Open discussion: The new mammogram guidelines

Hi Julia- While not personally impacted by these recommendations, I do listen with interest for my mom and sisters. First, I think it's important to note that this change in recommended testing was only for women not in an elevated risk group (e.g. women who have a family history of breast cancer). For women in those elevated risk groups, they continue to recommend earlier testing.

The conversation I heard on public radio (perhaps the show On Point?) two days ago helped me understand some justifications for the change in recommendations the balance of the population. Experts on the show said that earlier testing sometimes leads to the treatment of tumors that were not growing/threatening, causing some women to have necessary surgery and undergo the risks associated with that surgery.

I don't have good statistics on that front, though the program may have provided additional background before I tuned-in. Even with that data, it's impossible to weigh the impact of a lost life against the life impact of unnecessary surgery and potential complications for a broader population. I thought it was worth mentioning, though, that those supporting the change had non-financial explanations for doing so.

Hi Tom, thanks for kicking this off. You make a good point:

"First, I think it's important to note that this change in recommended testing was only for women not in an elevated risk group (e.g. women who have a family history of breast cancer)."

Some of the feedback I've received includes notes that this change actually puts us on par with Canada's practices.

At time of writing (and outside of NewsHour) I haven't seen people citing the medical reasoning, or communicating how that data shifted happened over time. That leaves us with - is this about cost? Does it tie into other healthcare issues? Or is it just the communication?

I'm really glad you spoke up here.

Note: I think you meant "causing some women to have [un]necessary surgery"

There goes the neighborhood!

Ah Liz, it isn't boring here.

I think there are some misconceptions about the new guidelines. First, they are not a "government" thing; they are a "medical professionals" thing. Secondly, as Tom pointed out, the new guidelines are only for NOT AT RISK patients. This phrase has been largely left out of the conversations I've heard. Third, there is medical evidence proving that repeated exposure to radiation is harmful and, in fact, puts you at a higher risk of getting many cancers (if not all of them). Fourth, it was a government panel who formed an opinion largely based on politics that decided annual mammograms the "gold standard" for all women. Fifth, the false reliance on mammography is keeping the medical community from researching and finding a better way to deal with breast cancer. Sixth, the decrease (3%? - not sure) in deaths due to breast cancer being cited by the AMA is due to better chemotherapy, not earlier detection, according to Dr. Susan Love ("The Breast Doctor") who has sanctioned the new guidelines.

Having said that, this discussion should never be about saving money; it should be about saving lives and the value of life itself. If one life is worth no more or less than another (and it's not!), let's talk about the safety of women who want/need abortions and can't get them.

I'll just add that common sense should always prevail: if you feel a lump (or notice any other warning signs of cancer), get it checked out - period.

Diana, thank you for a very complete reply - your note can actually stand alone, and if you don't mind, I'll quote you in its entirety.

This is a current topic on someone else's post, too. It sure has people talking. No doubt, it's because the news stories have left out the women at risk group out of their discussions. I personally am in the higher risk. My aunt died relatively young, before age 60, due to a very rare form of breast cancer. My cousin is already dealing with finding benign cysts that she has to pay attention to because of the high risk. Her mother found the lump initially through self-exam. Clearly self-exam is important, too, but not enough on its own, as my aunt's case brings so close to home.

Kitty: That is unfortunate and it's my understanding that genetics play a great role (albeit not the only one) in determining cancer risk.

So, according to AMA guidelines, the women in your family should be getting mammograms by the age of 30 (half the age of the relative at the time of their diagnosis) - is that correct?

Is that an appropriate guideline? Should it be earlier? Would you want to be tested more rigorously and at a younger age?

Tell that to the ****insurance company. And, my doctor. They still made me wait 'til age 40. So, I only just got the mammogram this year, after being so anxious for over a decade since my aunt died. The only reason I had one prior to age 40 was because I had a breast reduction. It is required to have a mammogram for any such breast surgery. If they adopt the new guidelines, they'll kick me to the curb again for another decade.

I think the guidelines are a long way's away from adoption. Plus, if you are high risk they won't apply anyway.

I hear you on the insurance company problem (thousands upon thousands of dollars later). Don't get me started.

LOL

For you folks wanting Obamacare. This is what's going to happen. Government advisory groups will come out with these reports and the people stuck with crappy government insurance will get less mamograms even though people like the American Cancer Society says this new guideline is a bad idea.

People, would you trust your health to the government if Bush was president? Or whoever is President in 4 or 8 years from now?

What happens if you fall out of range for what they call a "risk group"? or," Sorry, you are too young, that lump you found by your self exam is probably a false alarm, we won't give you a mamagram. "

RATIONING, get used to it people.

Oh, oh,

Looks like the Chicago Mobsters, Barack and Rahm, will have to start threatening and smearing the insurance industry some more!

HOW DARE THEY OFFER MAMOGRAMS TO PEOPLE THE GOVERNMENT SAYS DOENS'T NEED THEM!

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