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As far as death from breast cancer, screening mammogram has been studied. A lot. And a lot of people have a vested interest in proving mammograms to be 1) beneficial, 2) not beneficial and 3) needing more study.

You can’t remove the human element from anything. Most studies show benefit of mammography as a screening tool. But most studies have at least some bias (like 85%!).

Here is a meta-analysis, a study of many studies: https://pmc.ncbi.nlm.nih.gov/articles/PMC11885354/

MAHDOOD 8mo ago 💬 1

85% bias is crazyyy 😂

First sentence of the results section says:

“Of the 28 systematic reviews included, only 17.9% were rated as low risk of bias.”

Is this helpful to look at? Why was this even published? lol

Just from the introduction, it is suggesting that the meta analysis is focusing on false positives and improving early detection. It’s not about whether the screening itself is increasing risk.

This is one of my frustrations with the medical field. They begin addressing a problem with a presumption that a certain action is necessary and good (i.e. mammograms). For example, there has never been a long term placebo controlled double blind comparative study on any vaccine ever. And the reason they won’t do it is because they claim it would be unethical to withhold vaccines from the control group. But how is it unethical to withhold an unproven treatment? That means they start with the presumption that vaccines are safe and effective. A lot of what the medical industry does is pseudo science and it’s frustrating.

If you’re aware of any comparative studies regarding vaccines or mammograms please share them with me🫡

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Discussion

Dr. Bitcoin, MD 8mo ago 💬 1

You misunderstand the meta analysis and your actual question. Your question is equivalent to: “do mammograms decrease the rate of death by breast cancer?”

I’m gonna leave other subjects out of this for the moment because we will end up skimming the surface without being rigorous about what proof we actually seek.

That said, a better question than yours would be: “do mammograms increase lifespan?”

See the subtle difference? What good is it to save women from breast cancer if they become unbelievably more likely to die by lightning strike or alien abduction precisely because of mammograms? Competing causes of death matter and looking at lifespan allows us to consider all causes of mortality, reasonable and otherwise. To my knowledge, it’s never been proven reducing breast cancer by any means actually increases lifespan. It’s an assumption that treating disease leads to increased lifespan. It’s logical, but hard, expensive, and takes a very long time to study.

The meta analysis looks at 28 studies of breast cancer mortality reduction…the comparison groups are those who don’t use mammogram for detecting breast cancer. We have tons of data on rate of death for many diseases over many decades; we assume old rates are relevant today, and that’s a big issue with vaccines. Because the diseases the last few decades of childhood vaccines have been intended to prevent have become so rare, what is the acceptable risk from the vaccine itself? In the old days, risk of disease was high. But now risk of disease is low and our ability to treat is better. A similar argument can be made for breast cancer: treatment is better now than 20 years ago, does early detection still matter?

The rabbit holes go deep. But one common theme you’ll find is the real science rabbit holes are unbelievably deep; the pseudoscience rabbit holes are rather shallow, surprisingly shallow some times.

MAHDOOD 8mo ago 💬 1

That was not my question.

My question is: how do you know that women are better off doing regular mammograms than women that never do them? Are there any placebo controlled double blind comparative studies?

Just comparing lifespan or mortality rates isn’t good enough because there are other factors that play in like nutrition, stress, socioeconomic status, education. Correlation doesn’t equal causation.

Dr. Bitcoin, MD 8mo ago 💬 1

Better off? Financially? Lifespan? Mortality —All cause or breast cancer specific?

I think your question is more about prospective vs. retrospective.

Placebo controlled double blind prospective trials are the most definitive and by far the most expensive.

But they’re not always appropriate.

Suppose I have a treatment that prevents death from all causes and can even reverse death from any cause if used shortly after death.

How do I prove it works? If I keep the treatment to myself and wait until I’m 250 years old to share it, surely people will believe…but is that proof?

Suppose I give it to my family and friends and we all live to ages exceeding 200, but some die by car/boat/plane crash and the treatment can’t be applied. Is that proof?

Suppose I make the treatment fully available to anyone who wants it. And 50 years later we notice the number of humans claiming to be age 100-130 years old start to explode, but we also see plenty of people dying between 70-90. I would argue this is not proof, but it is good enough.

Suppose we put everyone in the world on this treatment and 100 years go by and the annual rate of death per drops from 750 per 100,000 to 10 per 100,000…I would argue this isn’t proof, but it is also good enough.

So how would we genuinely prove effectiveness of my treatment? Well, in a world where anyone and everyone can have it if they desire, we find volunteers or enslave/imprison people and assign some of them to the control group and others to the treatment group. Wait until 100% of one group is dead and then tell the world our results. I would argue this is proof but is evil to do to humans.

MAHDOOD 8mo ago

I was thinking better off in terms of health but I guess you could say financially too.

Breast cancer therapeutics industry is estimated to be worth about 34 billion and projected to double in less than 10 years. These placebo controlled trials are expensive but that’s not an excuse. There is plenty of money to do a study like that. But they don’t want to because this is their cash cow. I think you’d agree with me that this industry has incentive to diagnose and treat more breast cancer patients.

“So how would we genuinely prove effectiveness of my treatment? Well, in a world where anyone and everyone can have it if they desire, we find volunteers or enslave/imprison people and assign some of them to the control group and others to the treatment group. Wait until 100% of one group is dead and then tell the world our results. I would argue this is proof but is evil to do to humans.”

Based on your own words, you are admitting there isn’t any real scientific proof these mammograms are effective.

I agree with what you are saying for the most part. I guess where we diverge is your claim that it is evil or unethical to have a control group. It was considered “evil and/or unethical” to leave schizophrenics untreated in the past. So they did lobotomies on them instead. Doing that today would be considered evil. See how that becomes problematic? What is considered evil or unethical can change and we can’t be so confident that we are immune to making similar errors.

The medical field consistently starts with a presumption that treatment is necessary before finding any real evidence through experiments. Imagine 100 years from now, we are on a bitcoin standard and we’ve flushed out all the fiat funding and government influence from the medical field. Can you imagine a scenario where the medical field, in a free market, finds a different way to diagnose breast cancer without radiation. This new diagnostic tool becomes the standard and they find that the rate of breast cancer diagnoses has actually gone down because of this less harmful diagnostic measure? In this scenario the world may look back at our time period as insane for using radiation, the same way we look back at doctors doing lobotomies on schizophrenics.

Just some food for thought. Thanks for indulging me in this conversation it was very interesting and civil 🫡