COVID-19 vaccination and screening mammography
Reports of enlarged lymph nodes under the arm after COVID-19 vaccination have led doctors to tweak mammography guidelines. Antivaxxers, unsurprisingly, have tried to weaponize this observation to spread fear and confusion about these vaccines.
Dichotomous thinking and uncertainty in medicine and science
Medicine is by its very nature uncertain. Unfortunately, humans don't deal well with uncertainty, and our tendency towards dichotomous thinking leads us to think that if we're not absolutely certain about something we don't know anything.
Mammography and overdiagnosis, revisited
Another new study supports the hypothesis that overdiagnosis is a major problem in mammography screening programs. Predictably, it is attacked based on a misunderstanding of what overdiagnosis is.
When science- and evidence-based guidelines conflict with patient wishes: What’s a doc to do?
We use the term "science-based medicine" (SBM) because medicine isn't a science. The best medicine, however, is based in science. Patient values are also important, but what is a science-based doctor to do when SBM conflicts with what a patient or family wants?
Reclassifying thyroid cancer and the willful misunderstanding of overdiagnosis
If there’s one lesson that we here at Science-Based Medicine like to emphasize, it’s that practicing medicine and surgery is complicated. Part of the reason that it’s complicated is that for many diseases our understanding is incomplete, meaning that physicians have to apply existing science to their treatment as well as they can. The biology of cancer, in particular, can be vexing....
The American Cancer Society’s new mammography guidelines: Déjà vu all over again
One of the things that feels the weirdest about having done the same job, having been in the same specialty, for a longer and longer time is that you frequently feel, as the late, great Yogi Berra would have put it, déjà vu all over again. This is particularly true in science and medicine, where the same issues come up again and...
The uncertainty surrounding mammography continues
Mammography is a topic that, as a breast surgeon, I can’t get away from. It’s a tool that those of us who treat breast cancer patients have used for over 30 years to detect breast cancer earlier in asymptomatic women and thus decrease their risk of dying of breast cancer through early intervention. We have always known, however, that mammography is an...
Mandatory breast density reporting legislation: The law outpaces science, and not in a good way
Over the years, our bloggers here at Science-Based Medicine have written time and time again about the intersection of law and science in medicine. Sometimes, we support a particular bill or law, such as laws to protect children against religion-inspired medical neglect; laws making it harder for manufacturers of homeopathic “medicines” to deceive the public; or California Bill AB 2109, a bill...
In which Dr. Gorski is taken to task by an eminent radiologist for his posts on mammography
Introduction: An unexpected e-mail arrives One of the consequences of the growing traffic and prominence of this blog over the last few years is that people who would otherwise have probably ignored what I or my partners in blogging write now sometimes actually take notice. Nearly a decade ago, long before I joined this blog as a founding blogger, if I wrote...