Tuesday, November 17, 2009

Tuesday Short Rant: Breast Examination & Mammograms

Fresh off a great Breast Cancer Awareness Month, we were slapped in the face by the announcement that women should wait until age 50 to get a mammogram and should quit all the self-examinations. [insert outraged pause here]. From HuffPo/AP:

NEW YORK (AP)- Most women don't need a mammogram in their 40s and should get one every two years starting at 50, a government task force said Monday. It's a major reversal that conflicts with the American Cancer Society's long-standing position.

Also, the task force said breast self-exams do no good and women shouldn't be taught to do them.

For most of the past two decades, the cancer society has been recommending annual mammograms beginning at 40.

But the government panel of doctors and scientists concluded that getting screened for breast cancer so early and so often leads to too many false alarms and unneeded biopsies without substantially improving women's odds of survival.

"The benefits are less and the harms are greater when screening starts in the 40s," said Dr. Diana Petitti, vice chair of the panel.

The new guidelines were issued by the U.S. Preventive Services Task Force, whose stance influences coverage of screening tests by Medicare and many insurance companies.

Um, yeah – I will have call a flag on the play and shout bullshiggity on this whole thing up and through here. You are now saying that not only should women wait to get a mammogram but they should not do self-exams? The HELL? Now I am from a medical family, father and brother both physicians BUT what I hate about these so called "medical panels" is that they tend to talk out of their asses. There was a time about ten years ago when a new study was coming out weekly about what caused cancer: bacon, strawberries, Equal, white bread. Over the course of the next five years, each of those studies was contradicted by differing studies. Remember when oranges were the superfruit? Now it's pomegranate or açai berry? This leads me to believe that beyond the big three (cigarettes, asbestos and genetics), folks have no clue where cancer comes from or how to prevent it.

Why wouldn't you recommend something that aids in awareness and prevention? Who is this "task force" to tell women not to check themselves? I smell an insurance company hustle. The days of the free "Well Woman" exam are about to be thrown under the bus.

Kathleen Reardon, a professor at USC, wrote an article for HuffPo called
I'd be dead by now – The New Breast Cancer Guidelines. An excerpt:

I'd be dead by now if it weren't for breast self-examination. And had my doctor been less convinced of his own guidelines regarding women without a known history of breast cancer, my cancer would have been detected earlier and I would have been treated sooner and less aggressively. I was 32 years old.

The latest research is one more piece of information for the decision process women must make each year regarding mammography. That's it. If breast self-exam gives you greater peace of mind, no set of guidelines should deter you from it. If someone in your family found a lump in her breast that turned out to be breast cancer, what a team of doctors and researchers tells you is simply one piece of advice and perhaps irrelevant to your situation.

They are researchers looking at numbers. You are a person they do not know. I have high regard for many of the doctors weighing in on this subject, but let me bring it back to you, your wife, mother, sister, or friend. Anecdotal information is valuable. It is part of the larger picture. You also need to know yourself. If you're more interested in being sure than worried about being scared, find yourself a doctor who agrees with you. And get the mammogram recommended by the American Cancer Society before the insurance companies take that option away.

One other question: Where's the study on men not needing a prostate exam? [insert stern side-eye here] The American Cancer Society reports that the breast cancer death rate has been going down over the last fifteen years, they attribute this primarily to early detection. Damn the panel, check it yourself and get it checked if something doesn't feel right. What did ya'll think of this story?

19 comments:

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Rob said...

I'm with Ojo. Ladies, lets get those thangs checked up on the regular. Start early (20s) and keep it going. Real happy to offer my examination services free of charge. No job too big, no job too small. I'm here for you!

citizen ojo said...

What does that "death" panel know. I firmly believe the we should be checking breasts early and often. I try to check my wife as much as possible....oh and I haven't found cancer yet. Check a breast today - it's un-american if you don't.... This message has been approved by the Citizen Ojo Medical Association of America!!!!

ASmith said...

I 'bout flipped my ish when I read that this morning.

My aunt had breast cancer. How'd she find it? Self-exam.

Close friend (my age) just recently found a lump in her breast. How? Self-exam.

I mean COME ON ALREADY. How does that even make sense??

Whatever. Eff all them. No. For real.

Andrea M said...

let me climb aboard and call bs as well. DAMN! Sisters can't get a break. this STINKS of healthcare hustle - I agree

BB Waite said...

This is shiggity to the nth degree! My best friend's daughter was just diagnosed - she is 27. TWENTY SEVEN. Without self-exam, where would she be? They caught it early and she has a good prognosis but I don't understand making recommendations that will kill people. I really don't. Pray mightily people, the devil is busy.

tiffanyinhouston said...

I cussed so bad when I heard Dr. Nancy on the Today Show. They are all on that bullshit. I personally know 2 of my sorors who are my age (mid thirties) who have battled (and won) fights with breast cancer. I have the self exam instructions hanging from my linen closet door. I checks my tatas daily. I will be getting my first mammogram in 4 years. They are crazy as all get out if they think I'm going to stop being proactive about my own health.

OneChele said...

Le Sigh Ojo! Actually, we joke but my father found my mother's first lump. I blinked rapidly when she told me that (bad mental image), but there you go.

Sarah said...

I agree. I was dumb-founded when I read the article in the paper about it. I am not happy about how woman's health issues get treated in general, but what I would say about that is too much for a comment box. My sister who is two years older than I is, thankfully, getting all the tests and check ups a woman in her 40s is supposed to do. Me, I've so far been delinquent since I don't have health insurance and haven't for a while. I do, however, live my life in a healthy way and understand my own body. And I think you and others are right in saying this is going to effect what insurance companies will cover. For shame.

BB Waite said...

You are silly but SO right - THIS is the TRUE definition of a "death panel"

Steve said...

Co-signing Brother Ojo!

Steve said...

Yes, I think this is ridiculous. My mother was diagnosed at 33, beat it and it came back at 37, she beat it again. My aunt was not so lucky. Much as I joke about "playing doctor" (holding open auditions for Head Nurse right now! LOL), this statement just confuses a very simple issue. Women should be encouraged to do all they can to stay healthy and alive.

OneChele said...

Stern side-eye with pursed lips at "Head Nurse" Auditions. Beyond that, sorry for the loss of your aunt

Joy Andrews said...

I had hoped this was a mistake and someone would reverse it today. How insulting and condescending?

Grace said...

Oh my goodness - 27! This is why I wish this task force had thought about the ramifications of telling people to wait.

Pied Type said...

Amen, sister. I'm from a medical family too, and this is a huge step backwards. Hair-splitting over statistics is guaranteed to confuse the public and it's all the excuse the insurance companies need to stop paying for any screening for women under 50.

EC Thompson, MD said...

it's important for us to separate reality from hype. There's a lot of hype out there about breast cancer. The reality is this is a serious disease. Many serious people are looking at it and trying to figure out what is the best treatment options for women. Every now and then, someone will look at the data and come up with something completely different. I think that's what happened in this case. This government panel believes that the risks of radiation exposure plus the expense of tens of thousands of negative biopsies outweigh the benefits. As a surgeon, as someone who has followed the breast literature (at least I did in the past), I can say that these guys had the best of intentions but missed the mark. I get into some of the risks and benefits on my blog.

Let me just say I've seen hundreds if not thousands of women with breast cancer. Anything that we can do to decrease one woman suffering is worth the expense in my book.

Hidi said...

My question to the panel of doctors is Are you serious??? I do not want to sound cruel, but I wonder if they will be
"singing the same tune" if one of their love ones become a breast cancer patient. I cannot believe these doctors.
I have no words.........this is just DUMB. People please do not believe them. Seriously.

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