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Early detection of breast cancer is critical. Yet efforts to cut back on mammography or even stop screening altogether have been gaining ground in the medical community's decades-long debate over testing and treatment. It is not a purely scientific debate--back-room politics and hidden agendas have played as much a role as clinical data, leading to some surprising conclusions.
Written by one of the first physicians in the country to specialize in breast cancer risk assessment, genetic testing and high-risk interventions, this book focuses on the screening controversy and explains the arguments used on both sides. The author covers the history of screening, from the first mobile unit on the streets of Manhattan to the cutting edge imaging technology of today.
List of contents
Table of ContentsAcknowledgments
Preface
1.¿Last Word vs. Final Word
2.¿Early Diagnosis May Be the Key, but It's Not a Lock
3.¿Biology Can Trump, but Size Matters
4.¿Prostate Is Not Breast, So Give It a Rest
5.¿The Four Horsemen That Inflate the Power of Mammography
6.¿The Four Horsemen Are Throttled by Clinical Trials, but O Canada!
7.¿The Mammography Civil War (1993-1997)
8.¿The Number Games
9.¿The (Over)Selling of Mammography
10.¿The Evidence for Evidence-Based Medicine (or, How to Raise the
Bar of Bias: An Editorial)
11.¿Blame It on Canada (and Something's Rotten in Denmark, Too)
12.¿Overdiagnosis: Embracing Your Inner Malignancy
13.¿Overdiagnosis Part 2: A Way Out of the Wet Paper Bag
14.¿The Task Force Opens Fire
15.¿The Zombies Among Us
16.¿Circumstantial Evidence-Based Medicine
17.¿The Social Tsunami of Anti-Screening
18.¿The 2015 ACS Peace Accord-Science or Societal Pressure?
19.¿A Journey to the Pathology Lab to View the By-Products of Screening
20.¿Risk-Based Screening-It Feels So Right, but Wait...
21.¿The Greatest Story Never Told
22.¿The Myth of Mammography
23.¿Do These Genes Make Me Look Dense?
24.¿The Emperor of All Modalities
25.¿The Bright Side of the Dark Side of the Force
26.¿The Crystal Ball Is Fair to Partly Cloudy
Chapter Notes
Bibliography
Index
About the author
Alan B. Hollingsworth, M.D., serves as medical director of Mercy Breast Center, a screening and diagnostic facility at Mercy Hospital, Oklahoma City. He received his MD with Distinction from the University of Oklahoma College of Medicine in 1975 where he was elected First vice-president of Alpha Omega Alpha Honor Medical Society. He completed a residency in general surgery at the University of Oklahoma that included a one-year fellowship in surgical pathology at UCLA. He limited his practice to breast cancer surgery in the 1980s and was the founding medical director of Oklahoma's first multidisciplinary breast clinic at his alma mater where he was also named as the first holder of the G. Rainey Williams Chair in Surgical Breast Oncology. He was one of the first physicians in the country to begin a formal risk assessment program in 1993, and today his practice is limited to risk assessment, genetic testing, and multimodality screening for high-risk patients.
