LETTER : Breast cancer: we all know the bad news

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I READ Dr Smith's "Second Opinion" (Review, 7 May) with some disquiet. It seemed yet another article full of depressing details about survival from breast cancer.

One does not need statistics to prove that "early detection remains the best hope" rather than chemotherapy, nor that mammography has an important part to play. However, for those pre-menopausal women for whom Dr Smith concedes that chemotherapy is more effective, a general screening programme is not yet regarded as justifiable or even of proven use, and they must fall back on traditional examination, which may not result in the earliest detection.

I was further troubled by the comments on chemotherapy. First the standard treatment today is different from that in Italy in the 1970s, and insufficient emphasis was laid on this. Worse, Dr Smith's remarks about side-effects were likely to raise exaggerated fears among those about to undergo treatment. "Chemotherapy" is an emotive word, with images of hair loss, extreme sickness and debilitation, none of which formed part of my own experience. The worst elements were extreme tiredness and consequent irritability.

A year after my mastectomy I know that I am living with a potential time bomb but I also know the importance of a positive attitude to continued recovery. I appreciate the fostering of this by the medical team caring for me and wish that newspaper and magazine articles would follow suit rather than dwelling on mortality.

Frances M Green

Stowe, Bucks

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