Health workers march in Spain’s capital against cuts, reforms






MADRID (Reuters) – Thousands of health workers, on strike since last month, marched on Sunday in Madrid to protest against budget cuts and plans from the Spanish capital’s regional government to privatize the management of public hospitals and medical centers.


It was the third time doctors, nurses and health workers have rallied since the local authorities put forward a plan in October to place six hospitals and dozens of medical practices under private management. The plan also calls for patients to be charged a fee of 1 euro for prescriptions.






Workers launched an indefinite strike last month against the plan, which has not been endorsed by the centre-right government of Prime Minister Mariano Rajoy. Health workers in the capital are striking Monday-Thursday each week and seeing patients only on Fridays, while also responding to emergencies.


Spain’s 17 autonomous regions control health and education policies and spending. They have all had to implement steep cuts this year as the country struggles to meet tough European Union-agreed deficit targets.


Dressed in white scrubs, the protesters shouted slogans such as “Health is not for sale” and “Health 100 percent public, no to privatizations”.


“Of course, privatization can be reversed. Actually the question is not if it can be reversed, because privatization should never have a future,” said Luis Alvarez, an unemployed man from Madrid attending the demonstration.


Belen Padilla, a doctor at Madrid’s hospital Gregorio Maranon, said one million citizens had already signed a petition rejecting the plan.


(Reporting by Reuters Television; Writing by Julien Toyer; Editing by Peter Graff)


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Extreme Franchising: RadioShack in Afghanistan












The next time you stroll through downtown Kabul, you might be able to buy batteries from a RadioShack (RSH) outlet, the result of a new effort by the U.S. to shore up Afghanistan’s economy: selling American franchises to Afghan entrepreneurs.


The U.S. has set a 2014 deadline for troops to withdraw from Afghanistan and turn security over to Afghan military and police. That is prompting capital flight, depressing property values, and triggering other economic pain. That’s where franchising might fit—and an initial foray into the country proved promising, U.S. executives say.












“I didn’t have huge expectations going there that we would consummate an agreement, but after being there on the streets and seeing some fairly sophisticated [retail] operators in a very difficult climate, I’ve walked away with the fact that we would do business in Afghanistan,” says Martin Amschler, a RadioShack vice president who joined several American franchise executives to participate in a five-day matchmaking event in Kabul this week.


Organized by the U.S. Department of Commerce, the U.S. Agency for International Development, and the International Franchise Association (IFA), the event gave franchising brass a chance to explore the market and meet with Afghan businessmen and U.S. and Afghan officials. Outside of mostly fast-food chains on bases, there aren’t any American franchises in Afghanistan, says Beth Solomon, a vice president at the IFA who led the trip. “There is a vast culture of young [Afghans] who are very tech savvy, Internet savvy. Everyone’s got the latest Samsung or iPhone,” she says, “and there is disposable income.”


The big idea behind the effort is the “knowledge transfer” of infrastructure-building and business services expertise to locals to help rebuild the country, says Solomon, who recruited participants from RadioShack, Hertz Equipment Rental (HTZ), Tutor Doctor, and AlphaGraphics. “Franchising can be a very useful transitional economic development strategy, because the challenges of security and so forth can be minimized because it’s Afghan business leaders who are going to run these businesses,” says Solomon.


Of course, with more than one-third of Afghanistan’s 30 million people living below the poverty line, according to the CIA’s World Fact Book, much of the population can’t afford to buy an American franchise.


Bill Edwards, a seasoned franchising consultant who specializes in exporting American franchise brands such as Build-A-Bear Workshop (BBW) and Denny’s (DENN), and was on the trip for AlphaGraphics, doesn’t see a lack of Afghan investors. “There’s a lot of money there” willing to invest in American franchises, Edwards says. “There’s a need for Western business. There’s a market, there’s consumers, there’s funding, there’s capital. But there’s all the other challenges, of course.”


