Jenster's Musings

Tuesday, November 17, 2009

Are You Kidding Me??

I'm hopping mad about the U.S. Preventive Services Task Force's new recommendations on mammography and other excrement concerning breast cancer screening. These new guidelines seriously make me nauseous.

1. No mammograms until 50 and then only every other year.

* Because false positive mammograms cause undo anxiety and unnecessary biopsies.

Please forgive my insensitivity, but so-freakin-what! Isn't one woman's life worth just a little bit more than another woman's temporary anxiety? Not only that, but some mammograms scream CANCER! My oncologist took one look at my films and gave me a 95% probability of a malignancy.

Oncologist Mary Daly, chair of the clinical genetics department at Fox Chase Cancer Center in Philadelphia, said the reevaluation was flawed by its reliance on data from outmoded technology, namely film mammography. Digital mammograms, the new standard, have reduced the false-positive rate in women under 50.

* While annual mammography for all women beginning at age 40 reduced the death rate from breast cancer by at least 15 percent, the modeling studies showed the added benefit of starting before age 50 was modest, the researchers found.

Apparently the modest number of lives saved by annual mammography before 50 isn't worth anxiety and unnecessary biopsies in false-positive women.

* "... Petitti said. "Then there's the whole other line of problems that come into play, which is where there are some breast cancers detected that grow very slowly and would never have killed you."

But what about the very aggressive breast cancers, usually found in YOUNGER WOMEN? Those women have a much better chance of long-term survival when that cancer is found early.

And what about those women over 50 who have routine mammograms every year? My mother, for example. Her cancer was aggressive and if she hadn't had a mammogram until the following year there's no telling how far it would have spread.

2. [the task force] concludes that there is insufficient evidence to continue routine mammograms beyond age 74.

My mother was 73 when her cancer was found! So according to these guidelines, if her routine mammogram had been later in the year, like maybe AFTER she had turned 74, her cancer wouldn't have been found until it was much too late. What sense does this make???

3. The task force's new guidelines... also recommend against teaching women to do regular self-exams of their breasts.

Where's a punching bag when I really need one? This one slays me because here's the deal. Under the old guidelines, routine mammograms didn't start until age 40 because younger, denser breasts make it more difficult to interpret changes in the tissue. I was under 40 when I was diagnosed with breast cancer. Why? Because I just happened to be the patient of the best gynecologist in the entire world and he taught me how to do self-exams so I found my cancer early enough to treat it successfully. Even at that it had spread to my lymph nodes and was stage 2a, so what if I had waited until I was 40? My chances of recurrence would have greatly increased.

The whole thing just makes me want to cry. I feel like we've taken two steps back and I worry what this will mean for women. Breast cancer is the second leading cause of cancer deaths in women, but the statistics have been getting increasingly better due to early detection. I'm so afraid of a backslide because of these new guidelines.

So pardon me while I drag my soap box over here and climb on.

Ladies - know your breasts!! Husbands - know your wives breasts!! Contact your doctor if you notice any of the following:

- A lump that stays the same size throughout your cycle or gets bigger
Breast changes:
- Thickening
- Swelling
- Distortion
- Tenderness
- Skin irritation
- Redness
- Scaliness
- Peau d’orange (dimpled skin resembling an orange peel)
Nipple abnormalities:
- Ulceration
- Retraction
- Spontaneous discharge

Don't freak out because chances are you don't have cancer. But don't you think it's worth a little anxiety and a needle in your boob to be safe rather than sorry?

And feel free to thumb your nose at the U.S. Preventative Services Task Force.

*Italicized sections taken from the Washington Post, Tuesday, November 17, 2009.

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