Skip to main content

Part of the book series: Archives of Gynecology and Obstetrics ((AGYO))

  • 43 Accesses

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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 44.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 59.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. 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

    Article  CAS  PubMed  Google Scholar 

  2. Nielsen M, Jensen J, Andersen J (1984) Precancerous and cancerous breast lesions during lifetime and at autopsy. Cancer 54:612–615

    Article  CAS  PubMed  Google Scholar 

  3. Schmidt JG (1992) Früherkennung und Umgang mit Risikofaktoren. In: Kochen MM (Hrsg) Allgemeinmedizin. Hippokrates, Stuttgart, S 133–149

    Google Scholar 

  4. Sacks NP, Baum M (1993) Primary management of carcinoma of the breast. Lancet 342:1402–1408

    Article  CAS  PubMed  Google Scholar 

  5. 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

    CAS  PubMed  Google Scholar 

  6. Price A, Robinson L, Corner J, Yarnold JR (1995) Treatment of breast cancer. Lancet 343:427–428

    Article  Google Scholar 

  7. 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

    Article  CAS  PubMed  Google Scholar 

  8. Bailar JC III (1995) Surgery for early breast cancer — can less be more? N Engl J Med 333:1496–1498

    Article  PubMed  Google Scholar 

  9. 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

    Article  CAS  PubMed  Google Scholar 

  10. Henderson C, Canellos GP (1980) Cancer of the breast — The past decade. N Engl J Med 302:17–30,78–90

    Article  CAS  PubMed  Google Scholar 

  11. 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

    Article  CAS  PubMed  Google Scholar 

  12. Devitt JE (1994) Breast cancer: have we missed the forest because of the tree? Lancet 244:734–735

    Article  Google Scholar 

  13. Schmidt JG (1990) Response to Dr Shapiro’s dissent. J Clin Epidemiol 43:235–239

    Article  Google Scholar 

  14. Shapiro S, Strax P, Venet L (1971) Periodic breast cancer screening in reducing mortality from breast cancer. JAMA 215:1777–1785

    Article  CAS  PubMed  Google Scholar 

  15. 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

    Article  Google Scholar 

  16. 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

    Article  Google Scholar 

  17. 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

    Article  PubMed  Google Scholar 

  18. 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

    Article  CAS  PubMed  Google Scholar 

  19. 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

    Article  CAS  PubMed  Google Scholar 

  20. 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

    Article  CAS  PubMed  Google Scholar 

  21. 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

    Article  CAS  PubMed  Google Scholar 

  22. 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

    CAS  Google Scholar 

  23. 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

    CAS  Google Scholar 

  24. 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

    Article  PubMed  Google Scholar 

  25. Schmidt J (1988) Die Brustkrebs-Vorsorgeuntersuchung: Die kritische und praktisch relevante Beurteilung wissenschaftlicher Daten. Argument (Berlin) AS 178:100–122

    Google Scholar 

  26. Baum M (1995) Screening for breast cancer, time to think — and stop? Lancet 346:436–437

    Article  CAS  PubMed  Google Scholar 

  27. 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

    Article  CAS  PubMed  Google Scholar 

  28. Wettstein W (1994) Wenig Nutzen, aber viel Angst. Weltwoche 31:18

    Google Scholar 

  29. Schmidt JG (1990) The epidemiology of mass breast cancer screening: a plea for a valid measure of benefit. J Clin Epidemiol 43:215–225

    Article  CAS  PubMed  Google Scholar 

  30. Bouvier P, Doucet H, Jenneret O, Raymond L, Strasser T (1995) Ethische Fragen bei der Früherkennung. Schriftenreihe SGGP 43 1

    Google Scholar 

  31. Schmidt JG (1992) Natural history of breast cancer. Lancet 339:810

    Article  CAS  PubMed  Google Scholar 

  32. Eddy DM (1989) Screening for breast cancer. Ann Intern Med 111:389–399

    Article  CAS  PubMed  Google Scholar 

  33. Wright CJ, Mueller CB (1995) Screening mammography and public health policy: the need for perspective. Lancet 346:29–32

    Article  CAS  PubMed  Google Scholar 

  34. Roberts MM (1989) Breast screening: time for a rethink? BMJ 299:1153–1155

    Article  CAS  PubMed  Google Scholar 

  35. Bucher H, Gutzwiller F (Hrsg) (1994) Checkliste Gesundheitsberatung und Prävention. Thieme, Stuttgart New York

    Google Scholar 

  36. Krass S (1996) Das Prinzip Risiko. NZZ-Folio 7:28–29

    Google Scholar 

  37. Bundesamt für Gesundheitswesen und Schweizerische Krebsliga (1996) Nationales Krebs-Bekämpfungsprogramm. Brustkrebs: Fakten und Handlungsbedarf

    Google Scholar 

  38. Drummond MF, Stoddart GL, Torrance GW (1987) Methods for the economic evaluation of health care programmes. Oxford University Press, Oxford

    Google Scholar 

  39. 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

    Article  CAS  PubMed  Google Scholar 

  40. 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

    Article  CAS  PubMed  Google Scholar 

  41. Bailar JC, Smith EM (1986) Progress against cancer? N Engl J Med 314:1226–1232

    Article  PubMed  Google Scholar 

  42. 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

    Article  CAS  PubMed  Google Scholar 

  43. Early breast cancer trialists’ collaborative group (1992) Lancet 339:1–15, 71–85

    Google Scholar 

  44. Levy JA (1995) HIV research: a need to focus on the right target. Lancet 345:1619–1621

    Article  CAS  PubMed  Google Scholar 

  45. 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

    Article  CAS  PubMed  Google Scholar 

  46. Ramirez AJ, Craig TK, Watson JP, Fentiman IS, North WR, Rubens RD (1989) Stress and relapse of breast cancer. BMJ 298:291–293

    Article  CAS  PubMed  Google Scholar 

  47. 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

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

U. Haller O. R. Köchli

Rights and permissions

Reprints and permissions

Copyright information

© 1996 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

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

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-37809-0_27

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-37101-5

  • Online ISBN: 978-3-662-37809-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics