Zusammenfassung
In der Epidemiologie, bei genauer Betrachtung aber auch bei klinischen Studien, geht es um Untersuchungsergebnisse in Form von Häufigkeitszahlen oder Wahrscheinlichkeiten — Risikowahrscheinlichkeiten oder Erfolgswahrscheinlichkeiten. Dieses probabilistische Denken erfordert eine mentale Abstraktionsfähigkeit, die oft überfordert, und die Welt abstrakter Zahlen wird zudem häufig als zu „kalt“ abgelehnt — besonders bei einer schrecklichen Erkrankung wie dem Brustkrebs. Das ärztliche Alltagsdenken sowie auch die Vorstellungswelt der Patienten orientiert sich vielmehr an Bildern von Krankheiten, ihren Mechanismen und deren Bedrohlichkeit. Ich will deshalb einführend das emotionale Bild des Brustkrebses als bösartige Erkrankung, die in der gefühlsbeladenen Brust lokalisiert ist, mit dem heutigen Wissensstand konfrontieren.
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Literatur
Grady D, Rubin SM, Petitti DB, Fox CS, Black D, Ettinger B, Ernster VL, Cummings SR (1992) Hormone therapy to prevent disease and prolong life in postmenopausal women. Ann Intern Med 117:1016–1037
Nielsen M, Jensen J, Andersen J (1984) Precancerous and cancerous breast lesions during lifetime and at autopsy. Cancer 54:612–615
Schmidt JG (1992) Früherkennung und Umgang mit Risikofaktoren. In: Kochen MM (Hrsg) Allgemeinmedizin. Hippokrates, Stuttgart, S 133–149
Sacks NP, Baum M (1993) Primary management of carcinoma of the breast. Lancet 342:1402–1408
Cuzick J, Stewart H, Rutqvist L, Houghten J, Edwards R, Redmond C, Peto R, Baum M, Fisher B, Host H et al (1994) Cause-specific mortality in long-term survivors of breast cancer who participated in trials of radiotherapy. J Clin Oncol 12:447–453
Price A, Robinson L, Corner J, Yarnold JR (1995) Treatment of breast cancer. Lancet 343:427–428
Jacobson JA, Danforth DN, Cowan KH, d’Angelo T, Steinberg SM, Pierce L, Lippman ME, Lichter AS, Glatstein E, Okunieff P (1995) Ten-year results of a comparison of conservation with mastectomy in the treatment of stage I and II breast cancer. N Engl J Med 332:907–911
Bailar JC III (1995) Surgery for early breast cancer — can less be more? N Engl J Med 333:1496–1498
Gazet JC, Markopoulos C, Ford HT, Coombers RC, Bland JM, Dixon RC (1988) Prospective randomised trial of tamoxifen versus surgery in elderly patients with breast cancer. Lancet 1:679–681
Henderson C, Canellos GP (1980) Cancer of the breast — The past decade. N Engl J Med 302:17–30,78–90
Fisher B, Anderson S, Fisher ER, Redmond C, Wickerham DL, Wolmark N, Mamounas EP, Deutsch M, Margolese R (1991) Significance of ipsilateral breast tumour recurrence after lumpectomy. Lancet 338:327–331
Devitt JE (1994) Breast cancer: have we missed the forest because of the tree? Lancet 244:734–735
Schmidt JG (1990) Response to Dr Shapiro’s dissent. J Clin Epidemiol 43:235–239
Shapiro S, Strax P, Venet L (1971) Periodic breast cancer screening in reducing mortality from breast cancer. JAMA 215:1777–1785
Collette HJA, Day NE, Rombach JJ (1984) Evaluation of screening for breast cancer in a nonrandomized study (the DOM project) by means of a case-control study. Lancet I: 1224–1226
Verbeek ALM, Hendriks JH, Peeters PH, Sturmans F (1984) Reduction of breast cancer mortality through mass screening with modern mammography. First results of the Nijmegen project 1975–81. Lancet I:1222–1224
Tabár L, Fagerberg CJ, Gad A, Baldetrop L, Holmberg LH, Grontoft O, Ljungqvist U, Lundstrom B, Manson JC, Eklund G et al (1985) Reduction in mortality from breast cancer after mass screening with mammography. Lancet 1:829–832
Palli D, Del-Turco MR, Buiatti E, Carlis S, Ciatto S, Toscani L, Maltoni G (1986) A case-control study of the efficacy of a non-randomized breast cancer screening program in Florence (Italy). Int J Cancer 38:501–504
Andersson I, Aspegren K, Janzon L, Landberg T, Lindholm K, Linell F, Ljungberg O, Ranstam J, Sigfusson B (1988) Mammographic screening and mortality from breast cancer: the Malmö mammographic screening trial. BMJ 297:943–948
Roberts MM, Alexander FE, Anderson TJ, Chetty U, Donnan PT, Forrest P, Hepburn W, Huggins A, Kirkpatrick AE, Lamb J et al (1990) Edinburgh trial of screening for breast cancer: mortality at seven years. Lancet 335:241–246
