also, thanks for looking for alternative pictures. I think that the photo from Commons would be appropriate for the article. Axl ¤ [Talk] 09:50, 24 December 2009 (UTC)

Image for lead

I have cropped the commons image down in two different ways [8] and [9] which do people prefer? Should we keep the contra-lateral breast for contrast? Still needs to be labeled with the signs of breast cancer. Doc James (talk · contribs · email) 16:21, 24 December 2009 (UTC)

I've moved the mammogram image up to the lead for now and the excised tissue photo has a new home in pathophysiology (too bad about that blue background - really clashes). I have to say the commons image you've been working on wouldn't be the best for this article since it does not represent most women's experiences and is a rather extreme example. Gobonobo ^{T C} 18:30, 26 December 2009 (UTC)

I agree will put it in under signs and symptoms.Doc James (talk · contribs · email) 19:21, 26 December 2009 (UTC)

I am happy with the current image set-up :) Thanks Gobonobo and Doc James! Difu Wu (talk) 19:41, 26 December 2009 (UTC)

I have concerns about the recurrent breast cancer image. It is rare to see a case this advanced and it does not illustrate typical breast cancer. I worry that this is a misleading image for those unfamiliar with breast cancer. I'll try to find a more suitable image from commons. Gobonobo ^{T C} 20:16, 26 December 2009 (UTC)

It should be someplace in the article. Will move to prognosis. Thermography? Evidence? Here is a paper [10] Doc James (talk · contribs · email) 20:35, 26 December 2009 (UTC)

Pathophysiology

I wouldn't mind if somebody who knew more about the RAS/MEK/ERK pathway than I do would review that section. I know the PI3K/AKT pathway controls apoptosis. I'm not sure about RAS/MEK/ERK. --Nbauman (talk) 03:44, 24 December 2009 (UTC)

I could get you some refs but care little about pathophysiology... Doc James (talk · contribs · email) 23:47, 26 December 2009 (UTC)

Image

WP:IMAGE recommends that images be set to default. Gives all images the same width which I think is a good idea. Doc James (talk · contribs · email) 20:41, 26 December 2009 (UTC)

This article is too technical for a general audience

This article reads like a medical text book, but doctors don't rely on wikipedia for medical information. We should work together to make it more appropriate for a lay audience -- not more than a college educated audience, preferably less educated. I have made some small efforts to do that today but it is a big job. I hope others agree with me. Umarylandmd (talk) 16:23, 14 January 2010 (UTC)

Almost 50% of doctors actually do use Wikipedia [11] :-) But I do agree that we should write for a general audience.Doc James (talk · contribs · email) 19:39, 14 January 2010 (UTC)

OK, I made a few revisions and will keep working on it. Umarylandmd (talk) 20:50, 18 January 2010 (UTC)

Yes looks good.Doc James (talk · contribs · email) 20:55, 18 January 2010 (UTC)

Recurrent breast cancer image

I'd like to see the image that is currently in the Prognosis section removed from this article. This image is an extremely severe case of recurrent breast cancer that represents far less than 1% of breast cancer cases. As it does not represent most women's breast cancer experiences, it gives a false impression of what breast cancer looks like, especially for those unfamiliar with the topic. Gobonobo ^{T C} 20:18, 14 January 2010 (UTC)

This section is however not discussing common breast cancer but recurrent breast cancer. I have seen cases such as this. If we could get a range of images showing different degrees of disease we could than move this image to a gallery which would make it smaller. Am however not inclined to censor it just because some find the image disturbing. Cancer is disturbing. Even though the pink ribbon try to make it seem otherwise. I do agree that we should not have it in the lead were I initially place it. Axl btw though we should use it above...Doc James (talk · contribs · email) 20:46, 14 January 2010 (UTC)

I agree with Gobonobo. This photo is not at all typical of recurrent breast cancer. It would potentially provide false reassurance to women who think they don't have recurrent cancer because they don't look like this. And, it would be terrifying to children whose mothers have breast cancer. Since children use wikipedia, I think that is something we should be concerned about. Doc James says he has seen cases such as this, which I believe, but in what country and how many? This looks like a case of recurrence that was left untreated for a long time.