Apart from security, the biggest challenge would be vetting prospective buyers, says RadioShack’s Amschler. “But at the end of the day there are private contractors over there today that provide those services … and then, of course, we would have our own list of requirements in terms of net worth and what types of business experience they have,” he says.


Approved Afghan buyers would attend RadioShack University at corporate headquarters in Fort Worth and get “support on the ground” from RadioShack employees for about two weeks when a store opens, plus training visits throughout the year, Amschler says.


Among other efforts to stabilize Afghanistan’s economy, how significant could franchising be? A statement from the Commerce Department’s International Trade Administration about the conference notes “franchising has proven to be an ideal market vehicle for both employment and economic growth.” Edwards says he thinks franchising is “the model” because “it brings a business model that’s proven. It brings training, which is the thing they need; the skill set is just really not good there.”


Education is crucial to Afghanistan, says Rogelio Martinez, vice president of international franchise development at 30-employee Tutor Doctor, a “supplementary education” business that has sold about 400 franchises in 14 countries. “It’s something that everybody was talking about. [Afghan] business owners wanted to develop Afghan employees to take mid-level, senior-level management positions. Families want their kids to learn and attend good universities in Afghanistan or abroad.”


The Van Nuys (Calif.) company, which Martinez says charges franchisees about $ 57,000 to get started, provides training and an online tool that uses a Skype-like interface for tutors and students to communicate online. He expects to sell about seven franchises in Afghanistan in 2013. “They can’t be importing expats all the time; they need to have the local talent to have a sustainable model,” says Martinez.


David Riker, franchise development director for Hertz, is also optimistic about his company’s prospects in Afghanistan. Unlike fellow participants on the Kabul trip, he already has franchises on two military bases there, renting heavy machinery used in building roads and construction projects. “As the military draws down, Afghanistan is going to have to support more of its infrastructure, so that’s where the opportunity comes in,” Riker says. Depending on what kind of equipment a franchise buyer wants, getting started is “probably in the $ 3 million range.”


Aiding Afghanistan through franchising certainly won’t be quick, says Edwards. “Let’s not be too Pollyannaish. This is going to be a challenge, but it’s definitely an opportunity.”


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James Cameron Relives Voyage to Ocean’s Deepest Spot












SAN FRANCISCO — The first thing James Cameron saw 7 miles below the sea was man-made: tracks from a remotely operated vehicle.


“When I got to the bottom, I saw skid marks from the ROV,” Cameron said yesterday (Dec. 4) here at the annual meeting of the American Geophysical Union, referring to a 2009 survey by the Monterey Bay Aquarium Research Institute. Scientific results of the film director’s expedition to the Mariana Trench were presented at the meeting this week, and Cameron and the researchers described the highlights to a packed crowd.












Cameron reported a new, corrected depth for his landing — 35,803 feet (10,912 meters) — which beats by five feet (1.5 m) the record set by U.S. Navy Lt. Don Walsh and Jacques Piccard in 1960 at the same spot. However, “because the error [calculating the depth] on Don’s dive is much greater, we’re just going to have to call it a tie,” Cameron said.


Deepsea Challenger


Cameron’s Deepsea Challenger expedition made dives to the New Britain Trench and the Mariana Trench in the southwestern Pacific Ocean between Jan. 31 and April 3, with one manned dive by Cameron to the Mariana’s Challenger Deep, the deepest spot in any ocean.


Unusual, never-before-seen species were snared and brought back to the surface. A bizarre microbial mat community was discovered living on altered rocks in the Sirena Deep, another deep pool 6.77 miles (10.9 kilometers) below the surface.


Changes in temperature and salinity starting at 26,200 feet (8 km) deep hint at an unknown current coming into the Challenger Deep, said Doug Bartlett, a microbiology professor at the Scripps Institution of Oceanography at UC San Diego.


