Talk:Mammography/Archives/2014

Missing paragraph?

I just removed the sentence "Similarly, the risk of breast cancer to women over 55" from the Potential Risks section as it was incomplete; there was no period and it led directly into another unrelated sentence. It seems a paragraph was partially deleted at some point; anyone better with the history tools than me able to find out what it was and either restore it or confirm that it should be removed completely? —Preceding unsigned comment added by 66.74.164.155 (talk) 16:30, 17 November 2009 (UTC)

Sweden

As I understand it sweden was a pioneering country in starting the mass screenings for cancer with this method, since 1986 these are done on the entire population above a certain age. If there are good sources on this info, maybe it should be in the article? —Preceding unsigned comment added by 81.62.174.205 (talk) 15:22, 12 April 2009 (UTC)

Restoring sections from 5 March 2006 edit deleted by 205.188.117.67)

Today while researching a local news story, I discovered major sections of this article critical of mammography had been deleted by a vandal. As documented by Jim Hightower in his "Middle of the Road" book, by Sourcewatch and by Alternet, there is a propaganda campaign launched by industry to hide the actual causes of breast cancer. I have thus reverted these lost sections in the public interest ... Bhuston 12:02, 8 June 2006 (UTC)

removed oncogen AC references

june 25, 2006 Removed statements regarding "Oncogene AC". This statement was taken verbatim from another reference and the source of this data is not noted anywhere. Further, I performed a literature search and found no references to Oncogene AC in the context of radiation sensitivity or breast cancer. The statement that 10,000 cases of cancer will be cause by radiation to women as a result of this gene is not verifiable (by me) and will frighten women who have a genetic predisposition to cancer (BRCA 1 and 2) and dissuade them from getting mammography. In fact, it has been shown that mammography is even more important in these women, since it will find the cancers that they frequently develop, prior to their being palpalble. Thus leaving in this statement can cause women harm and its removal is necessary

If someone can supply the original research reference regarding oncogene AC, please do so.

Pshaffer 02:18, 26 June 2006 (UTC)

clarified false negative discussion

removed statement regarding numbers of false negatives attributed to NCI officials (the links did not link to reserach data, but to the general NCI pages, which did not allow the reader to assess the data. Also added information allowing readers to gain perspective on what the presence of false negatives might mean.

I am currently reviewing a recent paper that appears to have the most accurate information regarding false negative rates. When this is reviewed, it will be added. Pshaffer 03:16, 26 June 2006 (UTC)

Restoring beginning section

it seemed to me that the beginning of the article is missing. therefore i tried to restore this section. could anyone please be so kind to look over it? thanks. Minkus 20:37, 25 July 2006 (UTC)

Dose

The dose of radiation is contradictory throughout this article. At the beginning it says it's a low dose, 0.7 mSv. First off, this should be mGy since later you talk about rads which is the archaic measure of absorbed dose that has been superceeded by the Gray.

In any case, later on it says 1-10 rads, with 1 rad being modern. This is 0.01-0.1 Gy or 10-100 mGy, roughly in the same ballpark as 10-100 mSv, and no where near the claimed 0.7 mSv.

I don't know what the right thing to do here is, but the article should probably pick Grays or Sieverts and stick with them, and someone needs to figure out what the right numbers are. Gigs 17:10, 13 October 2006 (UTC)

Actually, scratch that, big parts of this article are copyvio from http://www.organicconsumers.org/Politics/mammogram092905.cfm. Deleting.

