All is well, but Kris
recently went through her annual mammogram, the discovery of a change from last year with development of a cluster of microcalcifications, another mammogram and a consultation, and then a biopsy and a consultation with the radiologist to be given a
clean bill of health. Whew! As her husband, the days of praying and waiting and wondering
and worrying ... some ups and downs ... yes ... a normal pattern for those who first learn of
potential cancer. And wonderful relief to learn that she's fine.
But now we are told ... maybe it was all for nothing. In fact, when Kris first read these reports she was not too happy. Are these doctors putting women through too much needless anxiety? Or, is this just a rogue report and finding?
Some recent studies are suggesting major shifting in the testing of women with mammograms. Some are saying no need for tests before 50; others are poo-poohing the idea that self-testing does much good ... and this recalls a debate all the way to Congress about a decade ago.
Some say this is insurance companies
telling us that mammograms aren't needed, and some pushback by saying insurance
companies don't want to pay the fees. Others are saying science is showing more
today and ... well, here's stuff from The Washington Post...
What do you think about these changes? Any stories to tell?
One side, this is a
bad move:
"We can't allow
the insurance industry to continue to drive health-care decisions,"
said Rep. Debbie Wasserman Schultz (D-Fla.),
who said earlier this year that she had undergone treatment for breast cancer.
The recommendations
also garnered harsh criticism from powerful medical groups including the
American Cancer Society -- which says it will continue to recommend regular
mammograms for women older than 40 -- and the Access to Medical Imaging
Coalition, which warned that the findings would "turn back the clock on
the war on breast cancer."
"The only
conclusion I can come to is it's economically motivated," said Carol H.
Lee, who chairs the American College of Radiology's breast-imaging commission.
"In this climate, when we are all paying attention to how we can decrease
the cost of health care, in my opinion that's the primary motivation."
But Ned Calonge, who
chairs the 16-member panel, defended the recommendations and denied that cost
or the debate over health-care reform played any role in the decision.
"Cost just isn't a consideration when the task force deliberates,"
said Calonge, who is also the chief medical officer for the Colorado Department
of Public Health and Environment. Twelve of the task force members were seated
during the Bush administration, and the remaining four were chosen before
President George W. Bush left office, he said.
To conduct the
review, Heidi D. Nelson of the Oregon Health & Science University in
Portland led an analysis of data from more than 40 studies, including a new
British study involving more than 160,000 women and data collected from more
than 600,000 women in the United States.
In addition, the task
force commissioned an unusual study led by Jeanne S. Mandelblatt of the
Georgetown Lombardi Comprehensive Cancer Center and funded by the National
Cancer Institute that involved six separate teams of researchers analyzing the
risks and benefits of 20 screening strategies.
"I think anytime you use science to kind of fundamentally change what people are used to, I think it's a difficult thing to grapple with," Calonge said of the new guidelines.
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Chris B, sorry, I am not commenting on what it says on the report, have a look at what I said in my comments- many women get full blown cancer treatment (surgery, chemo, radio-) for cancers that would never have affected this woman in her lifetime ie real cancers, but ones that could safely have been left untreated.
I am *not* talking about "false-positives" (yes the biopsy is stressful, but you'll get over it...)I am talking about "overdiagnosis"- and hence a woman becoming a "cancer patient" (unfortunate *and* life-altering)As I said, an estimated 10 cases per 2000 women screened, and only one life actually extended by catching a dangerous cancer early.
These patients do not know who they are (the doctors don't know which cancers can be safely ignored, that's the problem), so they count themselves "saved by mammography" when they are in fact victims of mammography. The side effects of their unecessary treatment may be severe, quite aside from the stress involved.
What about the women who can't afford mammograms, who have to depend on free clinics or whatnot? There's your rationing of life-and-death health care.
All this talk of risk and false positives and biopsies is irrelevant if the woman doesn't generate a profit and therefore entry into the system.
On an unrelated topic, I visit a lot of blogs and this beliefnet platform is the absolute worst. Ads on top, ads on bottom, ads when you try to go to a different page. It must hurt the traffic.
Kate @20: I was getting at that point with my comment about the importance of family history.
Logically, I can't can't put together the taskforce's recommendations and Jjoe's comment about free clinics. Except that maybe if we target screening mammograms to high-risk groups and follow the recommendations for the general population, we can afford to offer the screenings to target groups at free clinics. That's a stretch but maybe that's what he meant.
I'd still like to hear from the "outliers" of these recommendations: those women who are low-risk (especially no close family history), 40-49 years old, and who still developed breast cancer. I put that request up on my facebook and didn't get one reply.
Kate @20: I was getting at that point with my comment about the importance of family history.
Logically, I can't can't put together the taskforce's recommendations and Jjoe's comment about free clinics. Except that maybe if we target screening mammograms to high-risk groups and follow the recommendations for the general population, we can afford to offer the screenings to target groups at free clinics. That's a stretch but maybe that's what he meant.
I'd still like to hear from the "outliers" of these recommendations: those women who are low-risk (especially no close family history), 40-49 years old, and who still developed breast cancer. I put that request up on my facebook and didn't get one reply.
Is there an echo in this room?
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