Umarylandmd (talk) 00:34, 19 January 2010 (UTC)

One case 5 years ago in Canada. Have seen many cases of different cancers that look unfortunately similar. Will move it to a gallery to make it smaller and will describe it as severe. Breast cancer is sugar coated enough with pink ribbon and smiling "survivors" out for a run. I strongly feel we need balance. Hopefully we can find more images of different degrees. Found a few other images.Doc James (talk · contribs · email) 02:34, 19 January 2010 (UTC)

I think the gallery approach is a good one. The only problem is that commons is a little sparse when it comes to breast cancer photos at the moment. Thank you for revising the description as well. Gobonobo ^{T C} 02:34, 20 January 2010 (UTC)

Yes I am hesitant to ask people I see who have breast cancer if I can take photos. We need a female physician to do this I think or convince people to upload images. Most breast cancers however look like normal.Doc James (talk · contribs · email) 07:24, 20 January 2010 (UTC)

Thanks for the compromise. I agree that we don't have enough useful photos and that the "pink ribbon" approach is marketing rather than a balanced reality. Umarylandmd (talk) 13:35, 21 January 2010 (UTC)

Research and breast cancer cell lines

The Research section seemed to be just about breast cancer cell lines so I gave it that name and started a more general Research section which needs much more. Most of the BCC section could move to a new article eg breast cancer cell line. Rod57 (talk) 15:48, 24 March 2010 (UTC)

Someone renamed it back (without discussion) to "Research" which seems retrograde and very unbalanced. Can't find a quick way to see which edit(or) did it. Rod57 (talk) 01:05, 1 December 2010 (UTC)

9 ways to prevent breast cancer

Cancer of the breast is the most frequent malignancy that occurs in women. A little awareness goes a long way in terms of protection, while early diagnosis of breast cancer can even save your life.

Following are 9 natural ways to prevent from breast cancer

1. Every women should examine her breasts ever month.Any skin changes should also be noted, with changes in their shape and size. A lump or a cyst may just be a benign tumour, but it should be reported to the doctor immediately. There are many kinds of benign tumours of the breasts, but this is for your physician to decide.

2. Examine yourself every month just after the menstrual period. The best way to do this is by palpation of the breasts, with the flat of the hands, keeping the finger-tips together. Examine the upper part, the central and the lower parts, as well as the armpits.

3. Visual examination in front of a mirror helps to observe changes in size or outline, as well as any changes on the skin surface.

4. Some of the signs that may be danger signals, are certainly worth knowing. These are puckering of the skin, any discharge from the nipples, lumps, cysts or swellings, changes in the shape or size.

5. If there is pain that is not the normal pain that occurs before menstruation, it should be reported to the doctor. Regular self-examination of the breasts also helps one to become familiar with one's own normal size, shape and consistency, so that changes, if and when they occur, are more easily noticed.

6. Annual routine medical check-ups should also be undertaken. This is of particular importance after the age of thirty.The chances of malignancy increase with age and are more likely during middle age.

7. Self-examination and detection is one of the most effective ways by which possible malignant conditions are diagnosed and treated. Early detection has a very high cure rate-- about eighty percent. 8. The best way to examine yourself is to lie flat on a firm bed and then palpate the breasts with the flat of the palms. Changes in size and outline can be detected by observing the breasts in the mirror.

9. First with your arms at the sides and then with the arms held up over the head. While doing this, see if there are any changes in size, outline or skin surface.If it does than consult with doctor immediately. SOURCE:

Wikipedia is based on WP:MEDRS of which this is not. Doc James (talk · contribs · email) 05:56, 18 November 2010 (UTC)

Additionally, this isn't "nine ways to prevent breast cancer", because "detecting" isn't "preventing". This is "one way to detect cancer". Furthermore, it's really "one pretty much useless way to detect cancer", because breast self-examination was well studied in hundreds of thousands of women, and despite conventional wisdom saying that it "should" work, SBE didn't actually save any lives. Women noticing changes to their breasts without any sort of training or organized checking works just as well as following the advice given here. Breast cancer orgs that care about evidence-based medicine have dropped self-exams (except in women that are both high risk and highly motivated) in favor of breast awareness. WhatamIdoing (talk) 06:16, 18 November 2010 (UTC)

The pitfalls of evidence based medicine. Take one study from a western country and one from an Asian place with extremely low reported BC rates. This time I am not convinced that Cochrane came up with something useful doing a metanalysis of the 2. There has been much more research on mammograms and the results are not easy to interpret either. Richiez (talk) 11:33, 18 November 2010 (UTC)