Safety

Some discussion on safety of mammograms and consequences of exposure levels would be good. Can someone add that stuff? 149.167.200.118 21:11, 10 November 2006 (UTC)

Radiation risks and external links

I've tagged a few statements which appear to be cited to Dawn Prate regarding supposed radation risks of mammography. They are completely out of line with the actual published literature on radiation risk (e.g. PMID 9709287 or the NCI and USPTF statements) and are both incorrect and alarmist. Similarly, the external links section contained a wide range of links inappropriate under Wikipedia's guidelines on external links - including those which "mislead the reader through the use of factually incorrect information or unverified research", those which are primarily promotional in nature, and those which require registration to view. I've removed these. MastCell ^Talk 17:33, 9 April 2007 (UTC)

I have tried to verify risks of the method but the reference, which was an external website, was removed or relocated. URL update would be appreciated. Number 18: "Screening for Breast Cancer: Recommendations and Rationale" From the United States Preventive Task Force, a section of the Agency for Healthcare Research and Quality. Released February 2002; accessed April 9, 2007.

Mammography is not a treatment

"Mammography has been shown to reduce mortality from breast cancer."

I have a problem with this statement (besides the lack of a source). It's not mammography that reduces mortality, it's the actions taken as the result of a mammogram (mastectomy, biopsy, brachytherapy etc.) that reduce mortallity. Does anyone disagree? --63.240.90.36 (talk) 23:28, 16 September 2008 (UTC)

Here's a reference to a very large and detailed analysis: http://www.cochrane.org/reviews/en/ab001877.html 76.182.46.60 (talk) 11:38, 13 October 2008 (UTC)

Question

One question isn't addressed in the article: what if the woman has small breasts? How will the screening process work? 142.166.205.185 (talk) 00:15, 16 February 2009 (UTC)

The same as in all other women; Mammography is almost always possible, regardless of breast size (even in men). --WS (talk) 19:28, 30 July 2009 (UTC)

Undoing revision 309965068 (left/right switch)

Revision 309965068 switched "left" and "right" in the Results image caption without comment or discussion that I can find. I'm thinking it was vandalism, but I'm not knowledgeable on this subject, and would appreciate someone making sure the way it is now is accurate. --Renophaston (talk) 05:53, 20 September 2009 (UTC)

The dangers of Mammograms

Not only is the ionizing radation harmful for the human body but the compressions from Mammograms as well. No age is a good age to have a Mammogram. They should ban them from the U.S. and around the world. —Preceding unsigned comment added by 207.69.139.160 (talk) 23:54, 25 November 2009 (UTC)

I'd be interested to know more about this. Every single person I know who's had a mammogram says it's excruciatingly painful (including people with very small breasts, not just big ones). It strikes me that something which causes that much pain cannot be good for you, and might even initiate cancer or spread cancerous cells.Rowan Adams (talk) 09:03, 12 November 2011 (UTC)

Interesting idea, but an experiment to investigate this is likely to be deemed unethical. Fortunately there are new methods that aren't painful (also faster, with less exposure to radiation). Norman21 (talk) 12:41, 12 November 2011 (UTC)

Mammography vs. Sonography

Maybe I missed it, but was there any mentioning of pre-menopause women having denser breast with less fat tissue/more glandular tissue, hence less suitable or mammography? txs schomynv 11:54, 16 January 2010 (UTC) —Preceding unsigned comment added by Schomynv (talk • contribs)

Radiation does cause cancer, risk may be outweighed absent genetic susceptibility to radiation

"... Several recent studies suggesting that carriers of pathogenic alleles in DNA repair and damage recognition genes may have an increased risk of breast cancer following exposure to ionizing radiation, even at low doses[73]. Based on review of 117 studies related to screening mammography the authors concluded that “the risk for death due to breast cancer from the radiation exposure involved in mammography screening is small and is outweighed by a reduction in breast cancer mortality rates from early detection.”[74].

A. Sarvazyan,1 V. Egorov,1 J.S. Son,2 and C.S. Kaufman3 Cost-Effective Screening for Breast Cancer Worldwide: Current State and Future Directions

Breast Cancer. Author manuscript; available in PMC 2009 July 2.

Published in final edited form as: Breast Cancer. 2008 July 2; 1: 91–99.

