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They Say: No Breast Cancer Screening for Women Under 50
In the second trimester of my second pregnancy, my OB felt a suspicious breast lump.
The surgeon thought we should take it out — despite the fact that the ultrasound found it to be benign-looking, while my OB and I wanted to wait. Four months and one needle biopsy later (done for reassurance), I went under then knife while I was still breastfeeding my newborn.
The lump was thankfully benign. It was my second, my third occurred just last fall. That one was removed surgically after a failed core biopsy.
According to the U.S. Preventive Services Task force, those surgeries probably should never have occurred (and the third one certainly wouldn’t have occurred since it was discovered by mammogram). They recently announced controversial new guidelines that turn the tables on preventative breast health care for women.
For years, women have been dutifully getting mammograms and doing monthly breast self-exams, taking comfort in the fact that no news is good news, but bad news is better when caught early. The task force’s new guidelines, however, say that women under 50 don’t need regular mammograms and that older women need them just every two years. Not only that, they all but call breast self-exams useless.
The news has left women confused and concerned. Confused, because these guidelines are so wildly off-course from what our doctors have taught us. Concerned, because insurance companies may soon stop paying for preventative care. (That’s unlikely to happen any time soon, says Katherine Sebelius.)
The problem, says the group, is the risk/benefit ratio. Mammograms aren’t 100 percent effective in catching cancers, and false positives are very common, putting healthy women through unnecessary medical procedures and creating stress and anxiety. For one woman’s life to be saved from breast cancer by mammography, says the group, 1,900 women need to be screened.
Despite my three “false positives,” I’m not ready to give up on the notion that I play at least a small role in the health of my breasts. My second lump was felt through a SBE, my third through mammogram. And sure, they were benign — and I get that that’s the point, they never needed treatment in the first place — but what if they hadn’t been? I’d take that anxiety and minor surgery– even while nursing a newborn — over the worry that the lump may be something more sinister. And I can’t help but think about my co-workers and friends who’ve been dealt a different diagnosis, despite the fact that they’re young and weren’t thought to be at-risk.
What do you think about the group’s recommendation?
Photo: sunsets for you, Flickr
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6 Comments
PlumbLucky commented on Nov 19 09 at 9:45 amI know that my cousin, who was in a high risk group regardless of her young age, would have had an even MORE difficult time getting the diagnosis (one Dr. refused to refer her based on her age and age alone!) than she already did. Radical double M, ovaries removed, chemo, radiation, etc. and five years later…she beat it. And she still isn’t even forty yet.
She found the lump herself during a BSE. Somehow I don’t think she finds them “useless” as she’d likely be dead (the cancer was stage three by the time it was diagnosed!) by now had she not raised holy heck with her doctors.
theldara commented on Nov 19 09 at 11:02 amI lost my best friend at age 23 to breast cancer. She found a lump during a BSE at age 22, managed to get a doctor to FINALLY look at it a month later, and was immediately diagnosed at Stage IV. So, don’t tell me “too young”. Bull****. I, her mother, and her suriving sister would all tell you that we’d rather go through the axiety of a test that turned out negative than not know and end up dead. If you’ve got breasts, that means you’re NOT TOO YOUNG for breast cancer. Period.
Laure68 commented on Nov 19 09 at 11:19 amThe thing I really don’t understand about this new guideline is that they are saying this is for asymptomatic women only. If you have symptoms (a lump, etc.), you should still get a diagnostic mammogram. But, how do you know if you are symptomatic if you no longer perform BSE’s?
Em commented on Nov 19 09 at 12:58 pmThe recommendation isn’t for women NOT to get a mammogram, it’s for women to talk with their doctor before getting one annually just on autopilot. If the doctor discovers a lump during the yearly exam, she’ll surely order an ultrasound.
I would guess most of you are pro-healthcare reform, just based on the demographics of this site. The recommendation for people to skip unnecessary tests is a key one in controlling the cost of healthcare in the US, but yet everyone seems to agree that they’d want to have the mammogram no matter the value of the majority of results. Funny how controlling healthcare costs sounds like a good idea until someone suggests that you avoid having a test that may potentially help you out.
Laure68 commented on Nov 19 09 at 1:44 pmEm – one big problem is that this is confusing. This guideline says one thing, and the ACS is saying something else.
Thanks for bringing up the yearly exam given by your doctor. My main question was how do we discover if we are symptomatic before age 50, and I guess it would be through this exam.
I do agree that we should not perform tests that are not effective. I think this new guideline could have been conveyed a little more clearly, though. For example, why is it that screening 1900 needing to save one life (40 to 49 years) is too much, but screening 1300 to save one life (over 50 to 59 years) is appropriate. It seems that this was picked rather arbitrarily, but maybe there is some reasoning behind it.
Laure68 commented on Nov 19 09 at 1:45 pmSorry, I meant “screening 1900 to save one life”.
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