I’m sure you’ve probably heard by now the new advice that came out this morning regarding screening mammograms. 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.
The new advice says:
• Most women in their 40s should not routinely get mammograms.
• Women 50 to 74 should get a mammogram every other year until they turn 75, after which the risks and benefits are unknown. (The task force’s previous guidelines had no upper limit and called for exams every year or two.)
• The value of breast exams by doctors is unknown. And breast self-exams are of no value.
Well isn’t that all just great? So basically, this Task Force is saying that there is nothing you can do to screen for the disease, regardless of the many, many women who have caught breast cancer themselves (including my own mother) or had their lives saved by mammograms.
Dr. Nancy Snyderman, who seems to agree with the new advice, says that you’d have to screen 1,900 women to save one life, and therefore it’s not worth it. Maybe not unless that one life happens to be yours. Heck, even if it’s NOT yours, I still say it’s worth it. One life is worth 1,900 screenings. That one life is someone’s daughter, probably someone’s mother, someone’s wife. And The American Cancer Society agrees. They are not backing off their recommendations for women 40 and older to be screened annually. Particularly when you consider that breast cancer is the most common cancer and the second leading cause of cancer deaths in American women. More than 192,000 new cases and 40,000 deaths from the disease are expected in the U.S. this year.
I can’t help but wonder if money is playing a role in all this. And apparently Dr. Carol Lee is wondering the same thing. “Screening isn’t perfect. But it’s the best thing we have. And it works,” said Dr. Lee, a spokeswoman for the American College of Radiology. She suggested that cutting health care costs may have played a role in the decision, but Dr. Diana Petitti, vice chair of the panel said the task force does not consider cost or insurance in its review. Then again, Dr. Lee is a radiologist and a change in mammography recommendations means a change in her business.
But she’s not alone in her concerns about these new guidelines. The American College of Obstetricians and Gynecologists also has qualms. The organization’s Dr. Hal Lawrence said there is still significant benefit to women in their 40s, adding: “We think that women deserve that benefit.”
Doctors worry about the stress that screening and biopsies put women through, and I certainly acknowledge there is a stress factor in all of it. I’m a Hodkgin Lymphoma survivor and I get follow up CT scans to make sure the cancer hasn’t come back. I can tell you that I’d take the stress of those scans any day over the fear I’d have to live with without those scans. There may be stress in screening, but there is also some peace of mind that if you happen to be that one out of 1,900, you’ll have a fighting chance.
I just turned 40 this year and have already had my mammogram and I plan on continuing to have them every year. How about you?
Sara Ellington is the author of The Mommy Chronicles: Conversations Sharing the Comedy and Drama of Pregnancy and New Motherhood (Hay House, 2005) and The Must-Have Mom Manual (Ballantine/Random House, April 2009) now available at Target!