Thursday, November 19, 2009

The New Screening Recommendations Suck

...and it seems like everyone with a brain or who's been unfortunate enough to have undergone breast cancer treatment knows that.

In case you have been on an island without Internet, radio or television access for the last few days, on Monday, the United States Preventative Services Task Force - a panel of folks who review medical data (number crunchers, if you will) - came up with a crazy recommendation that women should start mammograms at age 50, get them every two years and not even bother with self breast exams because they tend to result in false positives that cause women needless stress and worry.

When my friend Denisa emailed me with the news, I thought it was a joke. She said she did, too, at first.

For the record, doctors and the American Cancer Society have been telling women who are not high risk (no personal or family history, no other history of "female" cancers, et al) to get their first - or baseline - mammogram at age 40 for two decades now. In that time the detection rate has increased while the death rate from the disease has dropped. For women with a family or personal history of BC or who have other risk factors, the recommended age is often even younger. For example, my mother was diagnosed with Stage III breast cancer when I was 21 years old. I also had a history of fibroadenomas (benign breast lumps), so my baseline mammo came when I was only 25 - the same year my mom died from the disease. I've seen studies that suggest women who have a first-degree female relative (mother, sister or grandmother) with breast cancer start mammography at least 10 years before the age the relative was diagnosed. This sudden shift - by a group of analyst, no less - is mind boggling to say the least.

When I was diagnosed at age 37 after finding a small lump, the mammogram that followed showed calcifications in the ducts of my right breast - and I know LOADS of women diagnosed in their early 20's, 30's and 40's. If we would have waited until our 50th birthdays to have our first mammograms, most of us probably would have had to been dug out of our graves first to do it.

One in eight American women will be diagnosed with breast cancer in her lifetime. Sure the risk increases as we age, but the reality is that this disease is not just one that older woman get. Most women diagnosed have none of the risk factors when they hear the words "you have cancer." And amazingly, women find most thickenings/changes/lumps themselves via self-exams. How this panel - which included not one oncologist or physician, by the way - could conclude that mammography and breast self exams offer no life-saving benefit for women under 50 is truly beyond me. Whether it was an attempt to save insurance companies money by reducing the number of "unnecessary" screenings or not, the recommendation is a totally stupid one.

For more on the panel's findings, click here.

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