The treatment of breast cancer provides another example of professional uncertainty. There is considerable variability in the use of surgery, radiotherapy, and chemotherapy. The best treatment of very early stage breast cancers and of ‘pseudo-cancers’ of the breast is unresolved, as is the ideal number of lymph nodes to remove from the armpit, or indeed whether any should be removed at all.
As if that were not enough, topics of particular interest to patients, such as relief of fatigue associated with therapy, or the best way of treating lymphoedema of the arm – a distressing and disabling aftermath of surgery and radiotherapy in the armpit – still have not been tested adequately.
Next: Addressing uncertainties about the effects of treatments