Interestingly, we require industrial facilities to keep risks from their activities below 1 in a million. But we can accept a much higher rate of women dying? I can't. Found mine at 38 in my initial screening. Forget insurance - you won't even get the chance to make the decision to pay for mammograms yourself if this becomes protocol - you won't be asked.
You misunderstand me, Michael. I support the government's right (and responsibility) to develop guidelines. That doesn't mean I endorse those guidelines. It's like we say about democracy – I don't agree with what you say, but I support your right to say it.
Yes, these new guidelines are a step backwards for women's health; and I'm VERY uncomfortable supporting the guidelines in print, because I don't want to be seen as agreeing with them. I simply wanted to point out that, looked at with a cold, calculating eye – which right or wrong, is how the government assesses things – they make sense.
But looking at them as a woman... they make no sense at all. - PJH
That makes no sense whatsoever, and I don't think anyone has misunderstood you. It saved your life, but you're willing to put someone else's life in jeopardy. That's just wrong.
If it's about the math, here's this: treating one woman with advanced cancer would pay for all those "unnecessary" mammograms with money left over. As someone who does not have health insurance and has had breast cancer I am painfully aware of just what it costs.
Again, you're misunderstanding what I wrote. I support the government's right and responsibility to develop public policy guidelines. That doesn't mean I agree with the guidelines. I'll continue to encourage every woman I know to get a mammogram starting at age 40, as I always have. The difference is, I'll now be working "outside the system." Which doesn't bother me in the least - thank God we live in a democracy, where it's possible to buck the system without being jailed, or worse. PJH
Hello. I just had cancer surgery and am undergoing radiation.The guidelines wouldn't be so bad if that was what they were. The bad part is these guidelines will be used to deny payment for claims for mammograms that don't match the insurance company's criteria. More than that, I feel this is the beginning of a downslide in providing health care for people insurance companies feel are too expensive to treat and maintain their enormous profit. I cite the Medicare Advantage plans that will be defunct at the end of the year. That is happening to me. As of December I have to find new insurance because I'm 66 and undesirable.
Sorry PJ, but I have to call bullshit on your comments above. Your post headline itself says that you SUPPORT the new guidelines.
As far as the danger of unnecessary anxiety goes... having suffered from anxiety myself, I can assure that while it is not fun, it does not kill you. My mother, having died from breast cancer, can not give any such assurance. Better to suffer a little anxiety than death in my opinion. I'm sure most would agree with me.
The GOVERNMENT does NOT have the right or responsibility to develop guidelines! Where is it in the CONSTITUTION? To support the GOVERNMENT's right to develop guidelines is the FIRST step towards making those guidelines mandatory and law. Surely you can see the inevitable consequences of your position??? The fact that everyone is supposedly misunderstanding your position shows a lack of logical thought on your part.
I think what the author is saying...is that she supports THIS government's right and responsibility to develop public policy guidelines.
If this were a different administration, you'd be beside yourself...as the rest of us are.
My mom was just diagnosed with breast cancer three months ago and will have to take Arimidex for the next five years.
It's nice that I'm not fifty yet.
oh you are soooooo very right on...AMEN to you and your comment!!!! please explain to me how one mamagram a year is more costly than allll the treatments for cancer for even a year would be ....just one more way for our charming Government to try and "cut costs"; umm nooo, cut them some where else please.
Hi PJ, I was pleasantly surprised to read about your perspective on this, because my initial reaction after seeing the news was of disgust at the new recommendation(especially as I keep hearing people trying to justify it today who were involved in making these recommendations). So I definitely do appreciate hearing these words of support coming from someone in your position.
What I still feel is missing is a real alternative for women to detect breast cancer, and I'm hoping that over the next several days/weeks/months we do get that. They are saying that self exams aren't valid either, so, then what option do we have? Otherwise I feel like this is a huge setback in women's health.
Thanks for sharing your perspective on this!
I think the main thing we can do to detect breast cancer early, Amy, is to be aware of breast changes. Not recommending "formal," once-a-month breast self exams is actually something the American Cancer Society has endorsed; it's felt that women forget, they get tired of it... they just don't do it. But if you know what your breast is supposed to feel like; and then, one day in the shower you notice that it feels different, and you call the doctor – that's what should happen. BSEs should evolve into a constant body-awareness regarding your breasts.