The filmmaker journeyed inside a high-tech lime-green machine — a steel sphere encased in foam — dubbed the Deepsea Challenger. The expedition traveled with two unmanned seafloor “landers” — large contraptions hoisted over the side of a ship and dropped to the seafloor. Once on the bottom, bait attached to the lander lured seafloor creatures to the craft, and a suite of instruments took samples, photographs and data. [Images: James Cameron's Historic Deep-Sea Dive]


The two contraptions working together proved to be a very good system, Cameron said. “We could rendezvous on the bottom and see the results of that bait running for six to eight hours, and that’s how Doug could find a new species of giant arthropod,” Cameron said.


Challenging journey


The March 26 dive proved to be a physical and mental challenge for Cameron. “I did yoga for six months so I could contort myself into the sphere,” he said.


As he sank through the water, Cameron said he “burned though my whole checklist,” designed to distract him during the long hours of the dive. “I still had 3,000 meters left to go with pretty much nothing left to do but sit quietly and think about the pressure building up around the hull,” he said.


The sub touched down gently, and Cameron immediately took a sample of the seafloor, as planned. This was a good contingency, because the sub’s hydraulic fluid line then burst, leaving him unable to collect more samples.


To his surprise, the sub’s voice communications worked perfectly. “We actually expected they wouldn’t, and I would have to default to texting,” he said. “Texting while driving is not a good thing, especially if you’re using two hands to operate seven joysticks and you’re 7 miles down.”


Cameron first drove the sub about 200 meters, finding the seafloor elevation stayed the same. In fact, Challenger Deep turned out to be remarkably flat, and the sub was easy to drive. “The vehicle was quite nimble, the sub’s yaw rate was very good,” he said. (Yaw describes the left-to-right rotation of a craft.)


A quick return


After about three hours, some of the submersible’s batteries had low charge readings, the steering was problematic, and it was time to return to the surface. The mission should have lasted five to six hours. “I hate this. I hated having to go back,” Cameron recalled thinking.


The trip to the top was mercifully short at 73 minutes. The submersible covered nearly 7 miles in a little over an hour — slow in a car, but like riding a missile for a human in a metal ball. Cameron said the surface trip is when he noticed the aches and pains from the cramped sub. “That’s when your butt is really sore, and when you notice how much it hurts.” [Infographic: James Cameron's Mariana Trench Dive]


The sub now sits in a barn in Santa Barbara, waiting for Cameron or another group with enough money to send it back to the deep ocean. He declined to say how much it cost to build and mount the expedition.


“I would love for the sub to dive again,” he said. “I personally feel that we just barely got started before we had to turn back and there’s just so much out there.”


“And if not, at the very least, the technical innovations can be incorporated into other vehicle platforms,” Cameron added. “As far as I’m concerned, it’s an open source situation.”


Reach Becky Oskin at [email protected]. Follow her on Twitter @beckyoskin. Follow OurAmazingPlanet on Twitter @OAPlanet. We’re also on Facebook and Google+.


Copyright 2012 OurAmazingPlanet, a TechMediaNetwork company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
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Mick Jagger and Keith Richards to duet on “Letterman” Top 10












LOS ANGELES (TheWrap.com) – Mick Jagger and Keith Richards are no strangers to Top 10 lists, but now they’re poised to expand their knowledge of them beyond the music charts.


Rolling Stones leaders Jagger and Richards will appear on “Late Show With David Letterman” on Tuesday to deliver the Top Ten list for the night, CBS said Friday.












Though this will mark the first time that Jagger and Richards have appeared on “Letterman,” they’ve appeared on the stage of the Ed Sullivan Theater – where “Late Show” is taped – before. The Stones made numerous appearances on “The Ed Sullivan Show,” starting with their maiden performance on October 25, 1964.


The group is currently celebrating its 50th anniversary and recently released the greatest-hits anthology “GRRR!” They be in the area to play the Barclays Center in Brooklyn on Saturday, and at Newark’s Prudential Center on Thursday.


