Breast Cancer Screening Debate Continues

AP quoted Karsten Jorgensen as saying: "There is a lot of over treatment happening, and it is time to re-evaluate whether the benefits really outweigh the harms." over treatment is what is considered biopsies performed that come back from pathology as being cancer free. This doesn't necessarily mean there is no disease, just not cancer. The harms are explained as a rise in woman's anxiety as they await diagnosis. I don't think that anxiety compares to a life lost or extensive radical surgery as compared to minimal surgery like a lumpectomy if the cancer is found early enough.

Many biopsies can be performed with just a needle, no surgery at all. This type of biopsy leaves no permanent effect, and no anesthesia is needed. It is usually only if this type of biopsy is performed and comes back positive is there a more invasive biopsy scheduled. I am trying very hard to not show how heavily I lean on the side of yearly mammograms starting at age forty. Younger if there's a problem. This is very difficult though, as my own experience which I share at the end of this article, and just plain common sense and statistics.

AP also reported that it was mentioned at the Breast Cancer Conference In Barcelona, Spain that last year ONLY five lives per one thousand screened were saved. Well, an estimate in 2007 declared there were 278,474,917 in the world. Of course that number can change a great deal, there are so many possibilities it's a mathematicians dream. Although the source, the name of the researchers that said this was not listed.

Breast Cancer Screening Debate Continues-What Side of The Fence The American Cancer Society Is On

Pro mammogram starting at forty and continuing annually or bi-annually.

Debbie Saslow, PhD, who is the director of breast cancer for the American Cancer Society states: "Women and doctors need to understand that we are more confident than ever in the benefits of mammography," she also stated that the mammogram is the gold standard for saving women's lives from breast cancer. The American Cancer Society's standards, or recommendations have not changed at all. They still recommend mammograms starting at forty, and continuing yearly thereafter. The way The American Cancer Society puts it is this. The point of a mammogram is to find abnormalities before they are even palpable. By finding them this early, cancer can be stopped before it spreads any further. If it is to the point of palpability, that chance exists. The benefit of this is twofold. This saves lives, and it reduces more radical surgeries.

Resources listed on the ACS website for women not covered for mammograms or are uninsured or low income:

Help with mammogram costs, ACS states most communities have programs to help these women. to find these community programs they ask you to call the ACS at 1-800-227-2345.

National Breast and Cervical Cancer Early Detection Program (NBCCEDP). This program states that they feel with the worry of the cost of screening and treatment if necessary, the woman can focus their energy on getting better, not finances. This program is in every state and works with Medicaid with matching funds from the CDC. People who need this program are asked to call the CDC at 1-800-CDC INFO (1-800-232-4636) or online.

Other Resource:

Susan G. Komen will get you any help you need in breast health. Either click the name, or call 1-877 GO KOMEN (1-877-465-6636)

Breast Cancer Screening Debate Continues-What Side of The Fence is The CDC Is On

Pro mammogram starting at forty and continuing annually or bi-annually.

The CDC website states that having annual or bi-annual mammograms significantly lowers a woman's risk of dying from breast cancer. While CDC states that it's important to have a clinical breast exam, and do periodic breast self-exams, these tests have not been shown to reduce the risk of dying from breast cancer.

The CDC states that a mammogram can detect cancer up to three years before there are any signs such as lumps, or symptoms. Because of this, women are treated very early and there is no spread, and can be treated and remain cancer free with normal healthy lifespans. Something very interesting provided by the CDC is a map of breast cancer statistics according to state. As a matter of fact, the CDC has begun a campaign called The Right To Know Campaign, please click on that link as it as very important information.

Breast Cancer Screening Debate Continues-What Side of The Fence The National Cancer Institute Is On

Ironically, NCI appears both pro and con on mammograms starting at forty and continuing annually or bi-annually.

The National Cancer Institute states all the same things as the CDC and the ACS. That it is extremely important to find masses before you can even feel them. NCI states that mammogram is a great tool in finding ductal carcinoma in situ which is an invasive cancer. This type of cancer would not be found through breast exams, or clinical breast exams. By the time there are symptoms of this cancer, chances are it has already spread. Yet they go on to state that since denser breasts appear whiter on a mammogram, and tumors appear white, women should wait until they are fifty, when their breasts are less dense. They state that the ability to find a tumor in women under fifty on a mammogram under fifty depends on the skill of the radiologist.