PMC 2613364 NIHMSID: NIHMS70779 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2613364/

Cardis E, Hall J, Tavtigian SV. Identification of women with an increased risk of developing radiation-induced breast cancer.

Breast Cancer Res. 2007;9(3):106.

Comment on:

   * Breast Cancer Res. 2007;9(2):R26. 

In the previous issue of Breast Cancer Research, Broeks and collaborators present the results of a study suggesting that germline mutations in BRCA1, BRCA2, ATM or CHEK2 may double the risk of radiation-induced contralateral breast cancer following radiotherapy for a first breast cancer. The assocation appeared to be strongest among women who were below the age of 40 at the time of their first breast cancer and among women who developed their second cancer 5 years or more after the first. While there were a number of methodological issues that might limit the conclusions drawn from this paper, this is one of several recent studies suggesting that carriers of pathogenic alleles in DNA repair and damage recognition genes may have an increased risk of breast cancer following exposure to ionising radiation, even at low doses. This finding has important implications for the protection of breast cancer patients and their close relatives. If confirmed, mutation carriers may wish to consider alternatives to X-ray for diagnostic purposes. The need for tailored cancer treatment strategies in carriers should also be evaluated carefully.

PMID 17617928

Cf.

Jansen-van der Weide MC, de Bock GH, Greuter MJW et al. Mammography screening and radiation-induced breast cancer among women with a familial or genetic predisposition: a metaanalysis. Presented at the 2009 annual meeting of the Radiological Society of North America. November 29-December 4, 2009, Chicago, IL. Abstract R022-04. —Preceding unsigned comment added by 66.167.95.147 (talk) 21:57, 14 March 2010 (UTC)

Citation Needed

What is the citation for, "Often women are quite distressed to be called back for a diagnostic mammogram. Most of these recalls will be false positive results. It helps to know these approximate statistics: of every 1,000 U.S. women who are screened, about 7% (70) will be called back for a diagnostic session (although some studies estimate the number closer to 10%–15%). About 10 of these individuals will be referred for a biopsy; the remaining 60 are found to be of benign cause. Of the 10 referred for biopsy, about 3.5 will have a cancer and 6.5 will not. Of the 3.5 who do have cancer, about 2 have a low stage cancer that will be essentially cured after treatment." Thank you.Reichspot (talk) 14:05, 6 October 2010 (UTC)

Material to incorporate?

The following was added to an article where it didn't belong (absorbance). I just deleted it there, but maybe it belongs in this article? Or a different article? (Risk factors for breast cancer#Mammographic density?) Or its own article? Here it is:

Mammographic density

Mammographic density refers to the relative proportions of radiodense area compared to the radiolucent area on a mammogram, which is basically an x-ray of the breast. The radiodense area on a mammogram is white and is associated with ductal and lobular epithelium, connective tissue and fluid in the breast. The radiolucent area is dark gray or black and is associated with fat in the breast. High mammographic density is associated with a higher risk of developing breast cancer, but the reasons for this link are not certain.

Good luck, thanks! --Steve (talk) 00:21, 10 December 2010 (UTC)

Request

REQUEST REMOVAL OF SEXIST, PATRONIZING LANGUAGE "However, some women who receive false-positive results become anxious, worried and distressed about the possibility of having breast cancer, feelings that can last for many years."

I think that this comment is sexist and patronizing, and should be deleted. We are talking about ADULT women, who are presumed capable of handling their "feelings." Please weigh the damage from (resolved) anxiety of a false positive against the damage of undetected breast cancer. Uvahoo (talk) 12:25, 4 June 2011 (UTC)

No problem: Just go convince all the expert reliable sources in the world to stop saying that a very large number women spend the time in between scheduling the mammogram and (finally) getting the results worrying that they might have cancer.