Frisell J, Eklund G, Hellstrom L, Lidbrink E, Rutqvist LE, Sornell A (1991) Randomized study of mammography screening — preliminary report on mortality in the Stockholm trial. Breast Cancer Res Treat 18:49–56
Miller AB, Baines CJ, To T, Wall C (1992) Canadian national breast screening study: 2. Breast cancer detection and death rates among women aged 50 to 59 years. Can Med Assoc J 147:1477–1488
Miller AB, Baines CJ, To T, Wall C (1992) Canadian national breast screening study: 1. Breast cancer detection and death rates among women aged 40 to 49 years. Can Med Assoc J 147:1459–1476
Nyström L, Rutqvist LE, Wall S, Lindgren A, Lindqvist M, Ryden S, Andersson I, Bjurstam N, Fagerberg G, Frisell J et al (1993) Breast cancer screening with mammography: overview of Swedish randomised trials. Lancet 341:973–978
Schmidt J (1988) Die Brustkrebs-Vorsorgeuntersuchung: Die kritische und praktisch relevante Beurteilung wissenschaftlicher Daten. Argument (Berlin) AS 178:100–122
Baum M (1995) Screening for breast cancer, time to think — and stop? Lancet 346:436–437
Guyatt G, Sackett DL, Sinclair JC et al. (1995) Users’ guides to the medical literature — IX. A method for grading health care recommendations. JAMA 274:1800–1804
Wettstein W (1994) Wenig Nutzen, aber viel Angst. Weltwoche 31:18
Schmidt JG (1990) The epidemiology of mass breast cancer screening: a plea for a valid measure of benefit. J Clin Epidemiol 43:215–225
Bouvier P, Doucet H, Jenneret O, Raymond L, Strasser T (1995) Ethische Fragen bei der Früherkennung. Schriftenreihe SGGP 43 1
Schmidt JG (1992) Natural history of breast cancer. Lancet 339:810
Eddy DM (1989) Screening for breast cancer. Ann Intern Med 111:389–399
Wright CJ, Mueller CB (1995) Screening mammography and public health policy: the need for perspective. Lancet 346:29–32
Roberts MM (1989) Breast screening: time for a rethink? BMJ 299:1153–1155
Bucher H, Gutzwiller F (Hrsg) (1994) Checkliste Gesundheitsberatung und Prävention. Thieme, Stuttgart New York
Krass S (1996) Das Prinzip Risiko. NZZ-Folio 7:28–29
Bundesamt für Gesundheitswesen und Schweizerische Krebsliga (1996) Nationales Krebs-Bekämpfungsprogramm. Brustkrebs: Fakten und Handlungsbedarf
Drummond MF, Stoddart GL, Torrance GW (1987) Methods for the economic evaluation of health care programmes. Oxford University Press, Oxford
Allebeck P, Bolund C, Ringback G (1989) Increased suicide rate in cancer patients. A cohort study based on the Swedish cancer-environment register. J Clin Epidemiol 42:611–616
Quinn M, Allen E (1995) Changes in incidence of and mortality from breast cancer in England and Wales since introduction of screening. BMJ 311:1391–1395
Bailar JC, Smith EM (1986) Progress against cancer? N Engl J Med 314:1226–1232
Swanson GM, Ragheb NE, Lin CS, Hankey BF, Miller B, Horn-Ross P, White E, Liff JM, Harlan LC, McWhorther WP et al (1993) Breast cancer among black and white women in the 1980s. Changing patterns in the United States by race, age, and extent of disease. Cancer 72:788–798
Early breast cancer trialists’ collaborative group (1992) Lancet 339:1–15, 71–85
Levy JA (1995) HIV research: a need to focus on the right target. Lancet 345:1619–1621
Hislop TG, Waxier NE, Coldman AJ, Elwood JM, Kan L (1987) The prognostic significance of psychosocial factors in women with breast cancer. J Chron Dis 40:729–735
Ramirez AJ, Craig TK, Watson JP, Fentiman IS, North WR, Rubens RD (1989) Stress and relapse of breast cancer. BMJ 298:291–293
Spiegel D, Bloom JR, Kraemer HC, Gottheil E (1989) Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet 11:888–891
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Schmidt, J.G. (1996). Was bringt das Screening beim Brustkrebs? Contra-Standpunkt. In: Haller, U., Köchli, O.R. (eds) Verhandlungen der Schweizerischen Gesellschaft für Gynäkologie und Geburtshilfe und der Schweizerischen Gesellschaft für Psychosomatische Gynäkologie und Geburtshilfe. Archives of Gynecology and Obstetrics. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-37809-0_27
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