It is even worse than I thought.. Russia and Shanghai. Not saying that russian study design was flawed but one needs to keep an eye on sometimes drastically different diagnostic procedures and possibilities. What happens in the USA when someone detects a breast lump? What happened in Russia at the time the study was running when someone detected a breast lump? Needless to explain that Shanghai with a low BC incidence may have very different results than western countries. Richiez (talk) 11:41, 18 November 2010 (UTC)

Which study do you refer too? Do we have other reviews that say differently?Doc James (talk · contribs · email) 17:55, 18 November 2010 (UTC)

The studies are covered in breast self-examination. I was referring to the Cochrane review which drew its conclusions from the above mentioned studies. I am not aware about any better sources. I think it is difficult to try to apply the results to other settings then where the studies were conducted. It may be also of interest that Peter Gøtzsche (one of the Cochrane investigators) is also very sceptical regarding mammography. Not without good reason but still.. what do we have left when he proves everything wrong? In Germany self exams are still widely recommended and despite mammography the popular opinion is that about 80% of BC cases are selfdetected. Richiez (talk) 20:26, 18 November 2010 (UTC)

There are basically no good studies that support SBE in an average-risk or low-risk population. The primary reason seems to be a matter of timing: A lump that is finally large enough to be detectable in SBE (or even clinical breast exam) has already been there for several years, and is going to be noticeable without any particular exam very soon. And since the difference in outcome between "detected during SBE in March" and "just happened to notice in May" are basically non-existent, it saves no lives. (It does increase the number of mammograms performed, negative biopsies, and fear, which I suppose is good news for businesses in the breast cancer industry.) WhatamIdoing (talk) 00:45, 19 November 2010 (UTC)

Agree with the lack of good studies. Additionally the differences between various forms of breast self examinations that have been recommended at various times in various places can be quite big and not so much different from the now advertised "breast awareness". Also many of the programs were partially concerned with largely useless stuff like looking for swollen lymph nodes. But then I think that some kind of formalised (self) examination is better than a fuzzy self awareness exactly as it is possible to tell the women what is useless. Richiez (talk) 10:24, 19 November 2010 (UTC)

Breast cancer awareness

I'm planning to start a new article at Breast cancer awareness in a few weeks. It will cover basically all of Breast cancer#Society_and_culture (except the art section). When it's done, we'll probably need to re-work this section as a {{Main}} summary of the new article.

If you have ideas, sources, etc., please feel free to help out. WhatamIdoing (talk) 20:59, 2 November 2010 (UTC)

As you can see from the no-longer red link above, the article has gone live. I plan to suggest it for the main page as a WP:Did You Know item, and I would be happy to have people here read it, improve it, and watchlist it. WhatamIdoing (talk) 22:23, 1 January 2011 (UTC)

HRT as a risk factor

Progestin HRT seems to be accepted as a risk factor for breast cancer [12] but the article doesn't seem to mention that. Rod57 (talk) 00:43, 1 December 2010 (UTC)

You are right, a prominent mention of HRT as risk factors belongs into the article.. it is mentioned in some places as an aside. I would not go as far as trying to differentiate various types of HRT, so far I am very sceptical that one is any safer than the other. I will look at it or be bold. Richiez (talk) 01:18, 2 January 2011 (UTC)

Screening

The text seems to have been added here. AFAICT, the information presented is correct and verifiable. The first half of the sentence (no evidence for either self-exams or clinical exams) can be verified through the no-cost portions of the cited Cochrane review. The second half of the sentence (the "slow-growing" claim) may or may not be mentioned in the gated paper. (If it isn't, then I've seen that claim elsewhere just in the last month or two; perhaps I'll be able to find the other source again.) WhatamIdoing (talk) 08:01, 3 January 2011 (UTC)

afaics the part "because by the time a lump is large enough to be found it is likely to have been growing for several years and will soon be large enough to be found without an exam" is unsupported by any source..certainly not Cochrane. Furthermore the CR does not conclude anything at all about CBE. Or if it does than it does so from 0 datasets. Even the claim about self exams is overstretched. You can not conclude this kind of statemnt just from mere lack of sources, negative statements require verification just as positive do. For this there should have been sufficient data to draw conclusion on premenopausal vs postmenopausal. The statement is missing any hints about limitations of examined data sets, to my knowledge no high risk or other special subgroups were examined and it is likely though unproven that there are substantial subgroups which could benefit.

