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Be Careful What You Wish For

File this under “BE CAREFUL WHAT YOU WISH FOR”:

Two recent articles question the value of advancing some of medicine’s newest diagnostic tools -- unless or until we have the professional knowledge and expertise to interpret them and/or effective health care treatments to address the ills uncovered.

In the first, studies (and lawsuits) suggest some pathologists have failed to keep pace with the increasing sophistication and sensitivity of mammograms and, as a result, are overdiagnosing and/or misdiagnosing ductal carcinoma in situ, or D.C.I.S., and other less common invasive breast cancers.  The advice:  If irregular cells are seen on a mammogram and a biopsy is recommended, consult only with pathologists who review at least 250 biopsies a year and with breast cancer specialists and seek additional opinions of the diagnosis before deciding upon surgery, radiation, or chemotherapy.

The second outlines proposed new guidelines for earlier diagnoses of Alzheimer’s Disease -- but argues, particularly because of the presence of plaque in most aging brains,  MRIs and brain scans can also misdiagnose and overdiagnose early-stage Alzheimer’s leading to unnecessary mental anguish and family stress at a time when no treatments have been successful in repairing or improving diminishing cognitive skills.  Other tests for earlier detection involve an analysis of spinal fluid, and while these are believed to be potentially more accurate diagnostic tools, they are invasive and expensive.  And again, medicine has no known effective treatments, making earlier detection relatively useless and potentially harmful -- if not cruel -- emotionally.