The group will also perform at the Hurricane Sandy benefit concert 12.12.12 – The Concert for Sandy Relief, which takes place Wednesday at Madison Square Garden. Other performers at the benefit will include Paul McCartney, the Who, Bruce Springsteen & the E Street Band, Billy Joel and Eric Clapton, among others.


Letterman has been rubbing shoulders with rock royalty lately – earlier this week, he was joined on his show by the surviving members of Led Zeppelin. Last weekend, Letterman and the group received Kennedy Center Honors.


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USDA to allow more meat, grains in school lunches












WASHINGTON (AP) — The Agriculture Department is responding to criticism over new school lunch rules by allowing more grains and meat in kids’ meals.


Agriculture Secretary Tom Vilsack told members of Congress in a letter Friday that the department will do away with daily and weekly limits of meats and grains. Several lawmakers wrote the department after the new rules went into effect in September saying kids aren’t getting enough to eat.












School administrators also complained, saying set maximums on grains and meats are too limiting as they try to plan daily meals.


“This flexibility is being provided to allow more time for the development of products that fit within the new standards while granting schools additional weekly menu planning options to help ensure that children receive a wholesome, nutritious meal every day of the week,” Vilsack said in a letter to Sen. John Hoeven, R-N.D.


The new guidelines were intended to address increasing childhood obesity levels. They set limits on calories and salt, and phase in more whole grains. Schools must offer at least one vegetable or fruit per meal. The department also dictated how much of certain food groups could be served.


While nutritionists and some parents have praised the new school lunch standards, others, including many conservative lawmakers, refer to them as government overreach. Yet many of those same lawmakers also have complained about hearing from constituents who say their kids are hungry at school.


Though broader calorie limits are still in place, the rules tweak will allow school lunch planners to use as many grains and as much meat as they want. In comments to USDA, many had said grains shouldn’t be limited because they are a part of so many meals, and that it was difficult to always find the right size of meat.


The new tweak doesn’t upset nutritionists who fought for the school lunch overhaul.


Margo Wootan, a nutrition lobbyist for the Center for Science in the Public Interest, says the change is minor and the new guidance shows that USDA will work with school nutrition officials and others who have concerns.


“It takes time to work out the kinks,” Wootan said. “This should show Congress that they don’t need to interfere legislatively.”


Congress has already interfered with the rules. Last year, after USDA first proposed the new guidelines, Congress prohibited USDA from limiting potatoes and French fries and allowed school lunchrooms to continue counting tomato paste on pizza as a vegetable.


The school lunch rules apply to federally subsidized lunches served to low-income children. Those meals have always been subject to nutritional guidelines because they are partially paid for by the federal government, but the new rules put broader restrictions on what could be served as childhood obesity rates have skyrocketed.


School kids can still buy additional foods in other parts of the lunchroom and the school. Congress two years ago directed USDA to regulate those foods as well, but the department has yet to issue those rules.


Sen. Hoeven, who had written Vilsack to express concern about the rules, said he will be supportive of the meals overhaul if the USDA continues to be flexible when problems arise.


“This is an important step,” he said. “They are responding and that’s what they need to do.”


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Oil prices fall slightly after US jobs report












The price of oil ended the week lower after the latest U.S. jobs report offered a mixed picture of the economy.


Benchmark oil dropped 33 cents to finish at $ 85.93 per barrel in New York Friday, which marked the fourth consecutive day of price declines. Oil fell 3.4 percent this week.












The Labor Department said 146,000 jobs were created in November, which was more than economists had anticipated. The unemployment rate fell to 7.7 percent from 7.9 percent in October, but that was largely because more people stopped looking for work and weren’t counted as unemployed. And job gains for September and October were revised lower.


Meanwhile, in another bad sign for energy demand in Europe, Germany’s central bank lowered its expectation for economic growth next year.


