Oh it's more than cost cutting.

As far as mammograms: too much radiation, too many false positives resulting in unnecessary further diagnostics/procedures.

In general, screening seems to only marginally improve health.

While I can see this perspective I wonder about the women that WOULD be saved by a mammogram before 50...it may not be many lives, but what cost do you put on each life?

Ahhh, you beat me to putting this question out to the women.

I fall into the hig risk catagory, so I've gotten a mammo every year since my early 30's. I'm now 40.

There was a compelling woman on the Today show, yesterday talking about the guidelines and how she presented it made a lot of sense. BC is an emotional issue so I can also understand the uproar. The guidelines were written based on research from very prestigious institutions and I'm sure changes like these aren't thrown out willy nilly.

I's also curious to hear what other women think about the new guidelines.

Can you check out this podcast? Dr. Hadler says it very well. Note: this is about screening mammos, not diagnostic, which are called for in the case of the person who posted above
http://www.peoplespharmacy.com/...-health-news-update/

So what about the women who don't fall into the risk category who, in their 30's, have had their cancer found by mammograms?

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I know I'm promiscuous, but in a classy way

I think it's bullshit. As do all the women I know from the YSC message board - those who were diagnosed with breast cancer in their 30s or 40s. Some of us with our first mammograms.

I wrote a post on it on my blog, summing up how I and many of us feel, but the gist of what this Task Force is saying is this: yes, these mammograms do save lives, but not enough to make the hassle or cost worthwhile. Our lives aren't important, those of us who were diagnosed young.

BC is much more aggressive in younger women, so if you don't catch it as early as possible, say via a mammogram, then forget it, it's basically a death sentence. And what the hell's with their saying that women shouldn't do self-exams? So basically just wait until the cancer is eating through your skin? I guess there's your cost-effectiveness, because you won't live too long at that point, with Stage 4 cancer.

And my question is this - if we're just trying to be cost-effective and go for the "greater good" and use "evidence-based medicine" - then hell, there are a LOT of tests and such out there that we should do away with, that aren't the least bit cost-effective. My example? The PKU test they do on all newborns. Taking blood, running labs, and why? There's only a 1/15,000 chance that a baby will have this. Isn't that the same principle, wasting a lot of money on what's needless testing for the vast majority?

If that's how we want our society to be, then let's at least be equitable about it, and not act like a woman's life is so less valuable and important than anyone else's.

Umm, not that I have too strong of an opinion about this!

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http://thethighmasterroutetokona.blogspot.com

How about having Viagra not covered by insurance and instead redirect that money to mammograms. Assholes. Breast Cancer is the number 2 cancer killer of women. At what point in time do health care professional place women's health issues on par with men's?

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Jen

"In order to keep a true perspective on one's importance, everyone should have a dog that worships him and a cat that will ignore him." - Dereke Bruce

That's the difference on the health care systems. The COMMON good vs MY good. At least here in the USA I have options that I discuss with my doc. I wonder if this research was done with the new ditgital machines. Also, after much discussion with radiologoists, I think that there is so much info because of all hte data we collect on each person the radiologist sees things earlier. What these shadows/spots mean is still being decided. Take those calcium deposit/spots one can see on the mammograms. Before, they could barely be detected, then they were seen and caused concern (enough to be biopsied) and now they are at the point that they watch those spots and see if they cluster. It's on going and I'm happy about it. I think radiologists take this very seriously.

 
No, the research wasn't done with new digital techniques - in fact, I think they just looked at old data, which is another point of contention. The American Cancer Society has a good summation/repudiation on their site: ACS view.

Which, again, basically brings up the whole cost-benefit thing again. The Task Force thinks that a 3% increase in death from these new guidelines is okay; I certainly do not. Yes, mammos aren't great, but they work well enough for a lot of us, and it's all we have. In addition to the BSE. Why they're recommending women not do that is a puzzle, but apparently those just "confuse" the poor wimmenfolk, who aren't sure what' they're looking for or what they might be finding.

The thing that to me is really bad is that this is a HUGE step back for women's health. HUGE. Because it's hard enough now to get women to get their mammograms, and this is basically saying ech, don't bother. Again, the problem is that cancer tends to grow VERY quickly in younger women, so waiting even a few years? Bad idea. And ANYONE can get it - only 20% of women have a family history. A lot of women are like me - zero risk factors, we exercise, eat right, etc. Do everything we're supposed to, yet still wind up with cancer, and they have no idea why. Why not be safe rather than sorry?