Wikipedia reports what the sources say, even if the sources say things that make you suspect that 100% of women are not emotionless robots who never worry that a cancer test will come back positive. I'm not going to censor out the well-document fact that humans sometimes experience unpleasant emotions merely because you believe that acknowledging this fact is "sexist" and "patronizing". WhatamIdoing (talk) 04:38, 28 October 2011 (UTC)

Fwiw, I'm pretty sure this statement would apply to men also about testicular cancer, etc. 74.250.138.188 (talk) 16:28, 30 October 2011 (UTC)

Unclear statement in the Procedures section

My comment is regarding a sentence about digital mammography in the Procedures section of the article. The paragraph states, "Until some years ago, mammography was typically performed with screen-film cassettes. Now, mammography is undergoing transition to digital detectors, known as digital mammography or Full Field Digital Mammography (FFDM). The first FFDM system was approved by the FDA in the U.S. in 2000. This progress is some years later than in general radiology."

What does the last sentence quoted above mean? (i.e., "This progress is some years later than in general radiology.") I could not figure out the intent of the sentence so that I could fix it. Rwindell (talk) 21:43, 20 July 2011 (UTC) R. Windell

Proposed deletion: Research alternatives to mammography

I propose the section, Research alternatives to mammography, be deleted. It's all about one commercial product, and doesn't have one good citation. We don't usually include research like this in a general article about something as important as mammography anyway.

We don't even have as much about digital mammography, which at least has some good publications in major journals. --Nbauman (talk) 18:55, 21 September 2011 (UTC)

Don't think the whole section should go, it covers several methods. Since some of these methods are being promoted as adjuncts to or replacements for mammography, I think it makes sense to cover them in the mammography article (if only to point out that they have not been demonstrated to have utility in primary screening, etc.) (Don't have to cover it from the research angle, could cover items that are being marketed as replacements/adjuncts to mammography, and their costs/limitations/proved benefits/etc.)

The material on Breastlight/Transillumination (which may be most of what you are referring to about one commercial product) does need condensation or removal. I flagged it with the advertising tag, I would be fine with removal of the two paragraphs about breastlight. Or paring it down to brief mention of transillumination, if there are research efforts in that area. Zodon (talk) 20:19, 23 September 2011 (UTC)

I checked the citation on Breastlight. It found 30% of the cancers in a group of women with diagnosed breast cancers. This is early research and not particularly promising. There are many other diagnostic technologies that are just as far or farther along. This is the kind of unproven basic research that usually gets deleted from WP articles. So it's not WP:NOTABLE. There are no secondary sources that say it's promising, so it's WP:RS. I'm deleting Breastlight. --Nbauman (talk) 18:19, 25 September 2011 (UTC)

Neutrality concern

Maybe I'm just being paranoid but there are a lot of references in this article that seem intended to play up fear factors and imperfections about mammography. While it definitely has its weaknesses along with its strengths I am concerned about lack of neutrality creeping into the article. I removed one kinda blatant (at least to me) example but someone else might want to take a closer look. Not sure how to flag it unfortunately. 74.250.138.188 (talk) 16:31, 30 October 2011 (UTC)

E.g., (one of many examples) "Some feel that these cancers are likely to be found at the next screening, still at a curable stage, and therefore it remains to be proven whether CAD will be eventually found to have any effect on patient outcome." [emphasis added] Isn't that like textbook weasel words? 74.250.138.188 (talk) 16:34, 30 October 2011 (UTC)

K, figured out how to add it :p 74.250.138.188 (talk) 16:37, 30 October 2011 (UTC)

To give more concrete examples, imo the downsides of mammography are overemphasized in the introduction (think it's ok to mention once, but my understanding is that it's not seen as THAT useless in the medical community, maybe I'm misinformed though). I deleted a reference to needle aspirations not being shown to spread cancer because it seemed irrelevant and meant only to insert the idea into people's heads. It gets a whole section on how it doesn't work in Results - again I think this is worth mentioning but deserves its own section (but should be confined to it and one mention in the intro, again just my take). It then has an entire section on risks that looks at least as long as any other section in the article, and is THEN followed by critiques. It basically just smells like someone pushing an anti-mammogram pov. Again I'm not against talking about its weaknesses, because like anything it will have them, and it may more than usual. Just don't like seeing an important article hyped so strongly against it when my understanding at least is that they're seen as generally useful in certain situations.