At the pump, the average price for gasoline fell nearly a penny to $ 3.37 per gallon, according to AAA, Wright Express and the Oil Price Information Service. That’s nearly 9 cents more than a year ago.


In other energy futures trading on the New York Mercantile Exchange:


Heating oil fell 2.79 cents to finish at $ 2.9153 per gallon.


Wholesale gasoline rose less than a penny to end at $ 2.5974 per gallon.


Natural gas fell 11.5 cents to finish at $ 3.551 per 1,000 cubic feet.


On the ICE Futures exchange in London:


Brent crude, which is used to price international varieties of oil, fell 1 cent to $ 107.02 per barrel.


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Protesters surge around Egypt’s presidential palace












CAIRO (Reuters) – Tens of thousands of Egyptian protesters surged around the presidential palace on Friday and the opposition rejected President Mohamed Mursi‘s call for dialogue to end a crisis that has polarized the nation and sparked deadly clashes.


The Islamist leader’s deputy said he could delay a December 15 referendum on a constitution that liberals opposed, although the concession only partly meets a list of opposition demands that include scrapping a decree that expanded Mursi‘s powers.












“The people want the downfall of the regime” and “Leave, leave,” crowds chanted after bursting through barbed wire barricades and climbing on tanks guarding the palace of Egypt‘s first freely elected president.


Their slogans echoed those used in a popular revolt that toppled Mursi’s predecessor Hosni Mubarak in February 2011.


Vice President Mahmoud Mekky said in a statement sent to local media that the president was prepared to postpone the referendum if that could be done without legal challenge.


The dialogue meeting was expected to go ahead on Saturday in the absence of most opposition factions. “Tomorrow everything will be on the table,” a presidential source said of the talks.


The opposition has demanded that Mursi rescind a November 22 decree giving himself wide powers and delay the vote set for December 15 on a constitution drafted by an Islamist-led assembly which they say fails to meet the aspirations of all Egyptians.


The state news agency reported that the election committee had postponed the start of voting for Egyptians abroad until Wednesday, instead of Saturday as planned. It did not say whether this would affect the timing of voting in Egypt.


Ahmed Said, leader of the liberal Free Egyptians Party, told Reuters that delaying expatriate voting was made to seem like a concession but would not change the opposition’s stance.


He said the core opposition demand was to freeze Mursi’s decree and “to reconsider the formation and structure of the constituent assembly”, not simply to postpone the referendum.


The opposition organized marches converging on the palace which elite Republican Guard units had ringed with tanks and barbed wire on Thursday after violence between supporters and opponents of Mursi killed seven people and wounded 350.


Islamists, who had obeyed a military order for demonstrators to leave the palace environs, held funerals on Friday at Cairo’s al-Azhar mosque for six Mursi partisans who were among the dead. “With our blood and souls, we sacrifice to Islam,” they chanted.


“ARM-TWISTING”


In a speech late on Thursday, Mursi had refused to retract his November 22 decree or cancel the referendum on the constitution, but offered talks on the way forward after the referendum.


The National Salvation Front, the main opposition coalition, said it would not join the dialogue. The Front’s coordinator, Mohamed ElBaradei, a Nobel peace laureate, dismissed the offer as “arm-twisting and imposition of a fait accompli”.


Murad Ali, spokesman of the Brotherhood’s Freedom and Justice Party (FJP), said opposition reactions were sad: “What exit to this crisis do they have other than dialogue?” he asked.


Mursi’s decree giving himself extra powers sparked the worst political crisis since he took office in June and set off renewed unrest that is dimming Egypt’s hopes of stability and economic recovery after nearly two years of turmoil following the overthrow of Mubarak, a military-backed strongman.


The turmoil has exposed contrasting visions for Egypt, one held by Islamists, who were suppressed for decades by the army, and another by their rivals, who fear religious conservatives want to squeeze out other voices and restrict social freedoms.


