As a breast cancer survivor, the past three and a half years have been an amazing learning experience for me. As powerful as my personal experience was, learning and becoming an educated advocate has also given me the opportunity to know when to speak up on an issue, and taught me the importance of weighing all aspects and facts before doing so.
Having said that, on Monday, November 16, 2009, the Lombardi Cancer Center at Georgetown University released an analysis led by Jeanne S. Mandelblatt, MD, MPH (of Georgetown Lombardi Comprehensive Cancer Center and a CISNET member), along with six independent team of researchers, which suggests that mammography screening should be done every other year and discouraged the efficacy of women performing breast self-exams and the usefulness of clinical breast exams.
I read the Mandelblatt study with shock, disbelief, outrage, then fear, and sadness for the women who might follow these guidelines.
I will address their recommendations below, and from the perspective of representing younger women - more specifically, the under 40 population:
1. The study states that a comprehensive analysis was done of various mammography screening schedules that suggest biennial screening of average risk women between the ages of 50 and 74 achieves the most benefits of annual screening but with less harm.
a. First of all, the public should be aware that this study is just that - a study. It is by no means a standard that is respected and accepted by the medical and the breast cancer community.
b. Secondly, I would like to know what parameters were used to define a "comprehensive analysis". I would like to know the demographics of the study participants (race, income, lifestyle, health history, age, etc.). Assuming this study was conducted on women over 40, it does not take into account the younger population, which are at a higher risk because they tend to have more aggressive breast cancers.
It is professionally reckless to conduct a study such as this, which excludes the young adult population and other demographics, which although are in the minority, are more adversely affected by breast cancer and experience wider disparities in care, treatment, long-term health, shortened life-span, fertility, financial and related health and life issues.
The women referred to in this study are stated to be of average risk, and between the ages of 50 and 74 and does not take into account the population of younger women, who are not "average" risk. It totally overlooks an entire population of women, who although get breast cancer less often than women over 40, 11,000 are diagnosed annually, and approximately 1,100 lose their lives because of late diagnosis, and because younger women tend to have more aggressive breast cancers. These women greatly benefit such as breast self examinations and mammography. Many of their breast cancers would not have been discovered otherwise.
