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Healthy Aging

Mammography Mayhem

By Sheryl Kraft

Created: 11/19/2009
Last Updated: 01/14/2010

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I'm sure by now you've heard about the U.S. Task Force's new standards for breast cancer screening. What I'm not so sure about is if any of us have been able to keep track of what's happening day to day, though. No sooner were these new recommendations made public that women and other groups, like the American Cancer Society, began to push back and question the motives and sanity behind them.

In case you missed it, the old guidelines - that women begin screening for breast cancer annually, starting at age 40 - were changed. Earlier this week, this federally-appointed task (the same ones who recommended that we get screened at age 40, by the way) changed their stance, saying that women should not start routine screening until age 50. On top of that, they also discouraged breast self-examination. Huh?

And then yesterday, Kathleen Sebelius, the secretary of health and human services, made a statement that these new recommendations "caused a great deal of confusion and worry" and the government's policies remain "unchanged." She went on to say that women should do what they've been doing and should not worry that their insurance companies will not cover the cost of their mammograms. But what I am so very confused about (among other things) is that this very task force is appointed by guess who? Ms. Sebelius's department.

So it seems that there is just a jumble of things going on and while I shy away from getting political, it's hard to ignore that this is a piece of the puzzle (that's all I'll say on that subject).

What I'm more passionate about is this: a mammogram is what saved my life. It found my cancer when I would never suspect it would find anything but normal breast tissue. I shouldn't have had a mammogram at 34 - but I did. And I obviously do not regret it.

I'd hate for other women to be denied that, too.

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These new guidelines make no sense. I cannot help but wonder whether the insurance company lobby didn't play a role in the change.

We shouldn't worry whether or not our insurance will cover it? What planet does the secretary live on? The one where we all have thousands of extra dollars lying around? Seriously, how out of touch is she?

I agree with Alexandra--and you! In reading more about this topic, my understanding is the task force has no oncologists or radiologists as part of their team. Again, from my readings it seems like these recommendations were made based on statistics versus careful thought on boutron. Bravo for bringing this topic up for more discussion!

Thank you for commenting on this topic. I am not very knowledgeable about the issue, but I happen to have a few friends, like you, who were diagnosed at a very young age. I just know that I am terribly grateful that they, and you, have overcome their cancers thanks to early diagnosis.

But wait -- these new guidelines only affect *routine* screenings. If a woman has a family history of breast cancer, as I did, she can choose to get mammograms before the normally recommended age -- again,as I did. I believe a mammogram at the age of 45 saved my life and will urge my daughter to begin screenings when she's 35. These new rules are guidelines, not mandates. We all still need to make our own decisions that are based on our individual circumstances.

Ruth - Absolutely, yes, they are not mandates. But they are causing tremendous confusion among women everywhere, and I fear that there are a lot of women out there who will not advocate for their own health as you did. It annoys me so that this panel made this "suggestion."
In my situation, there were no risk factors which led to my mammogram. Nothing to lead me to believe it would be anything but normal. It was simply meant as a baseline, not to diagnose anything suspicious. That's why I personally am in favor of earlier routine screening. Sometimes we just don't know.

Sheryl -- I thought I knew how I felt about this (vaguely in favor of the suggested changes), but have found I don't, really. The experts may be right on the numbers and statistics -- but they are talking about women's lives, and there's no way to quantify that. I've been surprised by the raw emotions it's stirred up in me to read others' comments. Makes me realize that all of us survivors are held together by a little Scotch tape and hope; when someone messes with that, it feels catastrophic.

Ruth, Scotch tape and hope...love that! It is most likely the survivors who are the most vociferous here. The more I read, too, the more confused I get - NOT because I agree (I don't think I'll ever change my stance) but because it is such a complicated, tangled issue. I can't help react emotionally when I read the word "unnecessary anxiety" attached to "early" mammograms. What are we, children? We can manage our own anxiety, thank you. And it's hard not to be just as emotional when there's something out - the best thing so far - that someone wants to take away.

Thanks for weighing in again!

This is really scary in particular as it coincides with another report that suggests young women should not get screened for cervical cancer until they are 21. Surely it should be in the doctors' - and insurers'- interest to catch these killer diseases as early as possible?

I totally agree, Ulrike. You'd think it would be in the insurer's interest to catch all diseases early, but unfortunately there's just not enough preventive medicine practiced in this country, in my opinion.Thanks for weighing in on this important topic!

I've followed this story closely and really don't know what to think. As a medical writer, I understand the mission of this task force and I don't get the feeling they are politically motivated. I think their work is being misunderstood. They are not making policy. They are looking at the data on a population basis, not on an individual person basis. It is also very dangerous to link this to the current fight for health care reform, which some conservatives are doing in an effort to discredit Obama.

I think people are confusing routine mammograms and diagnostic mammograms. The taskforce is not recommending against getting a mammogram when there is a suspicion of a problem. They just don't think routine mammograms are necessary in one's 40s due to the anxiety, radiation exposure (which can cause cancer), and unnecessary, disfiguring biopsies.

Personally, I think we should all have a baseline mammogram at age 40. Then, the interval from there should be decided with your health care provider based on your history and emotional comfort level.


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