Breast Cancer Screening: Where The Rubber Meets The Road
November 18th, 2009
The U.S. Preventive Services Task Force unleashed a tsunami this week with new breast cancer guidelines that are suspiciously timed to current efforts to rein in burgeoning healthcare costs. Indeed, the recommendations appear to be geared towards reducing overtreatment by eliminating what the Task Force considers unnecessary follow up screenings and tests. The recommendations even suggest the breast self-examination (BSE) should be discontinued.
In essence, what the Task Force concluded was that while screening reduces deaths from breast cancer, it does not save enough lives to justify associated costs.
To exacerbate the controversy, the American Cancer Society has publicly stated that it does not endorse Task Force recommendations and in a detailed analysis suggested that in the review of the evidence, the committee got caught up in semantics (i.e. risk versus benefit) and that at the very least, computer modeling may be flawed in terms of its ability to translate statistical data into real life.
Meanwhile, the New York Times reports that many doctors are ‘staying the course,’ and in between anger and disbelief, women across the nation are crowding the phone lines trying to discern what is true and what’s not.
Have we all gone mad?
Obviously, these new recommendations will be echoing in the halls of hearings that will determine the future role of mammography in government-run health programs, private insurance programs and the current healthcare reform initiative. Already, Congress is calling for Hearings. But more importantly, is the debacle is a prime example of what ails our healthcare system and reflective some of the more important changes that must take place if we are ever going to move forward in a way that benefits all the players. Truly, who’s really in the driver’s seat?
Related posts:
- Taking A Stand Against the U.S. Preventive Services Task Force’s “New Breast Cancer Guidelines”
- What the new cervical cancer screening guidelines mean for women
- In Honor of Breast Cancer Month
- My Hope Chest: How a Former Vegas Show Girl with Breast Cancer Tries to Help Uninsured Women Get Their Breasts Back
- A Taboo Explored: Cancer, Sex, and Intimacy
November 18th, 2009 at 8:08 pm
The National Women’s Health Network has been working to change these recommendations for 15 years. There is plenty of evidence that the new recommendations make better sense.
November 19th, 2009 at 9:05 am
Regardless of recommendations, we women are free to get a mammogram any time we like. If our insurance company chooses to follow the recommendations, we can still have a mammogram and pay for it out of our pockets.
The recommendations take the viewpoint of overall public health and the good of society, something many Americans are loath to consider. We need to assume personal responsibility for our own care, which INCLUDES paying out of pocket for tests we want, that might not be covered by insurance.
We all to take a more macro and societal view of “risk versus benefit”, and make our personal decisions within that framework.
November 22nd, 2009 at 11:32 am
This is not news – in fact, many doctors have said for years that mammography produced too many false positives. There is an alternative- thermography. Also, I hate to see Disuptive Women pick up the argument that this is an attempt at “rationing healthcare.” In fact, the opposite argument could be made – that the cancer industry and mammogram industry wants to continue what could be a useless test for profits. So I think we should be slow to start labeling a study as part of some great agenda.
November 22nd, 2009 at 11:32 am
I disagree, Sharon, probably because my routine annual mammo found my cancer when it was stage 0 – scattered cells – and not entrenched as might well have been the case a year later. Treatment was also considerably less expensive than multiple rounds of chemo. So what if there are false positives. You check them out and go on. It’s a screening and it does tell us important information.
November 22nd, 2009 at 11:34 am
Thermography can find problems 10 years sooner than painful mammograms, no pain, no radiation.
November 22nd, 2009 at 11:35 am
I was not surprised at this news, a few years ago the recommendations for yearly pap tests changed. With a history of 3 normal tests in 3 years, it is not recommended to have a pap test at yearly intervals depending on your age group. It is very confusing because gyn’s want us to come for a pelvic exam so why not do a pap test. but the cost of doing a bunch of normal tests is detrimental. The best physicians offer women the information and allow her to decide if she wants the pap test even if she is low risk. I hope the same wil happen with mammos. We should all unite and vow to request our mammos when we go to our gyns.
November 22nd, 2009 at 11:35 am
The cost of a PAP test is minimal. If a pelvic exam is being done do the PAP test. Just does not make any sense to me to not do it.
November 22nd, 2009 at 11:37 am
Have you noticed that none of the coverage of this change acknowledges that at least some of the doctors who oppose it stand to lose lots of imaging billings?
November 22nd, 2009 at 11:38 am
I have a 40 year old friend who just had a double mastectomy. Tell her that screening shouldn’t begin until 50.
November 22nd, 2009 at 3:34 pm
I am happy to see that this post engendered a healthy discussion about the new guidelines. It is a clear reflection of the disagreement over the ‘evidence’ that is taking place outside the virtual and media world. I encourage everyone to read as much as possible and make their own decisions based on their personal medical history, risk factors and other considerations. Hopefully, the situation itself has brought to fore how much we need better screening options. Clearly, mammography has many shortcomings.
December 10th, 2009 at 10:08 am
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