Tue
Nov 17 2009
11:25 am
What to do? Breast cancer screening guidelines changing?
By: bizgrrl

My first thought is WTF. I'll be very interested in how my personal doctors react to the announcement.

The United States Preventive Services Task Force is, according to the New York Times, an influential group that provides guidance to doctors, insurance companies and policy makers.

This group has elected to change their recommended guidelines for breast cancer screening. They now say to start having mammograms at 50 instead of 40 and to have them less frequently, every two years instead of every year. And it said doctors should stop teaching women to examine their breasts on a regular basis. It is also being reported, "The guidelines are not meant for women at increased risk for breast cancer."

...downsides of early screening: the false positives, the biopsies, the repeat diagnostic tests and the fallout from overly aggressive treatment, including immense psychological stress.

Now, apparently, mammograms can do more harm than benefit. I know medicine is not an exact science, but when they come out with this kind of announcement after years of pushing early screening, what are we supposed to think? Who is crying wolf?

Topics:
R. Neal's picture

Who is crying

Submitted by R. Neal on Tue, 2009/11/17 - 11:35am.

Who is crying wolf?

Insurance companies who don't want to pay for diagnostics?

Employers who don't want their premiums to go up to pay for diagnostics?

On the other hand, there may be some merit to concerns about false positives and aggressive treatments.

It also sounds like some risk factors and family history are considered in evaluating exceptions to the new guidelines, but not all.

Tess's picture

Self exams

Submitted by Tess on Tue, 2009/11/17 - 12:02pm.

I also heard that the same group said that docs should not encourage self exams, either. That those also don't work. (Tell that to the people I know who have found lumps that way.)

Andy Axel's picture

Can we assume that prostate

Submitted by Andy Axel on Tue, 2009/11/17 - 12:52pm.

Can we assume that prostate screening will get similar treatment?

____________________________

Calling to the underworld. Come out of the cupboard, you boys and girls.

smalc's picture

Well I, for one, hope self

Submitted by smalc on Tue, 2009/11/17 - 3:20pm.

Well I, for one, hope self prostate exams are not encouraged. :)

Giuseppe's picture

Bottom!!

Submitted by Giuseppe on Wed, 2009/11/18 - 8:02pm.

He shoots! He Scores!

Hayduke's picture

Not new

Submitted by Hayduke on Tue, 2009/11/17 - 12:58pm.

The results have been in for years on this, but, as metulj points out, it takes a while for the medical establishment to change. Testing for cancer seems like a no-brainer, but then we find that people who aren't tested end up having better life expectancy and quality than those who are. Trust the long-term statistical studies with huge data pools over clinical trials and intuitive reactions.

Treehouse's picture

As a breast cancer survivor

Submitted by Treehouse on Tue, 2009/11/17 - 9:23pm.

who found the lump, I certainly support self exams. But they and mammograms are not the be-all and end-all. Diagnostics are helpful but I am glad to see some caution because they don't know which cancers will grow and spread and which will probably not. They say some breast cancers have been growing for 30 years. I had two false-positives with MRI and even the doctors are apologizing to me. We're in a transition period of better diagnostics and treatments so changes are happening and normal. Trust yourself and stick with the doctors you trust is my advice.

bizgrrl's picture

Trust yourself and stick

Submitted by bizgrrl on Tue, 2009/11/17 - 11:10pm.

Trust yourself and stick with the doctors you trust is my advice.

Knowledge is key. I don't have the knowledge. I want to trust doctors but most doctors recent advice is now being reported as invalid. It's a scary web they weave, and I'm not sure who they are.

Hayduke's picture

Keep up with the latest

Submitted by Hayduke on Wed, 2009/11/18 - 3:39pm.

Keep up with the latest studies. Ask your doctor for her opinion on them. If she doesn't seem to have kept up or thought about them, or if there's reason to suspect financial concerns are having a bigger influence than science (ugly, but way too common, particularly in cardiology), it's time to find a new one.

StaceyDiamond's picture

screenings

Submitted by StaceyDiamond on Wed, 2009/11/18 - 10:33pm.

One doctor has been on tv accusing the politicians of setting us up for rationing. It could equally be true that its a way to save insurance companies money. Charlie Gibson brought up a great point IMO in an interview last week. He asked the person he was interviewing that if too much treatment is the problem why not keep the screening but change the treatment. I wonder how many folks are over-treated with chemotherapy and die from that.

Treehouse's picture

Good information

Submitted by Treehouse on Wed, 2009/11/18 - 10:33pm.

Echidne has comments and points to a good article about the screening conundrum

(link...)

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