And I believe in a woman's right to choose whether or not to have a mammogram, basing her decision on the data that says, yes, the vast majority of women will NOT get breast cancer; and that mammograms can produce false positives, which can lead to more testing and biopsies that turn out negative, all accompanied by emotional anxiety, some degree of pain and, of course financial expense. Knowing those facts, some women may choose to skip the mammograms; others may choose to have them. But it'll be a choice, not a guilt-inducing mandate.
Thanks for connecting here, Amy- PJH
Thanks PJ!
I think it's always a choice though. No one forces you to get a mammogram even today. My worry is insurance companies will move towards not even covering mammograms unless you jump through hoops, which will REALLY make it difficult for women to make that choice to get tested.
Do you know if there are statistics on what percentage of breast cancer cases are actually caught by getting mammograms? To me that's still the most important statistic because even if they bring a lot of false positives, if they are the most effective tool that we have to catch breast cancer as early on as possible, I still think we should be advocating for women to have them until we develop something better (or make them more effective).
Thanks again - great conversation!
i 100% totally agree w/ u...if we cannot get mamos & we do not do self exams, what alternitives are there for us?we die? we wake up when we r 50 & go for our 1rst mamo & find out we have stage 2 very agreesive cancer that has spread? go to Breastcancer.org & go to the discussion boards...so many of these women were diagonsed with either a mamo or self exam...& all of these women are under the age of 50...so they should just sit back & let the cancer invade their bodies?
I wasn't quite sure what to make of this news either and appreciate your honest take on it. On the one hand I was diagnosed with an aggressive form of BC (triple positive) at 42--granted the mammogram didn't pick anything up in January and I had a nearly 3 cm lump in May when I went in. I am actually grateful to hear that the medical field realizes the emotional costs of mammograms, false positives and unnecessary biopsies. Looking back at my experience I'd say from the time I found the lump to surgery/chemo was actually the worst. The uncertainties were debilitating. I'm all for reducing that! But women need to be educated just like PJ says. I had a history of cysts, so when I felt the lump I ignored it. I had no idea that I should check every lump no matter what.
I'm also really concerned about insurance companies taking advantage of this and I'm also concerned about the increased number of young women who are diagnosed with BC--I don't think women under 40 typically get mammograms in the first place so perhaps they'll still get checked if they have a concern, but overall, the policy could send the wrong message. If anything, another way to look at this is that it draws attention to a topic that could use more attention, believe it or not. Particularly because the medical field is saying what we need is money for prevention!
The longer a cancer grows inside you, the more you will have to go through to fight it, and the worse the chances are that you will win.
I am a survivor. A year a half now since treatment, I am being watched like a hawk and always wondering if it is licked for good. What I had to go through to get here has been at great financial and physical cost.
There had been some changes in that breast. It sort of turned under. There had been a stronger odor out of that underarm, and hard to wash out of my shirts. I had not put these together as I should have (and I share them here for other women), or perhaps I also would have gone to the doctor more quickly.
It is not hard to do a self-exam, and should be done both lying down and sitting up. Had I known that, I may have found my lump sooner. I was not having mammgrams, because I was pretty convinced of what is now being said by these studies, that I was too young to worry about it yet in my 40s. By the time I found my lump, by accidentally brushing over it with my hand while I was standing up (thought I felt a bug bite me), it was already Stage III, quite invasive, gone to ten of my nodes.
It seems to me, now that I am a BC survivor, and I travel in some support circles, that women are being diagnosed at an earlier and earlier age. I am hearing about more in their 30s, and some even younger.
I also hear quite often that a woman found her own cancer. Probably as often as I hear that it was found through a mammogram. I have also heard of mammograms failing to show what a woman can clearly feel.
Basically, if a woman IS aware of what to look for, learns to do her own exam correctly, sitting up and lying down, and decides based on risk when SHE believes she should start screening, talking that over with her doctor, I think that is the wise way to go. I don't think cold numbers and impersonal guidelines are the answer.
Women are not numbers. We are flesh and blood.
