Wednesday, November 18, 2009

The New Breast Cancer Screening Guidelines

Coincidentally, the new recommendations for mammograms came out in the print newspapers on the very same day that I had my annual mammogram scheduled. I’m now 45, and have been having one every year since the age of 40. My doctor, like most, had advised me to have a mammogram each year, and I was encouraged to do self-exams the rest of the year. So, the new screening guidelines were quite a shock.

In case you’ve been away from the news, new guidelines from the U.S. Preventive Services Task Force now say that routine mammograms are no longer necessary for women in their 40s who are of average cancer risk (i.e., no family history or genetic mutation). And women between the ages of 50 and 74 only need a mammogram every other year, they say. They also recommended that doctors no longer teach women about breast self-exams due to lack of evidence of their effectiveness.

My first gut reaction at hearing this news was “Yee-hah! I don’t have to get scared by this annual torture every year anymore.” I’m always on pins and needles until I hear that the results are fine. But then I thought about the possible scenarios if I didn’t undergo a yearly mammogram. The task force says that for each case of cancer death that is prevented among younger women, 1,900 women must be screened. But what if I was that one person in 1,900, and I hadn’t been screened?

During the month of October, Breast Cancer Awareness Month, my friend Stacey bravely wrote on this blog about her battle against breast cancer. With no family history of breast cancer and no genetic cause for it, Stacey was diagnosed with breast cancer at age 35. Her little boy was four years old at the time. She was having no symptoms and no reason to believe she might have cancer. But she had her annual gynecological exam with what many people might call an “overly cautious” doctor who recommended that his patients start getting mammograms at age 35. Stacey hesitated, thinking it was probably ridiculous, but she decided to go ahead. If her doctor had been following the new guidelines, Stacey probably wouldn’t have been tested until she was 50—if she had lived that long.

So, yes, a lot of money is spent on testing women who are healthy. And a lot of women are put through unnecessary anxiety. I know that firsthand. One of my mammograms looked suspicious and I had to go in for further testing. It wasn’t easy at all. But Stacey owes her life to the doctor who decided that waiting until age 50 wasn’t good enough. And Stacey’s little boy will get to grow up with a mommy.

1 comment:

  1. As a health business major, I have to leave my rant about this decision by the government! I have to agree wholeheartedly with the American Cancer Society's decision to pull away from this recommendation and continue to recommend mammograms for women earlier.

    It's just another example of our health industry focusing on downstream efforts (waiting until someone gets really sick) instead of upstream efforts like prevention and early diagnosis.

    If just 1 younger woman is saved because of an early mammogram or by doing a self-breast exam, it makes the costs involved of screening everyone worth it in my opinion. Which is more costly a mammogram or treating someone with stage 3 or 4 cancer? My mother had stage 4 cancer before anyone noticed it (not breast cancer). If her cancer was caught earlier, she may still be around today.

    I've known more younger women with no history of breast cancer getting this horrible disease. And, I can't believe that some of the top breast "experts" believe in this new recommendation based soley on "numbers" instead of looking at the US population.

    Now, in fairness, part of the argument on the other side is whether or not getting a yearly mammogram is safe. That opens up a whole other can of worms.

    I'm seeing my physician this week for my annual appt and this will certainly be something that I'll be discussing with her.

    Awesome article, Susan. Nicely written.


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