I do not judge Cochrane as a holy cow and am not quity happy about stuff like this. 2 diverse trials from somewhere, no information about mechanism of action, no expert plausibility assessment - do you trust that kind of stuff purely on the grounds that the numbers sum up? Richiez (talk) 18:14, 3 January 2011 (UTC)

So the Cochrane review says "One large population-based trial of clinical breast examination combined with breast self-examination was also included. The intervention was discontinued because of poor compliance with follow up and no conclusions could be drawn." That sounds to me like there is no research evidence supporting CBEs. Does it sound that way to you? Do you interpret the lack of evidence as meaning something else?

Alternatively, are you personally aware of any good research evidence that does support the effectiveness of CBEs? WhatamIdoing (talk) 03:58, 4 January 2011 (UTC)

Merge proposal

Does anyone have any opinions about the merge proposal at Breast cancer; calcium and vitamin D? I think it should be merged to something (either here, or at Risk factors for breast cancer). WhatamIdoing (talk) 21:32, 6 January 2011 (UTC)

Not sure how much will be left after a cleanup but I have added it to my watchlist. Richiez (talk) 17:39, 7 January 2011 (UTC)

  Y Merger complete. merged to Risk factors for breast cancer --KarlB (talk) 23:13, 7 July 2012 (UTC)

well-educated affluent women are more likely to have mammograms

This probably explains why they are more often diagnosed, but less often die. Mammograms find some cancers before they can grow, and other cancers that might never have grown. — Preceding unsigned comment added by Ocdncntx (talk • contribs) 19:59, 14 February 2011 (UTC)

Globocan sources

I've corrected the recently updated statistics. The column at Globocan that is labeled "ASR (W)" means "Weighted age-standardized rate", not "percentage of people who have this cancer". WhatamIdoing (talk) 18:01, 28 February 2011 (UTC)

tasteless vandalism?

I removed this sentence: "Breast cancers can be classified by constant rallying for a 'cure' and saggy breast nipples which fizzle with out salsa."

In case there was originally some point being made that needs to be reinserted, can someone professional please look at the classification section? I thought the sentence rude enough to simply remove it but can't judge the accuracy or completeness of what's left. Elinruby (talk) 04:48, 19 March 2011 (UTC)elinruby

I restored the original introductory sentence. Thank you for reverting the juvenile WP:Vandalism. The page has been WP:Semi-protected for the next few days, which reduces the odds of that happening by only allowing registered users like yourself to edit it. WhatamIdoing (talk) 04:57, 19 March 2011 (UTC)

Breast Cancer Culture may not belong here

I actually think that some of the sociological points are well taken. But... ok, I am here to look stuff up for a friend's mother and am a little overwhelmed as it is. I am thinking that if I were the actual patient it would simply be too much. I find it rather ironic that I am saying this as I have commented on some other medical pages saying that they are too geared to professionals. This one is too geared to women's studies majors. Your average user of this page is likely to want to know about staging and prognosis.

I think that the over-estimate of cancer risk is an important point and should stay; the rather interesting material about breast cancer in history and in art should become its own section and have a reference and a link here.

That is my reaction to the page as it is now. — Preceding unsigned comment added by Elinruby (talk • contribs) 05:04, 19 March 2011 (UTC)

Is there anything particular about staging and prognosis that you think is missing? In general, I don't think we should write articles for either patients or professionals, but I believe that all of our readers will be interested in the basics on these points.

As an aside, IMO all cancer patients ought to be given a printed page that says "You have <exact description of cancer type>. Based on your situation (e.g., gender, age, general health), if you did not have cancer, you would probably have lived to about age ___. Since you do have cancer, you will probably live to about age X if you do nothing, Y if you have surgery alone, Z if you have surgery and radiation..." We seem to have the data to do this; look at the CancerMath.net web calculator in the ==External links==. If we did this, then nobody would be faced with sorting through information about the dozens of cancers of the breast, trying to find the information that is actually applicable to individual situations. WhatamIdoing (talk) 19:56, 19 March 2011 (UTC)

I agree about the prognosis thing but in the case of this condition it seems that "standard of care" can actually be harmful (lymph node removal) so perhaps that is not always possible. I'm an information technology person so I am no expert tho...just good at google. I will try to come back soon and make some specific suggestions. Here. I think that people who know a lot more than I do are making a good effort w the page. In those circumstances I don't edit substance. Elinruby (talk) 10:07, 20 March 2011 (UTC)elinruby

I just realized that this is an overview page with a lot of subpages. I will have to come back to this but I have made some suggestions below. I am not sure if the content I suggest adding should be on the main pain, the sub-page or both. Right now tho I do not see it anywhere. If I am wrong, fine ;)

Axillary Node Dissection

Routinely done -- studies indicate it may not improve survival. Does have significant risks.

