Talk:Breast cancer

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,[1] 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. 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.

---

--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 [2]. 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 [3], 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.[4] 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:

• The Personal Is Scientific, the Scientific Is Political: The Public Paradigm of the Environmental Breast Cancer Movement
• Racing for the Cure, Walking Women, and Toxic Touring: Mapping Cultures of Action within the Bay Area Terrain of Breast Cancer futurebird 01:53, 30 October 2007 (UTC)

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: [5]). 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%: [6].

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: [7]. (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)

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)