The new proposed healthcare/government wants control of the money and will ration procedures in order to pay for the "new" healthcare reform. This is an example of the public being "trained" for future medicl care rationing. I was at a doctor's office today and read the Oct.26th issue of Newsweek which discusses the importance of early detection of cancer and specifically breast cancer. I know of 3 women who were diagnosed with breast cancers in their 30's. Hammels is clearly rationalizing and I cringe at the thought of what lengths some people like her will do to ration medical care in the future. I don't want a government agency telling my doctor and me what procedures I can or cannot have . This is a tragedy when people like Hammel sells out. Yes, communism & socialism iare based on "the greater good" of society, not the individual.
I AM A WOMEN WHOSE LIFE WAS SAVED BY A MAMMOGRAM. I WAS DIAGNOSED AT AGE 42 WITH AN AGGRESSIVE FORM OF BC THAT HAD IT NOT BEEN FOR MY MAMMOGRAM I WOULD PROBABLY NOT BE ALIVE TODAY. WHAT DETERMINES HIGH RISK, THE NEW RECOMMENDATIONS STATE THAT WOMEN 40 - 49 YO SHOULD ONLY BE SCREENED OF CONSIDERED HIGH RISK, I WAS NOT CONSIDERED HIGH RISK, I HAD NO FAMILY HISTORY OF BC, PERSONALLY I THINK IT WILL BE A HUGE STEP BACKWARDS FOR MAMMOGRAMS NOT TO START AT 40. ARE WE FORGETTING THAT 80% OF WOMEN DIAGNOSED HAVE NO FAMILY HISTORY.
I've had 7 yrs of mammo's from age 34 to 41 because of cysts. Doing a self breast exam, I found a tumor that mammo didn't find. I worry that 7yrs of radiation accumulating in my breast tissue could have been the cause of my breast cancer. I have been fighting the drs. to let me get an MRI instead because every time I get a mammo, the radiologist recommends an MRI . I just want a break from radiation for a yr. or two. Dr. won't cooperate.
I think you absolutely should be concerned about radiation doses. One single, low-dose exposure is one thing, but repeated exposures do matter. I have often wondered why no one was talking about this.
Several years ago I read two articles in medical journals on this issue. One was specifically about mammograms, and was entitled (if my memory is correct) "Are we causing the cancers we are trying to detect?". Another article discussed the lack of informed consent by patients undergoing diagnostic x-rays, CTs, etc., who were not being informed of the risks of accumulated lifetime exposure to radiation and its risks.
As in all things, women have to (or should) make informed choices, and weigh the benefits of the procedure against the risks. However, it is impossible to make truly informed choices if you are not provided with all the information necessary. If nothing else at least this has opened the door for more disussion on risks, something that has tended to be ignored with routine mammograms.
Hi I also have cystic breasts. I had my first mammo at 35 bx a doctor found a lump, having dense breasts, the mammo found nothing. I underwent surgical bioposy, the lump was removed and fortunately it was benign (one of my favorite words). 6 months later the surgeon felt another "lump" and suggested it be biopsied as well. I went for a second opinion (another mammo &?) where they found nothingnd I elected not to have the biopsy and instead to "watch it". I then had to have more frequent mammos and ultrasounds of the breast. Before it was standard order I'd request the ultrasound (especially if I went to a new doc), the doc would give it as an "as needed" order - and of course it was always needed. Now I go for an annual mammo, always with an order for a ultrasound and get an ultrasound every 6 months. (They are particularly watching a cyst that is under the scar from the biopsy). While MRI would certainly be a more thorough test, perhaps an ultrasound would be of benefit to you as well?
I had mammograms throughtout my 40s and was diagnosed with high grade, extensive DCIS at age 50. I had to have a mastectomy. Why didn't the mammogram pick it up 12 months earlier? Did the accumulated radiation from mammography cause/constribute to DCIS? I am torn between being extremely glad it was picked up before it became invasive but angry that I had to lose a breast. I had no family history and was low risk.
They told me that when you have a tumor that you can feel then it's been there for at least ten years.
Why did 7 years of mammograms not find it?
I wish that ultrasound was an answer to my above concerns, but they won't use them for the whole breast, just localized areas.
I have tried going through my primary Dr. and my surgeon to order an MRI and they both refused even after explaining my reasons and wanting to get a break from radiation. ( I also went through the six weeks of radiation treatment). I am very disappointed with my Drs. Right now because they are basically telling me I have no say in my care and I feel my reasoning has been pretty logical according to all my research in the last 2.5 years.