P.S., since this might not be noticed otherwise, please also check into Dr. Samuel S. Epstein, who is mentioned by name as a reference in the article. I don't know this guy well, but a quick looking around makes me suspect he's not the most dependable source. Though maybe that's not enough to remove it, I don't know Wikipedia policy that well... anyway I've more than said my schpiel here. (Sp?) Bon appetit. 74.250.138.188 (talk) 16:50, 30 October 2011 (UTC)

a minority of doctors believe that mammography DOES NOT reduce deaths from breast cancer?

Someone wrote that in the last sentence of the first paragraph. Not only is this untrue, but there are no citations for that. I believe whoever wrote that was referring to some old controversy a few years back which is addressed fully in this citation I am about to give you. This citation also includes new research that proves 100% without a doubt that mammograms reduce death by breast cancer. I don't know how to add citations, and I feel that I may get into a pissing match with people if I make an edit without giving a citation. This is the citation:

http://articles.latimes.com/2011/jun/28/health/la-he-mammography-20110628

I actually asked my attending about this (I'm on my ob/gyn rotation right now), and he mentioned that if a doctor here in the U.S. would ever recommend that a patient NOT get a mammogram because "they do not reduce cancer deaths", then that doctor will be standing in front of his state's medical board in no time. I guess what I'm trying to say is that those "minority doctors" who believe that mammograms don't help have now left that side of the debate (or they've left the practice of medicine).

Boonshofter 12:44, 15 April 2012 (UTC) — Preceding unsigned comment added by Boonshofter (talk • contribs)

The problem, evidently, is that mammograms often lead to harms from "diagnosis" stress, harmful tests and procedures, and increased risk of other cancers (from chemo, radiation and stress). Reduces death for some, but clearly more often causes harm. See http://www.cochrane.dk/screening/mammography-leaflet.pdf

Don't quote practitioners or your attending, but rather meta analysis of recent research.32cllou (talk) 00:14, 24 June 2012 (UTC)

The Cochrane Committee now recommends against mammograms for women of all ages

[1]

No better source that that. Comments before I fix the article?32cllou (talk) 18:31, 23 June 2012 (UTC)

We already state this here "The Cochrane analysis of screening indicates that it is "not clear whether screening does more good than harm". Have removed your addition due to style issues rather than concerns regarding the source as we already use this source here. Doc James (talk · contribs · email) (please reply on my talk page) 02:26, 25 June 2012 (UTC)

I'll paraphrase asap, thanks. The 2012 findings are more comprehensive and will be the focus. Does more harm than good for specific reasons cited.32cllou (talk) 15:24, 25 June 2012 (UTC)

Yes adding a line like. "The Cochrane Committee recommends against mammograms for women of all ages." would be good if the above ref supports it. I am unable to find support in this ref though. Can you quote the supporting text here? Doc James (talk · contribs · email) (please reply on my talk page) 01:36, 26 June 2012 (UTC)

Agreed I do not see in either source wording that can support the strong language proposed. We also want to make sure we give appropriate WP:WEIGHT here; while Cochrane is an excellent source, it is not the only source. Yobol (talk) 03:11, 26 June 2012 (UTC)

Lead

This section is a continuation of the conversation at Talk:Prostate-specific antigen#Use of paraphrase or quotes. Callanecc (talk) 14:15, 27 June 2012 (UTC)

The lead does not need to be supported by refs (but can be). It must however be supported by the body of the articles and the body of the article must be supported by references. Doc James (talk · contribs · email) (please reply on my talk page) 00:06, 27 June 2012 (UTC)

Good idea to move and info supported in body refs. But show me where you support those sentences.

