Thursday, July 16, 2015

CLARIFICATION NEEDED: MASTECTOMY AND METASTASIS. INPUT PLEASE!

My goal is to always speak in ways that all may hear. That, however, does not mean I will sit on the sidelines if something is off kilter. Slightly left or right of center? To each their own. To either extreme and my surly claws are out.

Two things. Or as is generally the case, likely half a dozen, but at this moment as I begin typing, it's just two things. First, I need some clarification with a quote that appeared in an article in the Wall Street Journal. I would like someone to elaborate and by someone, I mean someone who can point me to the evidence based research to back a statement that appeared in the Wall Street Journal in an article entitled:

The Double Mastectomy Rebellion

I'm going to bypass the title. Rebellious? Defiant? I think I may, in the age of shared decision making and patient centricity and encouraging patients to play an active role with their clinicians, take offense at the title but this debate has been raging for quite some time. A prominent surgeon wrote an op-ed in a medical journal suggesting that insurance companies refuse to pay for any mastectomy that the surgeon deems medically not necessary. I wrote about that in August of 2013. I was a bit irritated at the paternalistic tone in the article.

The Wall Street Journal took two years to pick up the story and decided to highlight this rebellion. Except for many of us, it's not a rebellion. It's a decision. It's a choice. It's something we feel strongly about doing. We are not being defiant as the title would suggest. We are asking questions, educating ourselves and participating in the informed decision making process. Rather than reinvent the wheel, I'd suggest you click back to my August, 2013 post. It hits the high notes.

Besides the choice of headline, I'd really like some of my doctor/researcher friends to point me to the studies to show me this is an accurate, scientifically studied statement and not just some sort of observational or anecdotal message that was thrown into the article. It jumped off the page at me because frankly, this did cross my mind as I was making my own decision in 2006.

Can someone tell me if this is true? And, if indeed it is true, point me to the research please.

"Meanwhile, doctors say, returning cancer is much more likely to spread or metastasize elsewhere in the body, such as bones, the liver or the brain."

I'd really like to know where this statement came from. Was it actually the doctors? Was it the interpretation of the author (and if so, why are the lungs left out... do your homework)? Is it a scare tactic to stop the defiant women from the ongoing rebellion? OR, is it scientifically true?

If it happens to be the latter of those statements, it would seem to me, the rebellion would be over.

Is this opinion, chatter or is it based on some form of evidence?

Weigh in, please. I could use some answers. And so could the rest of us.

I said two things earlier, didn't I? Well, the second thing can wait. If you head over to my personal Facebook page, you will see what that was all about. My page, like my life, is completely open for all to see so we don't need to be "friends" for you to read about the fact that I'm so over the use of the prevention word and I'm tired of complaining about promoting breast cancer awareness by using the body parts that I've long since had tossed into that medical waste field.


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