Also, I find it funny that they are worried about the doses of radiation a woman gets during a screening, but if you are found to actually HAVE breast cancer, they shoot so many rads at you in so many ways, you practically glow. Each time I asked about all the radiation numbers building, I was told it was only a low dose at best, and at worse less of a worry than the immediate concern of the cancer.
Since my diagnosis, I have had: numerous mammograms, so many I have lost count--not only diagnostic and follow-up, but also as guidance for either wires poked into me for surgery or a biopsy of something found after treatment--five CTs, numerous chest X-Rays, a fluoroscope for port placement, back and pelvis X-rays, one foot X-ray, and 5.5 weeks of radiation therapy. Also, use of radioactive dyes for: two MRIs, one bone scan, one DEXA scan, and one MUGA. This on top of a handful of x-rays I had in my earlier life, before cancer. Not one doctor has shown one iota of concern over all the radiation I am getting, though I have asked again and again if it is all necessary.
I don't know about the risks of radiation from yearly mammograms, but they used to say it wasn't very high. I do know a very old saying that comes to mind. "An ounce of prevention is worth a pound of cure."
PJ, thank you for the provocative and thought provoking post. You define the ethical issues clearly, and add important information to the debate. I can't help but agree with you philosophically that the government has the right....
Still, my vote is for mammogram screening in a woman's forties as it will according to the ACS reduce breast cancer deaths by 15%. That's a lot of women.
I know it, Jo-Ann. The "80% benefit for half the cost" they keep throwing around ignores the fact that the remaining 20% benefit is women's lives saved. How much is a life worth? That's the hot-potato question, the one no one wants to go on record about. Although the government effectively does go on record today - divide the money saved by the number of women who die because of that saved money, and there you have it: the feds have placed a dollar value on us. I realize that's WAY too black and white, but... well, it's a hard subject to get your head around, for sure. Thanks for connecting here again - PJH
I have to say that I am stunned by the new recommendations. I had my first mammo 5 weeks ago. I was told that my breast tissue was very dense and it was recommended to have another. One week later, as I am standing in the mammo room in a paper shirt, I was told that I needed to see a surgeon immediately. One week and a surgical biopsy later, I was told that I had malignant breast cancer. I have no family history of breast or ovarian cancer. Now, 3 weeks later, I have had an MRI, 2 sonos, CT of my torso, bone scan and a radical mastectomy of my left breast (with 20 lymph nodes removed: 2 of which were positive for cancer). I am considered Stage 2a, which means that the cancer has not metastised anywhere else in my body. At this point, I am looking at surgery to place a mediport, minimum of 6 chemo treatments, 5 yrs of medication, possible hair loss, at least 2 reconstruction surgeries and a lifetime of worry about whether or not this will come back or if my children will get breast cancer.
I just turned 42 last week. My birthday present was a mastectomy. So even though there are those that support the governments right to tell me that I shouldn't be concerned about BSE's or mammos before the age of 50, I have to whole-heartedly disagree with you. Had I not had the mammo, I wouldn't be alive at the age of 50 because my cancer is aggressive enough that I would probably be dead in the next couple of years. So to that panel, I say, let us as women who know our bodies better than anyone else, have the right to make the decision to have a life-saving mammo.
I am a woman who's mammogram missed my breast cancer, due to dense breast tissue, even after I felt a lump. A follow up sonogram warranted a biopsy. I had annual mammogram screenings after age 40 and at age 55 continue to have annual mammograms and breast MRI's. I know a lot of women who had breast cancer diagnoses because of mammogram screenings. So in their behalf, I wonder if the women in government along with the wives, daughters, mothers and girlfriends of the men in government will also be abiding by our new guidelines they find will save money for the good of all! When the people in government and their families live with the same health benefits, retirement benefits and social security that they vote in for the rest of us to have then I might reluctantly agree with their position to do away my screening health care benefits too. I have worked for 40 years and paid for my own healthcare insurance and my tax dollars have contributed to healthcare provided by the government. Without mammograms they may only lose a few thousand tax payers a year so maybe they are right after all........
