Comments on: Genetic tests for cancer

By: Anonymous

Anonymous — Fri, 14 Sep 2007 21:13:00 +0000

This is anon 12:55 (again);

I just wanted to say I'm sorry for my initial responses, and apologize to Mike that (I think) unfairly and somewhat caustically went after him.

In retrospect I over-reacted. I'm not a doctor...but i do get the gist of what people are saying about limitations of BRCA screening...particularly as it applies to men.

Anyways, thanks to you all with clearer heads than mine.

By: Anonymous

Anonymous — Fri, 14 Sep 2007 13:33:00 +0000

BRCA 1 is not clearly associated with an increased risk of male breast cancer though BRCA 2 is associated. But let’s be honest here, male breast cancer IS a rare entity with about 1,000-1,500 cases per year diagnosed. The bigger issue here is that BRCA testing should probably only be ordered by an oncologist trained in inherited malignancy syndromes (that would not be all oncologist’s by the way) in conjunction with genetic counseling. There needs to be a complete review of a family pedigree by a professional who can clearly document the risk of breast cancer occurance and the possible association of an inherited malignancy syndrome (we aren’t just talking breast cancer here guys). Frankly most docs aren’t qualified to do a good job of risk assessing the need for testing in thise setting let alone the lay public. But it is not about evidence-based medicine here, it is about Myriad making some $$$ on the fears of getting cancer. Disgusting.

By: Anonymous

Anonymous — Fri, 14 Sep 2007 00:47:00 +0000

Very unfortunate 12:55. I think that makes you miss the forest (big picture) from the tree (your father). I don’t know of any evidence of the BRCA gene and male breast cancer. Please provide links if I am wrong.

By: Anonymous

Anonymous — Thu, 13 Sep 2007 19:25:00 +0000

Mike,

I am anon 12:55

My father died of breast cancer because his physician ignoring his lump told him "men don't get breast cancer".

I never said you were sexist. If anything I'd say you're ignorant. If you really are a doctor, do your patients a favor and retire.

By: Mike

Mike — Thu, 13 Sep 2007 01:10:00 +0000

anon 12:55

If you are going to honestly sit there with a straight face and argue that male breast cancer is the issue alluded to, and that BRCA testing concerns mostly male patients, then you are just a complete and utter waste. Yes. lots of men worry about losing a breast. You're a joke.

But I know you'll never admit the stupidity of yoursexism remark. You can't win that one dear. And I'd love to see how youremove male ovaries. Let me know.

By: Alla

Alla — Wed, 12 Sep 2007 14:58:00 +0000

Anon at 12:55 – the breast cancer is much rarer in men, so consequently the probability is significantly lower than men would get genetic testing for breast cancer. Also, the example of ovaries is the most obvious one of unintended harm that came to mind. At least to me, given that I am a woman. I am sure doctors could find examples for men as well. It is utterly ridiculoous to bring up sexism because an example of unintended harm featured a woman.

medfriendly – another important criteria of screening tests is whether or not they actually decrease mortality from the desease.

I was the anon at 3:55 – clicking anonymous is quicker.

By: Anonymous

Anonymous — Wed, 12 Sep 2007 05:55:00 +0000

Mike, I truly hope you are not a doctor. Men get breast cancer too.

By: MedFriendly

MedFriendly — Wed, 12 Sep 2007 03:33:00 +0000

To properly judge the adequacy of this screening tests, we need to know a few basic statistics about it:
1) Sensitivity: the % of cases in which the test produces a positive result in people with breast cancer.
2) Sensitivity: the percent of cases in which the test produces a negative result in patients without cancer.
3)Positive predictive value: the probability that someone with a positive test result actually has breast cancer
4) Negative predictive value: the probability that someone with a negative test result does not have breast cancer.

Dominic A. Carone, Ph.D.
Founder and Webmaster of MedFriendly.com and The MedFriendly blog.

By: Anonymous

Anonymous — Wed, 12 Sep 2007 03:27:00 +0000

We have someone who doesn’t know what they are talking about in our midst. The article refers to breast cancer. This is MUCH more common in women (although very deadly in men too when it occurs due to the rarity). I can’t remember which BRCA it is, but there is also an increased risk of ovarian cancer with the breast cancer. So let’s say it is a false positive. I can see this leading to some very big problems. And just double checking by doing the same test won’t alleviate these problems.

By: Mike

Mike — Wed, 12 Sep 2007 03:08:00 +0000

anon 9:14

sexism??? The article is about breast cancer.