Mammography: What to Do Now?

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Coming from the medical point of view...as a current mammographer...I think these new guidelines will put women in harms way. The single most risk factor for having breast cancer is that we have BREASTS.
This week alone I have recieved pathology findings on 7 women with invasive ductal carcinomas. 5 out of these 7 women were referred for an annual screening exam (not having symptoms at the time of their exam). While I'm not sure how they will do with treatment and of the estimated survival rates...I wonder what their outcomes would be if these patients would have waited for another year before screening (most likely worse than when they were diagnosed)
We as women should not let a simple body structure such as a breast take out livelyhoods away. Mammograhy is a relatively inexpensive exam that takes only a few minutes and I definately have seen it make a difference in womens lives

michelel of CA 7:57PM November 18, 2009

Did any of you stating that these recommendations were made by a panel of men actually bother to find out more about the Preventive Service Task Force? Clearly, you didn't. Otherwise, you would know that 8 of the 16 members are women. A few recommendations of my own:
1. Quit playing the blame game.
2. The Preventive Service Task Force is not some overnight creation serving as a pawn for the government; the Task Force has been operating since 1984.
3. Mammography, like other screening tests, has risks and benefits. The benefits are more evident with increasing age.
4. Consider that these recommendations are intended for optimal population health, not individual health, which is why the recommendations include a caveat regarding pre-existing risk factors.
5. Learn the risk factors for breast cancer, which will ultimately facilitate discussions with your physician about an appropriate screening frequency tailored to your needs.
6. Quit being so afraid of science.

Reason of ND 6:46PM November 18, 2009

After years of pounding into women that you must get your annual mammogram starting at 40 and the fact that lifes have been saved because of this practice, we are now chainging this. I am a breast cancer survivor that was diagnosed in my 40s. Mammography saves lifes. It is a medical fact that most women who get breast cancer are not in a recognized risk factor category. I could cry that this committee is so stupid and did not even include an oncologist. Women, please insist on a screening memmogram starting at 40.

Roxanne Fowler of AZ 2:28PM November 18, 2009

To "simple amswer" and "good wake up call"
May I suggest you turn in your Medicare cards, Veteranss insurance cards, and all similar items? After all, these are government-managed programs using mostly private providers and (to quote Good Wake Up Call) "You don't want the government involved in health care in any way shape or form."
Talk is cheap - actions speak volumes.
Consider the actions suggested by Good Wake Up Call: "Many insurances will not pay for mammograms for any woman under 50 after this." Without guidelines, do you seriously think insurers would decide to pay anyway?
By the way, aren't these and all previous guidelines "Government involvement"? It seems our good people "simple amswer" and "good wake up call" would use a government guideline to defeat another. HMMMM

Fred of CA 1:53PM November 18, 2009

It seems to me the important message here is that women consult their doctor on a regular basis. Knowledgeable medical advice from a directly informed medical professional should be the cornerstone. The guidelines are just that - guidelines.
Organizations have always chosen which guidelines they support. Insurance companies are no different today than they were before.
The outcry by some who blast this as a precursor to "healthcare rationing" and worse conveniently forget that the health insurers already perform rationing of their own. What's more, under the guise of doing case-by-case administration, they offer only what they must and not what is medically advised by the persons closest to the situation.
The bad rap on government-managed care also forgets that at least government operates in a more transparent manner, and awards no incentive bonuses to administrators for reducing direct costs such as treatments and procedures.
PS I'm a medicare-age male whose Mother and Aunts had breast cancer at later stages of life.

Fred of CA 1:41PM November 18, 2009

My sister (whom died at the age of 47 - 3 years after self discovering a lump) was told at every annual exam with her gyno. "Have a mammogram at the age of 40 and then at the age of 45." Well, she had the mammogram at 40, went each year for the gyno annual exam. She was considered "Not at risk". My sister found her lump 5 months before her 45th birthday - Stage II. This lump would have been picked up well before then if she had done an annual mammogram. Unfortunately, she passed away from breast cancer 10 days before her 48th birthday. This should be a lesson to all women, start annual mammograms & breast at 40!!!! PS - she was at a National Cancer Center in NYC.

WY of CA 1:24PM November 18, 2009

Healthcare rationing has begun!!!!

Fran of NC 1:12PM November 18, 2009

The knee jerk reaction to this story is to play on the emotions and imply that this is a cost saving measure. It is an idea that will benefit patients. There are an overwhelming number of false positives, unnecessary biopsies, and even unnecessary surgeries and bouts of chemo caused by too many mammograms. It is counter intuitive for people to understand that too many tests, too much medicine harms people, but this is the case. Iatrogenics is a word my father, a doctor, taught me when I was very young. Iatrogenics is the FOURTH LEADING CAUSE of death in the USA. It means "doctor induced diseases." The evidence is clear and has been for years. Mortality rates and patient outcomes are better in small communities with fewer specialists and less tests. You should have early mammograms if breast cancer is in your family. If not, regular self exams will suffice. It is time for journalism to quit playing on people's fears and base stories on evidence based medicine.

amy Chapman of CA 1:09PM November 18, 2009

What does this report have to do with socialized medicine?? Last time I checked, it was the FOR PROFIT private insurance companies that have decided not to cover annual mammograms because a task force of 16 medical professionals (none of which were oncologists and more than a few are employed by the insurance companies).
This task force did not say insurance companies should not cover annual exams, the report stated exams should not be routine. Now women will have to pay out of pocket for exams, because insurance companies feel cancer detection for women is "selective".
So how do you like your private insurance coverage that already sees a person's gender as a pre-existing condition?

Heather of GA 1:07PM November 18, 2009

Women of African descent tend to have the most malignant form of breast cancer. According to womenshealth.gov "African American women are more likely than all other women to die from breast cancer. Tumors are found at a later, more advanced, stage so there are fewer treatment options. Some reasons for this may include not being able to get health care or... or not having insurance."
I am concerned that more women of African descent will contract and die from breast cancer as a result of these findings. We need to ENCOURAGE preventive action.
My concern is that health insurance companies will not allow Women of African descent to get a routine mammogram before age 50 and that many of these women may not reach age 50.

Tanya of CT 1:05PM November 18, 2009