I cannot find any way to agree with this. A mamogram found my tumor, undetectable by self exam. Who knows when it would have been big enough to be detected by touch as it was deep against my chest wall. I contribute my early detection to that mamogram. I had no history so I would not fall under the high risk catagory. No doubt it would have been more serious and costly for my insurance company. And possibly cost me my life. In my opinion this guideline is gender genicide. Instead of saving lives they will no doubt cost them. However the maney they will save for treatment and care treating these early detection cases will undoubtedly pay for the numerous unneeded procedures that insurance companies pay for everyday. I realize my daughters will come under the high risk catagory which will allow them earlier mamograms. But what about those women like me with no family history who have an aggressive cancer growing in there body and cant get a mamogram. This is uncivilized. Why are they not changing the guidelines for prostate screening. Is it because its a male disease?
This sickens me. I too, was not high or even moderate risk, yet here I sit today, with bilateral implants. Theses "guidlines" are thrown out there, and we all know the insurance companies are going to take them and run with them. I reluctantly say, I want to see the statistics in a few years, after theses guidelines have been utilized, of the number of deaths of women who have been diagnosed based on these guidelines.
I have just finished 35 rad treatments and have 3 more chemo to go. I strongly disagree with the new BCS guidelines. It is just another way the government is trying to control and give insurance companies another way out of paying without going through the hassle you usually have to anyway to get them to pay. My cancer was found with the mammogram, but had to go back for more pictures and mri. Even then, the Doctor said see you in six months, possibly benign. I had to go to my regular doctor in order to get a biopsy ordered. When the BC diagnoses came back, even my doctor was surprised and said he was glad we didn't wait six months to find the cancer. So ladies, I agree with those that say listen to your own bodies, too. I am just thankful for the mammagram that got my attention or I might not be here next year.
Hi everyone,
this is the site moderator here. I would just like to take a minute here to remind everyone that even though this is a hot-button issue, things need to stay civil. Threatening comments, comments cursing other members out, or calling them names will not be tolerated.
We are not asking that you agree with PJ, simply that if you disagree, you do so in a respectful manner.
Thank you.
Anjali
I believe people who support this study are completely out of their minds. As the daughter and granddaughter of women who died of breast cancer, two maternal aunts and two maternal cousinis who had either mastectomies or lumpectomies in their 40's, and two biopsies myself at age 44 and
51 you please use my family as one for whom getting mammograms in our 40's makes sense.
My first biopsy had pre-cancerous cells at age 44. The second was at 51 and had atypical hyperplasia that was watched carefully with even two mammograms per year.
My question now......what is next. Will it make any difference in the future regarding being high risk? Remember, at this time studies are out before this one that said women with high family history didn't have more of a risk of cancer than those that didn't...10% I think.
These "researchers" in my opinion, need to go back to the drawing board, become funded by anyone other than insurance companies or hospitals and get real about this subject.
For me, it turned me into an independent voter since this study group comes out of the HHS Department of the government.
Emily
Hi Emily, this is what the guidelines say (verbatim from the HHS site):
"The USPSTF recommends against routine screening mammography in women aged 40 to 49 years. The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account, including the patient's values regarding specific benefits and harms."
There are provisions for individual patient context.
The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account, including the patient's values regarding specific benefits and harms."
But, how long until the insurance companies decide it isn't necessary to pay for a patient's values and preferences?
Well, it is easy for you to say that you support the guidelines NOW because you have already been "saved." You would feel differently if you'd just been diagnosed and were told you could not have treatment because the GOVERNMENT decided you were not worth it. I cannot believe that you are willing to let the GOVERNMENT decide what is in our best interests. Your belief is based on socialism, not individual rights and liberty. You realize, of course, that once the GOVERNMENT WON'T pay for something that the next step (as in England) is that one will NOT be able to pay for treatment/tests ourselves. We would not even have such a healthcare cost problem if GOVERNMENT had not interfered in the health care arena to begin with. To let the GOVERNMENT, who has already caused major problems in our health care system, now totally control that system makes no sense whatsoever. If your breast cancer returns and the GOVERNMENT says you are not worth the expense of the treatment, I think then you will change your mind. Until then, I do not appreciate your opinions that put my healthcare and my life and my family's lives at risk!