• http://www.ecancermedicalscience.com/news-insider-news.asp?itemId=1078
• http://oncozine.ning.com/profiles/blogs/asco-2010-removing-axillary

some journal articles:

• http://archsurg.ama-assn.org/cgi/content/abstract/145/6/564
• http://www.cinj.org/documents/LocoregionalRecurrence.pdf

Maybe it's still controversial? But a patient that risks losing the use of her arm wants to know that there's a reason why she is doing it. IMHO the question should at least be mentioned.

Elinruby (talk) 11:04, 20 March 2011 (UTC)elinruby

Mastectomy does not improve odds

I do not see this mentioned anywhere and it's an important point. It gets a favorable mention in the case of BRCA, which may be appropriate. HOWEVER this section by its placement is given more importance than the other treatment options. — Preceding unsigned comment added by Elinruby (talk • contribs) 10:51, 20 March 2011 (UTC)

Just realized that of course this is too broad a statement -- certainly the article implies that mastectomy is a fine idea if you have the BRCA gene -- but this is why I am not trying to edit the main page. For some subset of patients however the statement is true, and matters a great deal. So should this not be mentioned? It does not seem to be a controversial notion.

http://www.cancer.gov/clinicaltrials/results/summary/2002/mastectomy-versus-lumpectomy1002

Very important to patients though. Why go through mastectomy and perhaps reconstruction if it will not improve outcome? OK -- there is a fine point about *somewhat* less local recurrence, yes? But does not improve survival? So nonetheless. Seems like lots of surgery with attendant risk, little benefit.

And I'd like to say again that newly-diagnosed patients are liable to read the BRCA statement over-broadly. Possibly this could be fixed by moving the Prevention section further down the page. The organization is a little sketchy any and could use work; for example prevention seems to want to be a subsection of Risk factors, then we have Pathophysiology the Diagnosis, then Screening, which might be part of Prevention, or vice versa. I'll add a separate item for this.

— Preceding unsigned comment added by Elinruby (talk • contribs) 15:09, 20 March 2011 (UTC)

The basic problem is this: Mastectomy does improve survival... for some patients. Even for fairly-early stage patients, it improves survival compared to lumpectomy without radiation and chemotherapy (that's why Nancy Reagan chose it: she preferred mastectomy and nothing else to lumpectomy followed by months of treatment; the two options produce identical results).

We shouldn't be making sweeping statements one way or the other, because the answer is "it depends". Individual patients really need to be talking to their own medical professionals, to get information that is correct for their own specific situations. WhatamIdoing (talk) 20:10, 24 March 2011 (UTC)

possibly needs work on format consistency, organization

So far I see:

As noted above, perhaps Prevention should be moved under Screening.

Perhaps the section sequence should be Screening, Diagnosis, Treatment vs current Diagnosis, Screening, Treatment

The current format uses unbolded titles and bolded subtitles. Offends readability. Suggest either all bold, or titles only in bold to make it easier to process the structure. — Preceding unsigned comment added by Elinruby (talk • contribs) 15:28, 20 March 2011 (UTC)

For the order, we should probably follow the advice at WP:MEDMOS#Sections. "Looking for cancer" (screening) is definitely not the same thing as "Stopping cancer from happening" (prevention).

Editors don't control the CSS, so we get no say over whether section headings are in bold-face type. WhatamIdoing (talk) 20:24, 24 March 2011 (UTC)

Breast cancer abortion link

As there is no link this will not be appropriate for either the prevention or the cause section. Maybe under society and culture but we must watch WP:DUE as mentioned by WAID Doc James (talk · contribs · email) 06:10, 25 March 2011 (UTC)

I agree that there's no need to provide this information on this page. When you consider the scope of the subject, it's such a trivial issue—on par with "anti-perspirant doesn't cause breast cancer" and "wearing a bra doesn't cause breast cancer", two similarly disproven 'causes' that we don't happen to mention on this page.