I know I'm ranting up here on my soapbox about this, and I apologize (kind of) for that, but when you've seen so many vibrant young women die of BC, and suffer through a horrible, painful death in the process, you tend to get a bit evangelistic about these things. Yes, mammos are annoying, but the difference between finding a stage 1 or 2 cancer and one that's stage 4 is immeasurable. And that can easily happen in less than a year, going from stage 1 to 4. Really. Have I mentioned how nasty Stage 4 BC is? Let's see, Courtney died in the hospital with her bones breaking every time she moved, since it had spread to her bones. Janet and Jen died when their organs stopped functioning and their bodies filled with fluid that they couldn't drain fast enough. Danelle wound up with a raging infection in her body that led to seizures and death. Oh, and Janet started out with DCIS, supposedly the kind of BC that "can't kill you." Right.

Melodramatic? Damn right. But if i scare even ONE person into getting a mammogram, it's worth sounding like a loon. So womens, get your fucking mammograms. Mens, get your wives or SOs to get them as well. Please.

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http://thethighmasterroutetokona.blogspot.com

This was a total boneheaded move by the medical panel. If we are going to have real healthcare reform, we are going to have to address cost issues like this. But, we also have to do it with a sense of context. Breast cancer affects so many women, and women generally don't endorse balancing cost against saving lives. This announcement could have been handled so much better by broaching it as a discussion of the facts rather than making a recommendation. Women are very practical people -- we do understand the need to be frugal and some women may choose to go the over 50 route in light of this new information and based on their personal circumstances and beliefs. It just can't be made to sound like we have to sacrafice a few of our friends to save a buck.

I don't know if you heard about another aspect of this report, which recommended against teaching regular self examination. NPR did a story about this yesterday. Apparently, the data does not support a conclusion that specific self examination is effective in detecting cancer. This seems contrary to common sense, but that's what they said.

Claudia and I have had the very same discussion not to long ago (we are both in agreement)... funny how many of the underlying reasons for the use of Viagra can be solved with a heathier life style. Fix the root cause and we'll all be better off.

Early detection of just about any cancer the best path. Early treatment can buy years of quality life even in the cases of incurable cancer.

Push back this bullshit... it may be a statistic but it's 100% if it happens to you.

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Jay

A recommendation was made the next day about Pap smears only necessary every 2 years because that is enough to catch most slow growing cancers.

-- Routine Paps should start at age 21. Previously, ACOG had urged a first Pap either within three years of first sexual intercourse or at age 21.
-- Women 30 and older should wait three years between Paps once they've had three consecutive clear tests. Other national guidelines have long recommended the three-year interval; ACOG had previously backed a two- to three-year wait.

What the fuck?!???

I am so angry about this I can barely speak. The gov of WA state, where I thankfully live, is a breast cancer survivor. It was caught in a routine mammogram she had when she announced she was running for gov to assure voters she was healthy. Turned out she was wrong. She had an immediate mastectomy and is clear of cancer. She is really really angry about this and was on the radio being very vocal. Good for her!

When I was 20 I was found to have abnormal cells on my cervix after a routine pap when I was in college. I had cryosurgery to have them removed. Pre-cancer. I was 20. It wouldn't have been caught for another year, and by then who knows what the status would have been.

I'm foaming at the mouth about all of this.

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Jen

"In order to keep a true perspective on one's importance, everyone should have a dog that worships him and a cat that will ignore him." - Dereke Bruce

An article this week in the San Francisco Chronicle contained at interesting statistic, suggesting that between ages 40 and 50, more cases of cancer are CAUSED by exposure to annual radiation through a mammogram than are detected by a mammogram.

I'd like to see a LOT more info about this, before taking a side.

I'm 41, not particularly high risk, and have never gotten a mammogram. I'm the exact demographic that needs to know what to do.

What I want to see in this public debate is more of the science, more about the risks of radiation versus non-detection.

Has the Onion done anything with this yet? That could be good...

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maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD

Not true, according to the Annals of Internal Medicine:

"Data Synthesis: In addition to publications from the original mammography trials, 117 studies were included in the review. Meta-analyses of randomized, controlled trials demonstrate a 7% to 23% reduction in breast cancer mortality rates with screening mammography in women 40 to 49 years of age. Screening mammography is associated with an increased risk for mastectomy but a decreased risk for adjuvant chemotherapy and hormone therapy. The risk for death due to breast cancer from the radiation exposure involved in mammography screening is small and is outweighed by a reduction in breast cancer mortality rates from early detection. Rates of false-positive results are high (20% to 56% after 10 mammograms), but false-positive results have little effect on psychological health or subsequent mammography adherence. Although many women report pain at the time of the mammography, few see pain as a deterrent to future screening. Evidence about the effect of negative screening mammography on psychological well-being or the subsequent clinical presentation of breast cancer is insufficient."

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http://thethighmasterroutetokona.blogspot.com

I may have issues with our governor however because of her advocacy on several issues I will continue to vote for her.

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Jay