You're jumping to some awfully big conclusions about what I believe in, based on my statement that it's the government's responsibility to develop public policy. That doesn't mean I agree with the recommendations of their hired task force. Which, by the way, have nothing to do with cancer treatment, but only screening of healthy populations. Anyway, thanks for connecting, and for the opportunity for some back-and-forth here- PJH
It has everything to do with cancer treatment because that will be the next thing to be rationed via guidelines. This whole issue is about the slippery slope of government control. I understand you don't support the guidelines, but you do support the right of the government to issue them. That is the problem. Government guidelines tend to becomes laws either directly or indirectly. You should become familiar with the Obama administration's concept of "Nudge." It's from the book: Nudge: Improving Decisions About Health, Wealth, and Happiness. It is written by Cass Sunstein, Regulatory Czar. It's about the method of controlling people through, not explicit laws, but by nudging them. "Nudge" promotes the idea of government regulating your lives through "incentives and disincentives" applied to the food you eat, the habits you have, etc. Now that the Breast Cancer Screening Guidelines say we no longer need mammograms before 40, the insurance companies can claim there is no need to pay for them. Thus, we are "nudged" into a practice of no mammograms before 40 without the government even having to pass a law. Very neatly done, I might say.
PJH:
The reason for the changed guidline as it was stated is that mammography may cause unnecessary diagnostic procedures due to false positives. But task force did not attempt to understand the reasons what cause those false positives. As you said, the taks force was made of a group of statisticians looking at "cold numbers".
Yes, mammography does lead to false postivies due to its technical limitations. But many of the false psotives are not caused by technical reasons but by the clinical practice of defensive medicine. I have worked with radiologists in the U.S. and in Europe. The physicians in the U.S. tend to call more women back for additional diagnosis, simply because they are worried about poential law suit.
So as you can see, goverment does not provide real solutions to real problems. On one hand, they put together those task forces to look for cost reduction, but they do not understand what are the real problems that lead to increased cost.
So there are many aspects to a controversay. The best science is for one to rely on his/her own experience to form a judgement. Science is common sense, is what people learn from their life experience. When you do nto trust yourself, you get lost.
I suppose saving this money will allow the legislators to waste more of ours on the nonesense they do now. The whole US system is completely out of wack...this is so Pelosi can spend almost 120,000 going cross country in her new jet.
Lets get this really in line and call a spade a spade.
I resent this. Mammograms have saved 8 of my friends lives..like it or not.. they found cancer with the "routine" mammograms.
Lets get real here.
PJ Hamel - how do you sleep at night? Who paid you to support this? This is all about money, it has nothing to do with the "anxiety" women go through. Anyone who agrees with these new guidelines has a financial benefit for doing so, otherwise what kind of human being would agree that doing away with early detection is doing women a favor.
LD, if you read carefully what I wrote, I said I support the government's right and responsibility to collect and analyze data, and formulate public policy. That doesn't mean I have to agree with it, nor follow it. I'll continue to tell every woman I know to get yearly mammograms starting at 40, understanding that you may indeed suffer some mental pain and anxiety, perhaps a needless biopsy. But isn't that worth saving your life? With this point of view, and the work I do as a breast cancer patient advocate, I actually sleep very well at night, aside from the usual menopausal wakeups... thanks for asking! PJH
Thaks for your input. I sleep well at night, thanks, and no one paid me to support this. Please re-read what I wrote: I support the government's right and responsibility to collect and analyze data, and use it to develop public policy. I don't agree with their conclusions, nor their recommendations. I fully intend to keep telling woman to have their y early mammograms, keeping in mind that they may result in false positives, callback mammograms, biopsies, and accompanying anxiety. To my mind, well worth it, considering you're dealing with your life. Cheers- PJH
PJ: I agree with your conclusions. But are you sure that the mammogram saved your life?
See article by Keen and Keen, noted at Medscape or open access journal biomedcentral.com, BMC Medical Decision Making, 2009.
No, I'm not sure. But given the cancer had already reached my lymph nodes, and I wouldn't have had a mammogram for another 3 years (under the new guidelines), and it was a type of cancer that doesn't form a lump - very sneaky - I think it probably would have metastasized by the time I discovered it. But thanks for the link - PJH
I appreciated your seeing that the USPTF might have a point of view, whether you agree with it or not. The harms of too many mammograms are not just unneeded biopsies but overdiagnosis -- some cancers especially DCIS might never harm the woman who harbors them.