For the NCI to state to wait until fifty to begin screening based solely on the fact that the radiologist needs skill to detect these tumors is something to take into consideration when comparing their thoughts on the new guidelines. Perhaps training the radiologists in this early detection would be a wiser choice, especially since NCI states by detecting the breast cancer early reduces deaths and more invasive procedures.

Breast Cancer Screening Debate Continues-U.S. Preventive Services Task Force (USPSTF)

USPSTF was pro-mammogram-is now seemingly the only government entity against it.

Ironically enough, it was this very task force who fought so hard for the war against breast cancer. Under their recommendations, women began getting their mammograms regularly at age forty and yearly afterward. It was after this was in place that death rates due to breast cancer dropped dramatically.

Who is U.S. Preventive Services Task Force, and what made them turn con after all those years and lives saved? USPSTF is a group of independent health experts convened by the Department of Health and Human Services. They have changed their recommendations based on, as stated on Web Md: "computer-simulated models comparing the expected outcomes under different screening scenarios" The USPSTF states that the new guidelines do not "ban" women under fifty from mammograms. They say it will only possibly change whether or not you will be covered by insurance.

"USPSTF extensive scientific evidence demonstrates that mammography reduces breast cancer mortality both among women aged 50 and older, as well as among women aged 40 to 49." and that the decision should be between the doctor and patient, as stated on the Susan G. Komen website.

So if the only group that is con-mammogram before fifty is also pro-mammogram before fifty, that leaves an awful lot of questions, such as why the change in guidelines? I can't seem to find an explanation for this. All the information stated above was from trusted government sites and researchers. As stated above, women won't be banned from the test, but if they are not covered, which the change in guidelines most likely will do, most will not be able to afford the test and treatment if there is cancer. If you have wealth, these guidelines won't do anything to you except you will have to pay yourself. However, if there is a case where there is symptoms or signs, the guidelines remain the same. The problem with that is as the CDC, ACS and NIH all say that it is the detection BEFORE any signs or symptoms that prevent breast cancer deaths.

I can tell you my own experience. I am not a breast cancer survivor, however, I do have multiple breast disorders. At the young age of twenty two, I found a breast lump. At first I was told to just wait it out, I was too young and the mammogram wouldn't see it anyway, as my breasts would be too dense. I wanted to know for sure though, as my mother's sister was just diagnosed with breast cancer, and treated, she was only forty years old. The mass was extremely small, but found on a mammogram.

She sought treatment immediately. This ended with a radical mastectomy. For some reason she felt the need to show me what she looked like under her shirt, this was before reconstruction. I believe this scarred me for life. It certainly scared the daylights out of me. This is why, although I was a mere twenty two, I was determined not to be ignored although I had no insurance. I went to a breast clinic run by Fitzgerald Mercy Hospital. They did the mammogram which did see the abnormality. This was followed by an ultrasound and a talk with David Bottler, MD, who I recently did an article on about plastic surgery.

I ended up in surgery. They indeed were tumors. Although benign, I was glad to have had them removed. For one, pathology let the doctors know exactly what they were and what I could do to reduce getting more. For two, the other two abnormal things found were now able to be watched. When I got home from my surgery I stood in the bathroom mirror and removed the bandages. I cried. Half my breast was gone, but the tears were of joy because although I still didn't know if it was cancerous yet, I was left with most of my breasts intact. Not long and I healed so well from the surgery, not did they become "even" again, there is no scar to be seen anywhere.

Something my aunt didn't have a chance for. It is now seventeen years later and my aunt is healthier and more youthful than myself. That mammogram at forty saved her life. That mammogram also saved me from getting tumors over and over again. I hope and pray that my insurance company continues to pay for my yearly mammograms that I need to watch the conditions I have. They also watch the tumors that did grow back and their size. If they don't, I will seek out clinics that will and stay on top of my health.

You and only you are in charge of your health. This is not a politician's decision to make for you. There are resources as I listed above if you are not covered because of health care coverage changes, and recommendation changes. If you have any doubt at all, anything even the slightest bit off, please contact one of the resources listed above.

Please view the video to see young breast cancer survivors.

Resources:
http://www.google.com/hostednews/ap/article/ALeqM5h0vCQJ_l_5dZhCkO2ElDQhntxpSQD9EMIH580
http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Updated_Breast_Cancer_Screening_Guidelines_Released.asp
http://www.cdc.gov/cancer/breast/basic_info/screening.htm
http://www.cancer.gov/cancertopics/pdq/screening/breast/Patient/page3
http://ww5.komen.org/KomenNewsArticle.aspx?id=6442451487
Personal experience