Caught in the middle are many of Egypt’s 83 million people who are desperate for an end to political turbulence threatening their precarious livelihoods in an economy under severe strain.


“We are so tired, by God,” said Mohamed Ali, a laborer. “I did not vote for Mursi nor anyone else. I only care about bringing food to my family, but I haven’t had work for a week.”


ECONOMIC PAIN


A long political standoff will make it harder for Mursi’s government to tackle the crushing budget deficit and stave off a balance of payments crisis. Austerity measures, especially cuts in costly fuel subsidies, seem inevitable to meet the terms of a $ 4.8-billion IMF loan that Egypt hopes to clinch this month.


U.S. President Barack Obama told Mursi on Thursday of his “deep concern” about casualties in this week’s clashes and said “dialogue should occur without preconditions”.


The upheaval in the most populous Arab nation worries the United States, which has given billions of dollars in military and other aid since Egypt made peace with Israel in 1979.


The conflict between Islamists and opponents who each believe the other is twisting the democratic rules to thwart them has poisoned the political atmosphere in Egypt.


The Muslim Brotherhood’s spokesman, Mahmoud Ghozlan, told Reuters that if the opposition shunned the dialogue “it shows that their intention is to remove Mursi from the presidency and not to cancel the decree or the constitution as they claim”.


Ayman Mohamed, 29, a protester at the palace, said Mursi should scrap the draft constitution and heed popular demands.


“He is the president of the republic. He can’t just work for the Muslim Brotherhood,” Mohamed said of the eight-decade-old Islamist movement that propelled Mursi from obscurity to power.


(Additional reporting by Omar Fahmy; Writing by Edmund Blair and Alistair Lyon; Editing by Giles Elgood)


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The Era of Twitter Without Instagram Has Now Begun












We know everyone is a little bummed about all those filtered photos disappearing from your Twitter streams this weekend, but let’s not get all worked up about it: They are disappearing, and there is no scandal.


RELATED: Why You Can’t See Instagram Photos on Twitter Anymore












TechCrunch’s  Drew Olanoff got a little too excited on Friday and thought a single in-stream photo meant that Instagram was allowing its Twitter cards back on Twitter and thought the two services were planning a sudden reunion. You may have seen some, too, but a Facebook spokesperson assured users these Instagram photos on Twitter were the last holdouts in the switchover. ”What you are seeing now may be some sort of regression depending on the mobile client, but we’re checking in with the engineers,” read Facebook’s statement, via Talking Points Memo’s Carl Franzen.


RELATED: How to Get Over the Twitter-Instagram War on Photos


Which means the end of this particular social-media marriage is upon us. Despite the immediate user backlash, Instagram CEO Kevin Systrom has made it pretty clear that the photo-sharing app doesn’t plan on making nice with Twitter. In case you hadn’t accepted the reality of Silicon Valley competition the first time around, this photo-friendly weekend might be the time to check out our handy three-step guide to getting over it. 


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“American Idol” producer Nigel Lythgoe signs with Shine America












LOS ANGELES (TheWrap.com) – “American Idol” and “So You Think You Can Dance” executive producer Nigel Lythgoe has entered a multi-year production deal with Shine America.


Under the exclusive deal between Nigel Lythgoe Productions and Shine, Lythgoe will jointly develop and produce entertainment franchises for the global television marketplace with the Shine Group, Shine America CEO Rich Ross said Thursday.












Nigel Lythgoe Productions will continue to be based in Los Angeles. The agreement begins January 1, 2013.


“I am thrilled to be teaming up with Shine to develop new shows for a global audience,” Lythgoe said. “We live in one world and need to create content for that market. I cannot think of a more exciting company to partner with in order to face that challenge.”


“Nigel is clearly one of the world’s leading television producers, with an un-matched track record in TV programming both here in the U.S. and in the UK,” Ross added. “We are thrilled to welcome Nigel and his team to the Shine family and we look forward to developing the next wave of entertainment franchises together.”