So sorry net benefit B grade moderate binnial 50 - 74. I usually read a page in a slow glance, and missed then shot off sorry. Researching for hours anticancer properties for tea then having it all deleted left me jaded.32cllou (talk) 00:34, 27 June 2012 (UTC) Babysitting now more tomorrow.32cllou (talk) 00:36, 27 June 2012 (UTC)

Have fixed some of it. Doc James (talk · contribs · email) (please reply on my talk page) 16:20, 27 June 2012 (UTC)

Thanks for the fix. Is the paraphrase OK? I removed the first sentence cause what women in countries did before updated info is not valuable info. I'd like to find another picture showing a mammography image being taken with the breast realistically hard smashed not gently pressed as shown. Painfully for majority. Where so you get realistic pictures?32cllou (talk) 03:24, 29 June 2012 (UTC)

I moved the discussion of the Nordic Cochrane to lower in the article (the lead is too long as is). I also restored the previous wording about the US task force as more consistent with their recommendations. Yobol (talk) 03:37, 29 June 2012 (UTC)

The cochrane 2012 is more important than the cochrane 2011, so I will remove that if you require. The lead is shorter than most so I disagree with your general ojbection. Please advise immediately. Seems your the one edit waring. I just updated the article with newest info from cochrane the most preferred reference.32cllou (talk) 03:51, 29 June 2012 (UTC)

We should be using the systematic review as the more authoritative source (per WP:MEDRS). A patient handout from one part of Cochrane is probably less authoritative than the systematic review. Yobol (talk) 03:54, 29 June 2012 (UTC)

Wrong as the cochrane is always preferred and they refer to that leaflet. thus linked and cochrane also thus fully authoritative. see discussion in PSA test.32cllou (talk) 04:04, 29 June 2012 (UTC) It is a UPDATED (even better than the 2011 cochrane) systematic review just written in lay terms. same diff when I paraphrase as requested.32cllou (talk) 04:05, 29 June 2012 (UTC)

I disagree. Let's wait for input from other editors to get some other opinions on which sources are more appropriate for lead. Yobol (talk) 04:15, 29 June 2012 (UTC)

Had other opinions see PSA. See WP:IRS cochrane is PREFERRED ref.32cllou (talk) 04:27, 29 June 2012 (UTC)

We need to add back higher risk of mastectomy w mammo screening.32cllou (talk) 04:38, 29 June 2012 (UTC)

Both are Cochrane produced. One is the systematic review and the other is based on the systematic review. Both basically say the same thing. From my brief look at it. Doc James (talk · contribs · email) (please reply on my talk page) 05:36, 29 June 2012 (UTC)

Screening vs diagnostic mammography

I think our article doesn't make a good distinction between screening and diagnostic mammography. The risk/benefit analysis doesn't apply equally to both. Yobol (talk) 03:47, 29 June 2012 (UTC)

Doesn't seem to apply to lead.32cllou (talk) 03:54, 29 June 2012 (UTC)

It applies to every part of the article. This talk page is for a discussion of the improvement of the article as a whole, not just what you are interested in. Yobol (talk) 03:56, 29 June 2012 (UTC)

Yes applies to all but no distinction prb in current lead. See current.32cllou (talk) 04:07, 29 June 2012 (UTC)

Again, I started this section to discuss improving the article with respect to differentiating diagnostic and screening mammography. If you have a comment about that topic, please say so, otherwise please stop responding with off topic commentary about whether or not you find it relevant. If you don't not find it relevant, then don't respond. Yobol (talk) 04:11, 29 June 2012 (UTC)

You said every part and I said don't see prb in lead.32cllou (talk) 04:13, 29 June 2012 (UTC) The second para deals only with mammography screening.32cllou (talk) 04:14, 29 June 2012 (UTC)

