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Breast Screening Blunder

November 20, 2009

She is 39 years old, a wife, a daughter, mother to three beautiful children.  She is also a breast cancer survivor.  Debbie found the lump herself, doing a routine breast self-exam–something she had been practicing for only a few months.   She had a mastectomy and is now 7 years cancer-free. 

Ilene was diagnosed with breast cancer at the age of 42.  A mammogram found a tumor the size of a golf ball in her right breast.  It was so deep, she had never even felt it.  It was Ilene’s first mammogram–something she only scheduled after two years of  prompting from her doctor.     After aggressive treatment, Ilene is alive and well–a 12 year breast cancer survivor. 

As a breast cancer awareness, prevention and screening advocate for nearly 20 years, I could give you dozens more stories just like those, which is why a recent report by the US Preventive Services Task Force is so upsetting.    This panel suggests changing the screening guidelines for breast cancer that have been so effective in saving women’s lives.  The standard guidelines from the American Cancer Society call for yearly mammograms starting at age 40.  The panel believes screening mammograms should start at age 50, and then only be done every other year.  The reason they give?   While some 15 percent of women in their 40s detect breast cancer through mammography, other women experience false positives, anxiety, and unnecessary biopsies as a result of the test.

WHAT?!?!  

You want to take away the most effective screening tool for 15 percent of all women in their 40’s so other women don’t have anxiety?!?   Ilene can’t believe it:  “I know I wouldn’t be here today if I hadn’t had that mammogram.  Anxiety doesn’t kill you.  Breast cancer can if it’s not caught early enough.”

The panel further suggests that breast self-exam is unnecessary and women shouldn’t be taught to do it…but statistics show 80% of cancerous breast lumps are found by women themselves.  Women like Debbie:  “I wasn’t always faithful about doing my breast self-exams.  I shudder to think what might have happened to me…to my children…if I hadn’t found that lump.”

Some medical experts contend the panel’s report is strictly based on cost-effectiveness:  “With its new recommendations, the [task force] is essentially telling women that mammography at age 40 to 49 saves lives; just not enough of them,”  said Dr. Otis Brawley, chief medical officer for the  American Cancer Society. 

According to The Society of Breast Imaging, “Since 1990, the breast cancer death rate in the US that had been unchanged in the preceding 50 years, has decreased by 30%, primarily due to screening mammography.”  The group also disagrees with the panel’s recommendation to screen only women who are at high risk:    “Only 10-25% of breast cancers occur in high risk women.  Not screening the others would miss 75-90% of breast cancers.” 

Women like Jane, who kept putting off her mammogram, even when she had a lump so large and so sore she couldn’t raise her arm.  When her co-workers finally dragged her to the doctor, it was too late.   When she was dying, she said to me, “Chrys, promise me you will tell my story to other women.  Tell them not to be stupid like me so they don’t end up dead like me.” 

Breast cancer is the most common cancer for women in the United States. This year, nearly 200,000 women will be diagnosed with invasive breast cancer.  The medical community and the American Cancer Society agree we should stick with the current guidelines: monthly breast self-exam, and yearly mammograms starting at age 40.    Because of those screenings, more women are catching breast cancer early, and more women are surviving the disease.   

Just ask Debbie or Ilene.  I wish the members of the task force had listened to their stories and met their families before they decided their lives weren’t worth the cost nor anxiety of a yearly mammogram or breast self-exam.

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5 comments

  1. A..men Chrys! I applaud your article! If these mammograms done in womens’ 40’s only detects 1 women in 5 with a tumor(statistic not verified) it is 1 more mom/sister/friend/daughter saved!! I pray that women will not follow this new advice and the insurance companies will not adopt them.
    Blessings,
    Melody Hill


  2. Chrys – You are always on the money, but on breast cancer you have true cred. This is totally ridiculous. Keep at it.


  3. Thanks, George! I will keep at it…every woman’s life is important!!


  4. My jaw about hit the ground when I heard that ridiculous recommendation! Obviously none of the people on that panel have a family member who has had breast cancer. I would much rather have been told it was a false alarm than to have gone through the agony that followed my 2nd bout with breast cancer. Granted, I’m now over 50, but the first time it was found in my first mamogram the year I turned 40. How much anxiety or money is a life worth? That panel has no clue!!


  5. Hi Carol!
    You are the perfect example of why those recommendations are crazy.
    What price tag do you put on a life?
    Thanks for reading…and commenting on the blog!
    Chrys



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