The Breast Brouhaha?

Breast cancer is the most common cancer among American women, except for skin cancers. The chance of developing invasive breast cancer at some time in a woman’s life is a little less than 1 in 8 (12%).

The American Cancer Society’s most recent estimates for breast cancer in the United States are for 2009:

  • about 192,370 new cases of invasive breast cancer will be diagnosed in women
  • about 62,280 new cases of carcinoma in situ (CIS) will be diagnosed (CIS is non-invasive and is the earliest form of breast cancer).
  • about 40,170 women will die from breast cancer

Breast cancer is the second leading cause of cancer death in women, exceeded only by lung cancer. The chance that breast cancer will be responsible for a woman’s death is about 1 in 35 (about 3%). Death rates from breast cancer have been declining since about 1990, with larger decreases in women younger than 50. These decreases are believed to be the result of earlier detection through screening and increased awareness

If you’re like me, you’re wondering why there would be any changes in mammogram recommendations with statistics like this.  Last week, the U.S. Preventive Service Task Force recommended changes from a 20 year practice of screening women for breast cancer at age 40.  They also recommend that women 50-74 should get mammograms LESS often, every 2 years instead of annually.   Here’s the kicker:  Doctors should not teach women self-examination because it serves little benefit.  WTH?!?    

U.S. Preventive Service Task Force claims that “overtreatment” is pushing these guidelines.  They are saying that younger women have the least to gain from early screening and early screening causes to many ‘false positives’ which is when the mammogram produces suspicious findings and the women is actually cancer free.    So essentially they’re saying mammograms saves lives between the ages of 40-49, but just not enough of them.

This new recommendation, they claim, is in pace with the rest of the world when it comes to mammogram testing.  Am I supposed to be comforted by that when Americans have the most diagnosed cases of breast cancer in the world?  The rest of the world may be able to afford waiting to test at 50, but not the United States. 

Mammograms cut the risk of dying from breast cancer by 15%.

17% of breast cancer deaths occurred in women who were diagnosed in their 40s.

I guess those numbers don’t mean anything.  Also, let’s not forget about the huge disparity in diagnosis, treatment and death in African American women from this disease.  They already die at a higher and faster rate from this disease than any race of women.  Taking away 10 years of early screening would not be detrimental?

I don’t buy any of the Task Force findings.  I am not a doctor but it does not make sense medically to me, that testing for the 2nd leading cause of death in this country for women should be done later than sooner. 

Why the change?  And why the change now?  During this countries first REAL possibility of healthcare reform and the crash of our economy, are these recommendations just a big coincidence?  Insurance companies are probably doing cartwheels up and down their Corporate Office corridors.  Imagine how much money they pocket if they no longer have to pay for mammograms?  Imagine how much money they save if there were no more “false positives” to pay for?  MONEY! MONEY! MONEY!  As of now, insurance companies are not refusing to pay for mammograms for women in their 40s but how much are you, U.S. Preventive Service Task Force, willing to bet after this storm settles, we will begin hearing about mammograms not being covered?  You willing to bet one of your breasts?  I doubt it.

“This is one screening test I recommend unequivocally, and would recommend to any woman 40 and over,” ~ American Cancer Society, Chief Medical Officer, Dr. Otis Brawley.

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