MAYBE the mammogram did save your life, it does for some. But are you sure?
For some women who THINK it saved their life (maybe you, maybe not), if they had not been diagnosed with cancer, NOTHING would have happened -- instead, they now have massive medical trauma and expense and life-changing and life-disrupting experiences, medical side-effects, etc.
It's NOT about money -- it's about the BALANCE of benefits and harms.
I consciously choose NOT to have mammograms because although there are no certainties I know a LOT of women ARE harmed compared to those who benefit and I think it's the right side to gamble on given my personal values.
If you choose differently, I DO want insurance to cover your mammogram. If someone has any symptoms or a lump at any age, they ABSOLUTELY should get a mammogram. But unless I get a symptom or lump, count me out -- and thank goodness for these sensible, humanistic USPTF guidelines!
To Texas:
God help you if you ever have symptoms, especially beyond a lump, that turns
out to be breast cancer, because by that time it most likely will be too late as
it will have mestastasized. If you find a lump and it turns out to be a very aggressive
type of cancer, stage III or more good luck again, because you will be history. I
have a low aggressive type of breast cancer and I must say, that some are either
so naive, so uneducated about different types of breast cancer or anything about
breast cancer, or have so little ability to empathasize with the fear and seriousness
about this disease, that they will have an attitude such as yours unless or until it
happens to them (you) or one of their daughters or perhaps a sister. Also, the
results of this task force will make it so much more likely that insurance companies
will have yet another excuse not to cover mammograms for women under 50. I
would suggest you educate yourself about breast cancer and google this task
force and the rationale for their findings. It's just one contradiction after another.
My mom was in the "low risk" category, but still absolutely should have had mammograms a lot earlier in life. She died from breast cancer many years ago, and yet there is not a day that goes by that I don't think about her and her terrible agonizing struggle with this horrible disease. Her oncologist was convinced that earlier mammograms would have both detected her cancer and would have saved her life because I spoke to him many times about her condition. She was the kindest, most loving and giving person I have ever known...so it is very difficult for me not to get emotional about this.
I'm so sorry to hear about your mother. Now, unfortunately, she's an example of
what will start to happen again with these new guidelines. Talk about going back-
wards! My mother, grandmother and aunt all had breast cancer, had mastectomies,
and didn't die from breast cancer. My mother passed away last week at 98. It is
heritable in my family (obviously). I did go to a genetic counselor and got tested.
Of course I didn't have the BRCA I or BRCA II gene, but a gene that they don't
have a genetic marker for yet. I had a lumpectomy and a week before I was to
start radiation, I decided to have a mastectomy and some reconstruction. This is
definitely the more difficult "road" but it worked for those before me so I figured
the permanent solution, rather than a 5 or 10 year warranty that is the gist of
studies done on radiation. Since I was diagnosed in early August of this year I
have talked to so many women and more often than not, after radiation, their
cancer has come back so I detoured and took another route!
The very fatal flaw in the taskforce's report is their definition of RISK. I don't know many people who would trade a little discomfort and worry for a chance of missing an early stage breast cancer. I feel as if it is the 6o's and DRs. have patted me on the head and said there there little lady, we'll take care of everything. I am and was fully capable of deciding the degree of risk I face and dealing with it. I had a mammogram in my mid 40"s and began yearly ones in my early 50's, but no one in my family has ever had any kind of cancer.
A lot of issues are confused here. This panel (of doctors and scientists) made a recommendation based on science and is separate from the government. Public policy is rarely made on science alone nor should it. This recommendation is based on one study. One study won't change policy nor will it change insurance policies either. This study was simply a study and not done for the purpose of setting government policy. Studies have to be duplicated and reviewed numerous times before a change is made.
Is it accurate? Likely. Will it cause change down the road? Likely. There is a flaw in this study and again, I feels like I got the short end of the statistic stick. Young women who get breast cancer often get a more aggressive form of breast cancer, often genetically linked, HER2 positive, triple negative -- the toughest forms to treat successfully. If we aren't finding it early, ie from screening, we are doing young women a disservice. Even though our numbers are few, we need it to be caught early more than any other group. This is where the study is flawed.
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So, does the Gov pay for the screening mammos...???
I thought it was the insurance companies...