Shine America, the U.S. arm of the Shine Group, the production company chaired by Rupert Murdoch‘s daughter Elisabeth Murdoch, produces and distributes a variety of scripted and unscripted programs. Past and current shows include “The Biggest Loser,” “The Office,” “Ugly Betty,” “Tabatha Takes Over,” and adaptations of Shine Group formats “MasterChef” and “Minute to Win It.”


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Should breast cancer patients skip the pre-op MRI?












NEW YORK (Reuters Health) – A new review of existing evidence suggests that using magnetic resonance imaging to “stage” a woman’s breast cancer before surgery might do more harm than good.


MRI produces a much clearer image than X-rays and ultrasound, and is recommended for detecting early tumors in women at increased risk for breast cancer. But routinely using the technology once any woman is diagnosed with a tumor may lead to more radical surgery without any benefits, says a team of Australian and U.S. researchers.












They found that about 26 percent of women who had a pre-operative MRI to help determine the extent and severity of their tumor ended up having their entire breast removed, compared to about 18 percent of those whose surgeons only used traditional methods of characterizing the cancer.


“I wasn’t surprised by the results at all. What I am surprised by was the strength of the data,” said Dr. Monica Morrow, the study’s senior author and the chief of breast service at Memorial Sloan-Kettering Cancer Center in New York.


Because MRIs are more sensitive than mammograms, some doctors think they are a good tool for identifying the precise outlines of cancerous tissue. Others, however, have begun to question whether the imaging led surgeons to remove more breast tissue than necessary.


Moreover, women who have MRIs before breast surgery seem to be no less likely to need a second surgery to remove additional cancerous tissue.


A study published in September, for instance, found that among more than 300 women who underwent breast cancer surgery, just as many of those who had an MRI before the first surgery ended up having a repeat operation. (see Reuters Health article of September 25, 2012 here: http://reut.rs/Oogm3c)


An MRI can also add more than $ 1,000 to a patient’s bill.


“I think more surgeons are starting to question this because they’re seeing the outcomes,” Morrow said.


For the new study, she and her colleagues pulled together data from nine previous studies to see if MRIs influenced the number of women who had their breast removed or who had a second surgery to remove additional cancer.


From the nine studies, the researchers had information on 3,112 women who had breast cancer surgery.


Overall, the team found that about 16 percent of the women who had an MRI ended up having the entire cancerous breast removed, known as a mastectomy, during their first surgery. That’s compared to about 8 percent of women who did not have an MRI.


They also found that having an MRI before surgery did not influence whether women would need additional surgery to remove more tissue. In each group, between 11 percent and 12 percent had to go back under the knife.


After taking into account the women’s initial surgery and the second operations, the researchers calculated that about 26 percent of those who had an MRI ended up having their entire breast removed, compared to 18 percent in the no-MRI group.


“It causes more mastectomies to start with, but it doesn’t decrease the number of women who started out wanting a lumpectomy and needing a mastectomy,” said Morrow of preoperative MRIs.


The study did not look at long term outcomes, including how many women survived beyond five years. Nor did it examine the use of MRI to screen the opposite breast for signs that cancer had spread, the researchers note in their report, which is published in the Annals of Surgery.


These results do not apply to certain subgroups of patients, they add, including women with genetic mutations that predispose them to cancer and those whose other diagnostic tests produced conflicting results.


But based on the short term measures of how many surgeries women got and how much tissue surgeons removed from them, Morrow told Reuters Health that MRIs do not seem to have a place in breast cancer surgery.


“There may be select circumstances where we’d use it to solve a problem, but for most women with breast cancer they don’t need an MRI for their evaluation,” she said.


SOURCE: http://bit.ly/RdZNIw Annals of Surgery, online November 26, 2012.


(This story was refiles to change “woman” to “women” in second paragraph.)


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