Proposal to move information to Breast cancer screening

Much of the information in the risks and benefits section seems more appropriate for the breast cancer screening article. We could move the majority of the information there, leaving a condensed summary with hatnote to the main article there. Yobol (talk) 04:08, 29 June 2012 (UTC)

I'll place 2012 Cochrane into BS once you find it OK.32cllou (talk) 04:11, 29 June 2012 (UTC)

Most of that info is old less accurate so fix it before moving. See WP:IRS and update.32cllou (talk) —Preceding undated comment added 04:30, 29 June 2012 (UTC)

Let me know when you have updated all that old bad info to Cochrane 2012 info see 32cllou (talk) 00:16, 30 June 2012 (UTC)

While Cochrane is a great source, we do not use it to the exclusion of everything else.Doc James (talk · contribs · email) (please reply on my talk page) 00:16, 9 July 2012 (UTC)

Cochrane is based on the largest, longest data set of studies. Until a more complete analysis is published, Cochrane (per wiki too) is primary. You are free to submit what you think is better for discussion here before inclusion.32cllou (talk) 00:29, 9 July 2012 (UTC)

No we provide a balanced overview of the high quality literature from the last 5 years. Continued removal of other high quality sources will result in you being blocked for disruptive editing. Remember Wikipedia is based on consensus. Doc James (talk · contribs · email) (please reply on my talk page) 01:31, 9 July 2012 (UTC)

I have reviewed wiki policy and do not find an arbitrary 5 year inclusion rule. Please direct me to that entry. Non factual info should not be moved but rather deleted. You know that Cochrane 2012 is using the same trials in meta as prior reviews, but with more complete data leading to stronger broader findings and recommendations, which are always preferred to more weaker (less data) prior statements. Consensus never outweighs clear known fact. And you know Cochrane is preferred primary. Looks like your disruptive non factual editing will lead you to be global wiki banned.32cllou (talk) 07:52, 11 July 2012 (UTC)

Please review WP:MEDRS again, we use reviews from the past 5 years. Cochrane is only one of many possible sources to use, and continually trying to imply that it is the only source that we should use is going to get you nowhere. Implications that Doc James is going to get "wiki banned" for enforcing our guidelines and policies are laughable on its face. Yobol (talk) 16:19, 11 July 2012 (UTC)

Proposal to remove marketing picture of mammography

Someone needs to find a picture that is accurate. The current picture is of a young woman, not a 50 year old. Her breast is barely pressed by the machine. Her breast is severely smashed hard in a normal image procedure. 50% of women complain of pain during or after the procedure, and actual complaints are typically fewer than actual pain. Please provide or the picture will be removed.32cllou (talk) 22:16, 8 July 2012 (UTC)

Disagree, this seems to be an adequate pictorial representation, which the National Cancer Institute (the source of the picture) seems to find appropriate enough. Yobol (talk) 22:34, 8 July 2012 (UTC)

Feel free to proposal another but do not support the removal of this one.Doc James (talk · contribs · email) (please reply on my talk page) 00:12, 9 July 2012 (UTC)

You here state that the picture is representative?32cllou (talk) 00:28, 9 July 2012 (UTC) PS you're a working DR, you should take a pic with permission to wiki. I don't think we should have a pic at all since the procedure is not recommended anyway.32cllou (talk) 17:10, 9 July 2012 (UTC) Yobol, I couldn't find that pic on the NCI website please direct me.32cllou (talk) 17:15, 9 July 2012 (UTC)

Here. Yobol (talk) 17:23, 9 July 2012 (UTC)

Thank you, NCI pic can be left in if you insist, though it is not representative of fact. Will look for accurate depiction.32cllou (talk) 19:11, 9 July 2012 (UTC)

US POV

Only seems to mention US practice. Could mention Canada, UK, Australia etc and even non-english speaking countries. - Rod57 (talk) 14:48, 12 March 2012 (UTC. I agree, would be helpful to know more about the regulation & practices of nations other than US. Anyone able to add?