Addicted to Mammograms

[tonysam]

THE United States Preventive Services Task Force’s recommendation this week that women begin regular breast cancer screening at age 50 rather than 40 is really nothing new. It’s almost identical to the position the group held in the 1990s.

Nor is the controversy that has flared since the announcement something new. It’s the same debate that’s gone on in medicine since 1971, when the very first large-scale, randomized trial of screening mammography found that it saved the lives only of women aged 50 or older. Despite the evidence, doctors continued to screen women in their 40s.

Again in 1977, after an official of the National Cancer Institute voiced concern that women in their 40s were getting too much radiation from unnecessary screening, the National Institutes of Health held a consensus conference on mammography, which concluded that most women should wait until they’re 50 to have regular screenings.

Why do we keep coming around to the same advice — but never comfortably follow it? The answer is far older than mammography itself. It dates to the late 19th century, when society was becoming increasingly disappointed, pessimistic and fearful over the lack of medical progress against cancer. Doctors had come to understand the germ theory of infectious disease and had witnessed the decline of epidemic illnesses like cholera. But their efforts against cancer had gone nowhere.

More

Interesting piece, looking at the issue from a historical viewpoint.

[babylonsister]

1. I want to see a study of the number of women who got a mammo between

the ages of 40-50 who had their lives saved. I really need to see that.

I found my cancer, at the age of 27. I was lucky.

[Bitwit1234]

12. Maybe this is unusual

My sister had a mammography ever single solitary since she was in her 40's. And all of a sudden in 2000 the doctor found she had breast cancer. And it was very advanced. the mammography each year did not detect her's. She had surgery and after five years the doctor thought she was cancer free. But it had metastasized and she passed away. So sometimes they help and sometimes they don't.

[babylonsister]

14. I had a friend who found a lump on her relatively flat chest

and was told by her doc she was not at risk. She died about 5 years later from breast cancer. I don't know what mammograms helped or hurt her case, but she was my friend and I miss her.

Mammograms don't help everyone, but I'd still like to know how many lives they've save prior to the year of 50.

[emilyg]

21. Mine found at 49.

[alarimer]

42. fewer than those that undergo unnecessary treatment because of false positives.

In all this discussion, no one is talking about false negatives. This test is very poor for being able to tell something dangerous apart from something that is not dangerous.

I would rather we do fewer tests and put some of the money saved into making better tests and better treatments.

Many of the "cancers" that are detected would never develop into actual cancer and many of the ones that are detected do not respond to treatment anyway. We really gain nothing by doing mammograms every single year before age 50. In fact Canada and most of Europe use guidelines similar to what just came out, yet they do not have greater breast cancer rates as a result of that.

Americans are so pig-ignorant about science in general the fear-mongering about breast cancer is so outrageous that it is no surprise that people are letting their ignorance show.

[catnhatnh]

2. Oh Fucking Horsecock

"Addicted to mammograms"-Because they're fun???Think guys get proctos for kicks? They fucking save lives. It ISN"T interesting, it is cost reducing bullshit. Historically everyone dies. Tests that save humans are priceless.

[Berry Cool]

4. PLEASE read the article before you criticize.

It makes a very compelling case that, statistically, mammograms DON'T "fucking save lives" nearly as often as the heavy publicity campaigns for them have told us they do. It is NOT just "cost reducing bullshit."

[tonysam]

5. Read the article, please.

Don't judge the article by the headline. The writer has a fascinating look at breast cancer. This author has written a book about breast cancer.

[Bitwit1234]

13. PS

I just had one today on doctor's orders and they are NOT FUN. THEY HURT LIKE HELL. I told the tech that with all the modern equipment etc why can't they make a machine that takes the mammography and does not cause such intense pain. Kinda scared tho. She kept coming back and taking more x pics of the right breast. And from the pic on the screen it look like a large fibroid spot.

[Berry Cool]

27. The article does not SAY they are "fun."

It's not an article about people who keep getting mammos over and over because they love it. READ THE ARTICLE. Sheesh.

[Recursion]

28. Laser mammography has been available for about a decade now

It's not really clear why it's not catching on.

[Robyn66]

17. There are some very anti-mammogram people here

They dismiss cancer survivor's input as merely "anecdotal" so don't expect to make any headway. I can only hope they all stay healthy.

