Monday, November 23, 2009

MAMMOGRAM MESS

We have been cajoled, pressured, brain-washed -- educated, thoroughly, carefully taught, warned, reminded -- YOU'VE GOT TO HAVE A YEARLY MAMMOGRAM!

Associated Press Featured News quotes the latest, recommendations from the "US Preventative Services Task Force, (USPSTF):

●Women in their 40's do not need yearly mammograms. Dr. Diana Petitti, vice-chairman of the Task Force panel, says benefits are less, the harms are greater if you start in the 40's.

(Huh? So later is better? Um ... what are the "harms?" Are Diana's conclusions based on numbers, like medical costs?)

●Susan Pisano, spokeswoman for America's Insurance Plans, an industry group, says the insurance coverage isn't likely to change because of the new guidelines.

(Um... who is in the industry group? Insurance companies?)

● The Task Force panel says that women 50 to 74 should get a mammogram every other year until they turn 75, after which the risks and benefits are unknown.

(I thought the old guidelines had no "age" limit, and suggested "every year or two. What made them modify this? )

● Value of breast exams by doctors is unknown. And breast self-exams are of no value.

(Does that mean my doctor can't feel a lump? That I can't feel a lump? What about those cards in women's shower-rooms that depict the circular motion we should use to feel for lumps? )

●The latest Issue of Annals of Internal Medicine supports the new recommendations.

●The World Health Organization agrees; It says screening should start at age 50; and be done every two years. Great Britain doctors say every three years.

BUT –
The American Cancer Society says they're wrong.

Their Chief medical officer, Dr. Otis Brawley, responding to the new guidelines, said, "This is one screening test I recommend unequivocally, and would recommend to any woman 40 and over." And Dr. Len Lichtenfeld, Brawley's Deputy Chief Medical Officer, says "Our concern is that as a result of that confusion, women may elect not to get screened at all. And that, to me, would be a serious problem."

And the AP report on the American Cancer Society and the USPSTF goes on and on:

There are 192,000 new cases and 40,000 deaths from breast cancer expected in the U.S. this year. There are numbers about risk factors -- probabilities of dying of breast cancer in your forties are 3% – ages fifty to seventy, the risk drops to 16% -- five lives will saved per thousand, versus only one death more, if you start screening at forty, but with early screening there will be approximately 470 false alarms -- a huge cost in terms of unneeded biopsies, medical expense, and worry ...

(Expense for whom? Worry? Each year every woman worries as her mammogram looms. Not testing will NOT take away the worry that's been drilled into us for more than thirty years.)

It's a blizzard of information, and I want to know how this new, shocking, turnaround got to be front and center, major, seriously significant, urgent, BIG DEAL NEWS -- bumping Health-care, Obama bowing to an Emperor, Guantanamo, and the Fort Hood Murderer out of the spotlight?

I think it was a couple of facts -- tidbits, life and death statistics with more than a modicum of shock value -- landing -- kerplunk -- on some producer's desk, waking him, jolting him into a "hey, WOW -- this is soap! deodorant! Jenny Craig, Nurtisystem! Olay! Pantene, Revlon, Loreal look-your-best Bowflex, bottom-line bonanza!" And kazoom -- the producer's got this mammogram ball rolling down the money hill!

Whoa ... says Dr. Em, backing out of the way. doing what she's been doing with medical rules in order to survive.

1. I never got yearly mammograms.

2. I don't mention that anyone had breast cancer in my family.

3. I make medical decisions for myself, based on what I've learned.

4. If I'd followed medical advice, I'd be leading a sedentary life, NOT able to dance, eating a limited diet -- no pears, celery, string beans, popcorn, grapes, plums, cherries, apples -- green apples, one of my favorite foods!

5. I checked the USPSTF index on Osteoporosis, Arthritis, and back pain -- subjects I know a lot about -- its conclusions are not directives , they are qualified IFS.

Go with what you feel you ought to do. We're being sold an idea on top of the idea that we already bought. You can't return the old one to the store and get a refund. Your daughter can't get a refund on it, so she'll buy when she's old enough to pick out what she prefers.

Be your own doctor. And have a little laugh ...

1 comment:

Carola said...

This is actually not news. I knew about it 15 years ago when studies were first coming out. My HMO has been a leader in breast cancer screening research and has been tracking all of us (who are willing) to see the results of screening. Back when I was in my 40s, I discussed it with the breast cancer nurse, and we agreed that it was really pointless to do it at that age, although a baseline would be nice. Either the cancer would be extremely aggressive in which case a mammogram wouldn't catch it early enough, or it would be the treatable kind, which can be treated later as well as sooner. The cancer in our family is highly treatable: I report to my doctors that it is in our family, but that nobody ever died of it. I think your decision for yourself is correct; but I am getting screened. But what's weird is that all this information has been known for years!!! but nobody wanted to hear it.

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