[Editor’s note: Dr. Charles Dinerstein, M.D. is Senior Medical Fellow at the American Council on Science and Health.]
The diagnosis of breast cancer begins with identifying “a lump” whether detected by the patient or by screening mammography which detects more smaller lumps because it is more sensitive in finding the proverbial ‘needle in the haystack.’
Because our science showed that as cancer got larger, it became ‘more aggressive,’ we sought to find lumps earlier before the situation becomes more difficult or hopeless…It wasn’t simply that size mattered, but for mammography, it was all that could be measured. Once identified, the lump biopsied, cancer confirmed and treatment initiated.
[In this study, the researchers] correlated the size of breast cancer at detection with the three markers we use to measure biological behavior, the grade (increasing abnormal appearance of the cells), and the response to estrogen and progesterone.
If you look across the categories of tumor size, the percentage of cancers with favorable biologic behavior decrease. Proof that size does matter. But when you look at the individual columns, you see that size is heterogeneous regarding behavior. Some small tumors are biologically very aggressive (unfavorable in the chart) and others not so much…The authors conclude, “Both tumor size and biologic features influence prognosis, but frequently a large favorable tumor can have a better prognosis than a small unfavorable tumor.”
[Read the full study here (behind paywall)]
The GLP aggregated and excerpted this blog/article to reflect the diversity of news, opinion, and analysis. Read full, original post: Can Small Breast Cancers Be Good? The Dance Of Therapy And Diagnosis