[tonysam]

19. No, that's not true.

People are against unnecessary medical treatment, that's all.

[Berry Cool]

3. Thank you! K&R

Some telling quotes:

By 1913, the surgeons and gynecologists who started the American Society for the Control of Cancer (later the American Cancer Society) had begun an anti-cancer campaign that, among other things, advised women to see their doctors “without delay” if they had a breast lump. Their message promoted the idea that if cancer was detected early enough, surgery could cure it.

This claim, like the cancer theory it was built on, was based on intuition and wishful thinking...But it did create a culture of fear around breast cancer...

During the 1930s and ’40s...the apparent improved cancer survival rates — a result of more people receiving diagnoses, many for cancers that were not lethal — seemed to prove the effectiveness of the “do not delay” campaign...By the 1950s, some skeptics were pointing out that despite all the apparent progress, mortality rates for breast cancer had hardly budged...

When the 1971 evidence came along that mammograms were of very limited benefit to women under 50, it ran up against the logic of the early-detection model and the entrenched cycles of fear and control...

...You need to screen 1,900 women in their 40s for 10 years in order to prevent one death from breast cancer, and in the process you will have generated more than 1,000 false-positive screens and all the overtreatment they entail. This doesn’t make sense.

[sandnsea]

11. So stop the overtreatment, not the early detection

Breast cancer is a slow growing cancer. If you find something in a mammogram, it's okay to watch it over a course of years. That's the answer, not sticking your head in the sand and pretending that what you don't know won't kill you.

[FLyellowdog]

22. This is not true.

Some breast cancers are extremely fast growing. Breast cancer is not just one kind of cancer. The term emcompasses many different forms of breast cancer.

[sandnsea]

24. Agressive breast cancer is completely different

I don't even know that they diagnose it with a mammogram. It'll be visible to the eye though. Most breast cancer grows slowly so it would be acceptable to watch a mammogram spot and not jump right to a biopsy at any irregularity.

[FLyellowdog]

25. I'm sure my friend will be glad to hear this.

She has had mammograms every six months for 10 years and her regular exam in May of last year didn't show anything wrong. Yet, her exam in November showed cancer. Hers was not aggressive breast cancer of which you speak, but it doesn't seem like hers was so "slow growing". Twelve months later, including a double mastectomy, chemo, radiation, and reconstructive surgery still in progress, she's doing as well as can be expected.

I have NEVER met anyone who thought it would be ok to just wait and see if a mammogram spot would get worse or get better. Biopsies hardly if ever produce false positives. A follow-up sonogram and then a biopsy seems a more prudent way to go. We're only talking about someone's life, you know.

[sandnsea]

26. Hers could have been growing for years

She is the point they're making. Mammograms don't necessarily catch every small start of a growth.

Watching mammogram spots is what they're doing now. I have one being watched and got, gosh, 5 opinions on it now that I think of it. My doctor, the radiologist, the 2nd opinion radiologist, and 2 doctors who are friends. It's fine. I've had a mammogram, 2nd batch of mammograms and a sonogram. We'll check it again in 6 months. It's not going to be any more life threatening then than it is now, even if it does turn out to be cancer although there is a very small chance of that.

And I'm sorry to hear about your friend and hope they get all the cancer.

[geckosfeet]

6. So? Are all these studies being released sponsored by insurance companies

who want to reduce testing? Where are the god damn investigative reporters? Doctors didn't just dream this shit up. Doctors want to save lives. Doctors would ask for test after test if they thought it would save their patients.

Cancer knows no age groups. If you have it when you are 40 it will still kill you. Detection is the only way to provide a fighting chance.

This issue should be to determine what kind of testing can we do to detect breast cancer without exposing women to damaging radiation. But that would require real work and research sponsored by someone.

[tonysam]

7. There is no evidence the breast cancer panel was bought off.

This matter has been debated for YEARS, as this piece notes.

[catnhatnh]

9. Yep

But this reform year certain preventative test are suddenly valueless, and suddenly the reduced intensity x-rays now used are worthless and dangerous and self-exams for lumps are garbage and young women who had the exams and are alive because of them are "statistical anomalies", Right???

[geckosfeet]

20. Yes. No evidence that prevention saves lives. Hogwash.

[Recursion]

30. But, in fact, there's no evidence that it does in this case

If mammograms and biopsies (to say nothing of surgical removal) were side-effect free, this wouldn't be an issue. As it is, the task force's job is to weigh potential harms against each other, and they have.