The fact that somebody asked about it five years ago is irrelevant: consensus can change, and it has. (By contrast, all of these things should be mentioned at the risk factors for breast cancer article.) WhatamIdoing (talk) 01:51, 26 March 2011 (UTC)

Agreed - without reliable sources to lend weight to such an hypothesis, it's simply speculation. -- Scray (talk) 20:36, 26 March 2011 (UTC)

Strange tone in sentence in pink ribbon section

This sentence from the pink ribbon section is a little odd, the generalization at the end does not add anything to the article and needs proof to be there. The first part seems worded incorrectly as well.

original: "...or to identify products that the manufacturer would like to sell to consumers that are interested in breast cancer—usually white, middle-aged, middle-class, educated women."

I would suggest: "...or to identify products that are being sold with part of the profits going to breast cancer related charities." —Preceding unsigned comment added by 142.244.143.177 (talk) 01:52, 18 May 2011 (UTC)

Word missing in Diagnosis section

In addition vacuum-assisted breast biopsy (VAB) may help diagnose breast cancer among patients with a mammographically detected breast (what??) in women.[52]

lump? tumor? mass?

Elinruby (talk) 10:43, 20 March 2011 (UTC)elinruby

You don't need to type your account name after the four tildes; the tilde signature-code adds it automatically.

I don't know the answer to your question. The source (PMID 20130983) says exactly that. I wonder if this detail is really worth mentioning on this page. WhatamIdoing (talk) 20:05, 24 March 2011 (UTC)

well, the sentence does not make sense the way it is. I hesitate to try to fix it because this is not my field. The entire sentence for that matter could go.... of course biopsy helps diagnose cancer. — Preceding unsigned comment added by Elinruby (talk • contribs) 07:46, 22 June 2011 (UTC)

Chemotherapy section questions

Main page does not mention Taxol or ACT. Does mention CAT tho, so perhaps this is an oversight? Or is this combination unusual? I'd also love to see a risk-benefit analysis for adriamycin somewhere -- probably not on this page -- but I am not sure that actually exists anywhere let alone on wikipedia. — Preceding unsigned comment added by Elinruby (talk • contribs) 11:19, 20 March 2011 (UTC)

Aren't CAT and ACT the same thing? WhatamIdoing (talk) 20:22, 24 March 2011 (UTC)

I dunno. Are they? — Preceding unsigned comment added by Elinruby (talk • contribs) 07:49, 22 June 2011 (UTC)

every lump in the breast

Pls is every lump found in one's breast cancerous — Preceding unsigned comment added by 41.73.13.162 (talk) 11:56, 1 June 2011 (UTC) No, but this is not the place to be seeking specific personal answers (if that is your intent). Nonetheless, from an intellectual perspective your question serves as a stimulus to some thought that the differential possibilities of breast lumps, or indeed mammographic abnormalities, which ARE in fact mentioned tangentially in the article ("clear fluid from lump indicates...") might be briefly but more clearly alluded to in the article.FeatherPluma (talk) 02:13, 5 July 2011 (UTC) I made a some minor adjustments to the text of the article to accommodate the intellectual perspective of your question; I personally think from the encyclopedia point of view that going further than what has been done is unnecessary. I hope any possible personal condition you have has been addressed by competent professional medical assessment.FeatherPluma (talk) 03:46, 7 July 2011 (UTC)

Prognosis

The Prognosis subject is poorly written. It provides little or no information for the general reader hoping to find information on possible outcomes. Instead the section gives a rather academic approach to the definition of prognosis. Survival figures are available evn though Breast Cancer is complex. Mercks Manual has a good approach, giving survival for various stages of a middle ground type tumor. This is far better than Wikipedia's Breast Cancer prognosis. ~ ~ ~ ~ — Preceding unsigned comment added by Oncologee (talk • contribs) 11:57, 14 August 2011 (UTC)

Yes please feel free to improve this page. Doc James (talk · contribs · email) 13:31, 7 September 2011 (UTC)

Anyone wanting this information about a specific, individual case will want to look at the ==External link== to CancerMath.net, which will provide an estimate based on the details of the specific case. Also, not for linking in the article, but this comic strip is pretty much reality: even if the average prognosis excellent, you could be the unexpected relapser—and even if it's lousy, you could be the unexpected survivor. WhatamIdoing (talk) 20:05, 14 September 2011 (UTC)

References

Reference no.63 - looks like vandalism as the URL directs to an article on Peyronie's disease. Shall I change back to the Breast Cancer section in the Merck Manual?Treagle (talk) 14:24, 12 September 2011 (UTC)

