WHY SCREENING HAS NOT STOPPED METASTASIS?

This may explain why more deaths aren't prevented by breast cancer screening

Thus the LA Times titles an article based on an essay by three cancer scientists, published in the New England Journal of Medicine.

  

“The article starts:  “the incidence of metastatic breast cancer — the kind that has already spread to another organ by the time it is found — has remained essentially unchanged since 1975.”

“The idea, of course is to catch cancer before it can spread.”  As we read on, we may want to say instead, ..the idea has been to catch it before it spreads. Not working so well for us.

The article's surprise is a comparison of our BC non-success story with the success, believe it or not, of the prostate cancer screening situation.  Catching prostate cancer early has improved amazingly since discovery of a blood test for an antigen specific to the prostate – PSA.  Metastatic prostate cancer has been basically halved. 

So far it seems there is no similar antigen for breast cancer.  We have been screening, and screening, and our numbers don't change.

The essay suggests two possible reasons why our BC situation fails to succeed.

I’m going to copy their reasons direct from the LA Times:

“The first is that mammograms just aren’t good enough to find metastatic breast cancers before they spread. If there were a breast cancer equivalent of PSA — a biomarker that could be found in blood — perhaps screening outcomes would be different.

A more likely explanation is that breast cancer doesn’t necessarily start in one place and then spread to others.  Indeed, breast cancer researcher extraordinaire Dr. Bernard Fisher argues that by the time the cancer can be detected, it has already become a systemic disease.

To me, Dr. Fisher, seems to be agreeing with the first explanation, seems to say the starting cells are too little to find, and they’re on the move early.

But breast cancer may not start in just one place?!

I know our major hospitals basically seem to agree with Dana-Farber, the one I’ve quoted recently.  D-F states "All breast cancers initially form inside the milk duct near the area where the duct meets the milk gland, or lobule..."

Yet the essayists are not alone in thinking it's how the cells start and how they act.  Their “more likely explanation” has been hinted at before.  

Let’s go back to another article:

  https://www.nlm.nih.gov/medlineplus/news/fullstory_154216.htmlTHURSDAY, Aug. 20, 2015 (HealthDay News)  Early Stage Breast Cancer Far From a Death Sentence: Study  

See HEN BACKTALK post "... AND MAMMOGRAM WARS" October 7, 2015

“… Narod (study author) explained.:

 " 'In all, 956 women in the study ultimately died of breast cancer. Of those, 517 never had invasive cancer in the breast after treatment seemed to cure their DCIS. That means that the cancerous breast cells from their DCIS had escaped at some point and survived in the lungs or bone, later developing into a deadly cancer' “  (Bolding mine)

 "...seemed to cure their DCIS."  That stopped me in my tracks the first time I read it.

But Dr. Narod's explanation is right on point with the essayists from Times/NEJM article.  He,insists that 

         DCIS cells escaped, probably before or during the original treatment, 
         and “survived in the lungs or bone."

Perhaps these two reports are only a tip of the iceberg.  But their bottom line for us is this: that we’ve been mammogrammed, perhaps repeatedly, but perhaps...

AFTER the DCIS cell train had already left the station, bound for the rest of our bodies.

           

More later on possible cancer cells in the blood  

I wish you health.

http://www.latimes.com/science/sciencenow/la-sci-sn-breast-prostate-cancer-progression-20151028-story.html