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January 15, 2013

'Overdiagnosis' on table for medical talk

“There’s no such thing as breast cancer,” says Dr. Rich Sagall.

Sagall— physician, vice chairman of Gloucester’s Board of Health, and founding president of NeedyMeds, the innovative national RX savings program — will, he promises, clarify what he means by this when he diagnoses the ills of today’s diagnostic practices at tonight’s monthly gathering of the Cape Ann Skeptics — an organization he also helped found.

His talk, starting at 6:45 p.m. at Main Street’s La Trattoria restaurant, covers a spectrum from how cure rates can be manipulated, to how health care providers get credit for cures they shouldn’t.

Its title focus — “Are you really sick? Overdiagnosis, misdiagnosis, and the natural course of disease” — touches on topics that are giving rise to growing concern in medical science circles, with recent research debunking the value of everything from early screenings (including mammograms) to “medicalizing” social disabilities like shyness into conditions like “social anxiety disorder” requiring “treatment” and “medication.”

Sagall, who places a high value on having a good heathy skepticism about everything, has been keeping an increasingly skeptical eye on breast cancer. And he’s not alone. Google the words ‘“overdiagnosis breast cancer,” and you’ll find headlines in some of the most esteemed medical publications, including the New England Journal of Medicine, and BMJ (formerly the Boston Medical Journal).

Sagall feels the issues surrounding overdiagnosis have become important enough to warrant flagging the public’s attention any which way he can — even if it’s with risking readership wrath by declaring “there’s no such thing as breast cancer” in a cancer-conscious community like Cape Ann.

What Sagall means, he explains, is that “‘breast cancer’ is actually an umbrella term used to describe multiple cancerous conditions and stages of conditions that can occur in the breast. Along with multiple variants, there are multiple factors — the patient’s age, general health, family medical history, her own medical history, etc. all of which can contribute to very different implications for any given patient. Including the fact that, left untreated, an early stage tumor may never grow, an early stage condition may never progress, or actually regress.”

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