Following on from my comment about Reference no.63, I have been unable to edit the reference section as none of the items appear in the edit screen. Treagle (talk) 10:01, 13 September 2011 (UTC)

OK, a bit more digging reveals that several of the references that link to the Merck Manuals appear to have been vandalised. I have looked back thru to early 2010 to see when this might have occurred, but not found the event yet. I will continue to look back to see if I can find the original links, but it would be a good idea for regular editors / subject experts to check this entire article for accuracy in the mean time. I am only a casual Wikipedia editor with no expertise in this area (I only visited as I'm researching on behalf of a friends wife). It is a pretty shitty person who would vandalise these pages. — Preceding unsigned comment added by Treagle (talk • contribs) 10:24, 13 September 2011 (UTC) Treagle (talk) 10:28, 13 September 2011 (UTC)

Once I've tackled the Merck references I'll check the others. Hopefully they'll be OK. If anyone else feels better qualified to carry out this repair job just let me know. Treagle (talk) 16:09, 13 September 2011 (UTC)

The links for the following references to Merck hosted content are suspect: 9, 16, 48, 63 & 73. 9 & 16 link to Merck Home Manual articles on infertility. 48, 63 & 73 link to a Merck article on Peyronies disease. I will attempt to edit the URL's for these references. Treagle (talk) 10:24, 14 September 2011 (UTC)

OK, I've tried and failed to edit the References section. None of the references appear in the edit window for this section, so I guess there is some other mechanism for making changes to this section. I will try and find a Wikipedia contact associated with this article and ask for guidance.Treagle (talk) 10:30, 14 September 2011 (UTC)

I have check two of them 9 and 63 and they appear to work for me?Doc James (talk · contribs · email) 18:34, 14 September 2011 (UTC)

Hi Treagle,

Welcome to Wikipedia, and thank you for boldly attempting to fix the problem. The world needs more people like you! The reason you're not seeing the citations where you expected to is that the text is actually tucked away up in the article, next to the ^[63] label, and then the software gathers them up and displays them together at the bottom. So for ref #63 (currently; the numbers change automatically whenever anyone adds or removes one), you need to edit the "Treatment" section and look for the gobbledegook after the sentence closest to ref #63. That particular URL takes me to a reasonable-looking page, so perhaps that one has already been fixed. If it's not working for you, then you might need to clear the cache in your web browser.

BTW, if you're doing real-world research, you might like to look at http://www.ncbi.nlm.nih.gov/books/NBK20777/ It's 10 years old, so some statistics will be out of date, but it's a medical school textbook on cancer, freely available online, with a lot more information than could ever appear on Wikipedia. WhatamIdoing (talk) 19:57, 14 September 2011 (UTC)

Technical stuff

I've removed this from the lead:

Increased circulating levels of L-alpha-lysophosphatidylinositol (LPI) are associated with cancer and LPI is a potent, ligand for the G-protein-coupled receptor GPR55. Expression of Candidate of metastasis and protein 8, also known as NUPR1, correlate with outcome in breast cancer.The endogenous cannabinoid anandamide inhibits human breast cancer cell proliferation in a P8 dependent fashion, as do phytocannabinoids

because it plainly doesn't belong there. I'm just not sure where it does belong. It's densely technical, and probably of no value to 99% of our readers. Is there some more specialized Pathophysiology of breast cancer somewhere? WhatamIdoing (talk) 19:38, 9 November 2011 (UTC)

Sourcification

After James (Jmh649 (talk · contribs)) posted on WT:MED that this was a very high-traffic article I thought I'd come and have a look. What strikes me is how many of the references are not quite what one would call WP:MEDRS-compliant. Many of them are information pages and such, and I even noticed an abstract published at an ASCO conference. This could really do with fixing. I've tidied a few references, and will try to make some time over the next few days to sort out some of the weaker sources. JFW | T@lk 14:02, 22 November 2011 (UTC)

I wrote some of it, and added references mostly to NEJM, Harrison's and Merck Manual. I came back to look at it and it had been extensively edited, with most of the references lost.

Agree some sources aren't too good. If you look at the end of the following source, you'll see that Genentech paid for it to be ghostwritten by a third party:

Jahanzeb M (August 2008). "Adjuvant trastuzumab therapy for HER2-positive breast cancer". Clin. Breast Cancer 8 (4): 324–33. doi:10.3816/CBC.2008.n.037. PMID 18757259. --Nbauman (talk) 05:25, 12 February 2012 (UTC)