Overdiagnosis and Overtreatment- Challenging the Status Quo

Making progress requires making change, and often that means challenging the status quo.  As scientists and researchers working to improve breast cancer prevention, detection, and treatment, we literally put the norms to the test by evaluating new approaches in comparison to existing standards of care.

Over the past years breast cancer experts have learned a lot about breast cancer biology and how some cancers behave. We’ve learned that some are slow growing and less likely to cause harm, and others are much more aggressive and dangerous. Technology has also improved to help detect some cancers earlier, but these are usually the slow growing cancers, whereas the most aggressive cancers are often found by women themselves between routine screenings. In recent years there has been greater recognition that overdiagnosis – defined as detecting a cancer, often through screening, that would not have caused symptoms in a person’s lifetime- represents an important harm from breast cancer screening.  Subsequently diagnoses and treatment continues to rise, but annual deaths due to aggressive breast cancers remain unchanged.

These facts have forced WISDOM’s researchers to ask hard questions that challenge the norms such as – Do we need to redefine what we call cancer? Are we doing our best to detect the cancers that are most dangerous? What is the impact of detecting and treating cancers that aren’t likely to become a danger? Are there better ways to keep an eye on non-harmful cancers? Are there ways to prevent them from ever progressing?   How can we make sure we are providing the right level of care without doing too much, or not enough?

Concerns around overdiagnosis and overtreatment in breast cancer are not new, but there is new work being done to try and get to answers and solutions.  We invite you to learn more about these topics by reading the following articles:

  • Hot off the press, This ARTICLE discusses the “overdiagnosis industry” and alternatives that may be less harmful to patients, featuring Dr. Esserman, WISDOM’s founder.
  • This ARTICLE reviews a new study on the impact of diagnosing and treating less harmful cancers specifically in women over age 70.

We’d love to hear your thoughts on these important issues. Email us your perspectives at wisdomcommunity@ucsf.edu


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