[geckosfeet]

35. Only the countless stories of women under 40 who had their cancers detected and lives saved.

Statistics are one thing. Peoples lives are not statistics.

As for the task force - yes they did their job. But the point is to find more effective screening methods to replace the less effective ones. Simply to say screening is not necessary is absurd.

[Recursion]

36. Well, the issue is with "and lives saved"

The death rate from breast cancer hasn't dropped in the past century or so; the evidence points to the conclusion that the women who got early treatment weren't actually at risk.

[tonysam]

38. The panel never said that, if you had bothered to read the report

n/t

[uberblonde]

8. Women's health groups have been saying this for years.

Because exposing your breasts to radiation every year actually puts you at higher risk for cancer.

Why is this so hard to understand?

[tonysam]

10. Because people think the worst, and now that there may be some kind of health care reform

passed by Congress, they are afraid of rationing of services.

I have been reading about this controversy for YEARS.

[Recursion]

32. There's an inexplicable resistance to laser mammography

I can't even be cynical and say it's about money, because it doesn't seem to be. But providers simply aren't using laser mammography even though the technology is out there.

[get the red out]

15. False positives

All I can say is that my Dr started me on mammograms at age 39, no breast cancer in my family. Since then I have been worn out with the false positives. I am grateful they haven't biopsied but used a sonogram, but the scare letter became common for me due to some benign liquid cysts (which my Mother has often had, but has never had breast cancer). The answer when I would get a false positive was, the cyst is benign, it won't do anything but we need to mammogram you every six months for a while anyway. I'm not complaining, I am damn grateful I have health insurance and can get necessary tests. But I am glad if they are taking a look at some of the potential problems with early and constant mammograms. I have often thought to myself that I understand completely why some women won't even go get a mammogram when they have insurance. The first time or two I got that letter the stress just about made me sick.

This is going to sound very bad to some people and probably be taken wrong, but I think they have gone overboard with the pink ribbons and the fear. I see a pink ribbon and I get a sick feeling, it is like the message comes out as EVERY woman gets breast cancer when I think they intended for the message to be for people to donate to breast cancer research. A friend had a false positive on a mammogram and she said "i don't care if they say it's benign, I'm having it OUT!" She was convinced that even non-cancer was cancer. She went back and they found NOTHING the second time. There ended up being nothing to have taken out.

[Berry Cool]

31. Hear, hear. Enough with the pink-ribbon shit.

We're way overdosed on "breast cancer AWARENESS" and woefully miseducated on "breast cancer FACTS."

[Recursion]

34. Did you read Ehrenreich's book?

She has some pretty harsh words for the pink ribbon groups. One group she wrote about kicks you out if your cancer metastasizes so that you won't be a drag on the other participants.

[get the red out]

40. No, I had no idea

I have always just been so grateful they couldn't find any cancer in me with the constant mammograms that I have avoided the subject completely otherwise. I just tune out the whole "pink" deal because I don't want to buy into the false idea that seems to arise that virtually all women will get breast cancer. That's really sad! If support isn't the purpose of these groups, what is the purpose?

[catnhatnh]

16. Unless of course the title of the OP is a lie

tell me about the women "addicted to mammograms". I mean, just because they are not mostly enjoyable.

[Berry Cool]

29. The article, I repeat, is NOT about women who get mammograms over and over

because they are "addicted to them" and "enjoy having them." It's about our SOCIETY's addiction to them as if they were a freaking cure for cancer.

[MannyGoldstein]

18. This Is A Huge Problem In Health Care Policy

Nobody wants less care, even when less care results in better outcomes - as it often does.

[Peregrine Took]

23. I once heard a salesman of medical equipment call a local talk show.

He said he sold mammogram machines to both Canada and the U.S. and the Canadian doctors were only interested in the accuracy of the machines while the American doctors were only interested in how many shots the machine could handle and never inquired about the accuracy of same.

[DU GrovelBot]

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[bemildred]

37. Good piece. nt

[tonysam]

39. I agree

It takes somebody who has researched the history of breast cancer "prevention" to know the arguments for it are nothing new.

[JonQ]

41. I think this is one of those issues you aren't allowed to discuss on here

pretty soon you will be accused of hating women and wanting to murder them.

rec'd for what it's worth.