littlek
 
Reply Mon 16 Nov, 2009 05:05 pm
Quote:
The US Preventive Services Task Force, established by the federal government to set standards on disease prevention and primary care, concluded that mammography saves relatively few lives in women 40 to 49, and that this benefit is eclipsed by the risks, including tests that erroneously detect tumors when none exist.

The task force used a similar analysis to determine that women from 50 to 74 -- when breast cancer becomes increasingly common -- should be screened, but that little was gained by performing mammograms on a yearly schedule. The panel also found that breast self-examinations are not useful, at any age.

The guidelines, published in the Annals of Internal Medicine, will likely sow considerable consternation among women and their doctors. Recommendations on who should be screened -- and when -- have vacillated for decades, although in recent years, most groups have championed breast cancer screening starting at 40. In fact, the Preventive Services Task Force seven years ago endorsed exactly such a policy. The American Cancer Society and the National Cancer Institute, the government's cancer research agency, continue to advise routine mammograms for this age group.


From: http://www.boston.com/news/health/blog/2009/11/delay_routine_m.html

Well, ladies (and gents), what do you think? Is this a godsend to you, or do you worry about an increase in serious breast cancer cases?
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BillRM
 
  1  
Reply Mon 16 Nov, 2009 06:03 pm
@littlek,
One wonder how many health insurance companies people directly or indirectly were on that task force.
0 Replies
 
littlek
 
  1  
Reply Mon 16 Nov, 2009 06:11 pm
I don't know (is there a way to find out?).

I always felt like it was stupid to radiate tissue that you feared might get cancer - seems to be contradictory practice. Of course, it was said to save many lives. So, <shrug>.

If health insurance companies held sway in this piece of news, wouldn't they be pimping the idea of MRIs as a replacement to mammograms? They're much more lucrative for them.
0 Replies
 
ossobuco
 
  1  
Reply Mon 16 Nov, 2009 06:29 pm
My reply is mixed. I know enough women who lived with and died from bc in their forties to still be for the chase, despite the mishugas (where is Roberta to fix my spelling) with non life threatening findings. I do agree with the, ah, taunt, re self breast checks... somewhat.

My bc was found on probably my nineteenth mammo, when I was 59. Two calcifications. This was at a good radiologist's place near a good med center. The radiologist did the ultrasound just after the mammo and said (from what he saw) I should have a needle biopsy, which I did the next day. I am a ballsy broad on occasion, but I got in because I wouldn't take no (I was only in LA that week and perhaps had the right mds' names) and because of a national disaster which made for at least one cancellation. I've talked about that before on a2k). Much sturm and drang later, invasive ca was the result of the pathology, and in surgery was found to have been galumphing along.

This was nothing I could have detected by breast checks.

Alternately, I've a friend of a friend who did find a lump on breast check, and found herself (long story) in stage four. She ended up with a bone marrow transplant that worked, far as I know, and that was at least a decade ago.

I know many breast cas are slow, as are many prostate cancers. Some aren't, and we await the science to tell the difference.
I don't know the answer to the thread conundrum, but individual lives do matter in some sort of contretemps re costs in either money or anxiety.

0 Replies
 
Linkat
 
  1  
Reply Tue 17 Nov, 2009 11:05 am
I've known two women who have detected breast cancer through a self exam.

I wonder how expensive a mammo is....
0 Replies
 
ossobuco
 
  1  
Reply Wed 18 Nov, 2009 05:28 pm
An opinion piece about this issue --
(I agree with her take on it)

http://www.sfgate.com/cgi-bin/blogs/gurley/detail?entry_id=51917&tsp=1
sozobe
 
  1  
Reply Wed 18 Nov, 2009 05:45 pm
@ossobuco,
Helpful. Thanks.

It doesn't seem to account for the harm of radiation itself -- is that negligible?
ossobuco
 
  1  
Reply Wed 18 Nov, 2009 05:56 pm
@sozobe,
I think it is - compared to rads in radiation therapy, or even in the rads in the mini xrays I took of people just admitted to or just leaving the hospital back in the late fifties. My first job, geez. Anyway, they were discontinued since their purpose was to find tb in the population (and our research, which I also got involved in showed we didn't find any) and.. the minifilms were said to have 500x the rads (whatever the word was) of a regular 14 x 17 xray, since they were photofluographs. Older a2kers may remember putting their feet in machines at Buster Brown stores - those were photofluorographs too, or at least I remember that they were.
On the other hand, I don't have any numbers to back my opinions up re 1 mammo a year being no worry re rads.
0 Replies
 
littlek
 
  1  
Reply Wed 18 Nov, 2009 05:57 pm
Thanks for that article, osso!
0 Replies
 
Linkat
 
  1  
Reply Thu 19 Nov, 2009 12:05 pm
@sozobe,
Modern-day mammography only involves a tiny amount of radiation " even less than that used in a standard chest X-ray.

Radiation is measured in rads. To give you an idea of just how low radiation exposure is during a mammogram, consider the following comparison. The views (individual x-ray shots) taken during a mammogram (usually 2 are taken) are around 0.1 - 0.2 rads. By comparison, cancer patients undergoing radiation treatment often receive anywhere from 1000 to 7000 or more rads in a normal course of therapy.
0 Replies
 
Linkat
 
  1  
Reply Thu 19 Nov, 2009 12:09 pm
I heard the other day on the radio that a mmogram only cost some where around $200. I thought that seemed low and know that often times the truth isn't told so I looked this up -

For an uninsured patient, typical full-price cost of a mammogram ranges from $80 to $120 or more, with an average of about $102, according to Blue Cross Blue Shield of North Carolina. Some providers charge more, and some offer an uninsured discount. For example, at the Kapiolani Medical Center in Aiea, Hawaii, where the full price is about $212, an uninsured patient would pay about $127 to $148.

ossobuco
 
  1  
Reply Thu 19 Nov, 2009 12:28 pm
@Linkat,
I remember paying $75. but not of course since I've been w/ medicare.
BillRM
 
  0  
Reply Thu 19 Nov, 2009 01:32 pm
@ossobuco,
At a hundred dollars and one in 2000 screening showing cancer that would mean it cost all of 200,000 to save a woman life on average.

Seem high to me now if it was a man then well worth the price.

JUST KIDDING............
Tai Chi
 
  2  
Reply Thu 19 Nov, 2009 01:51 pm
@BillRM,
BillRM wrote:

At a hundred dollars and one in 2000 screening showing cancer that would mean it cost all of 200,000 to save a woman life on average.

Seem high to me now if it was a man then well worth the price.

JUST KIDDING............


Gosh, Bill, is there any post you won't respond to inappropriately?
Walter Hinteler
 
  1  
Reply Thu 19 Nov, 2009 03:01 pm
We've in Germany a 'mammography-screening-program', which is totally free for all mandatory insured women between 50 and 69 (those, who are privately insured have to pay for it - something like $100 or less, depending in the insurer).

It's said to be a big success.
BillRM
 
  0  
Reply Thu 19 Nov, 2009 03:11 pm
@Tai Chi,
Gosh, Bill, is there any post you won't respond to inappropriately?
--------------------------------------------------------------------------------
NO
0 Replies
 
ossobuco
 
  1  
Reply Thu 19 Nov, 2009 07:09 pm
This one annoys me but in the interest of fair play, I'll give the link -

http://view.mail.health.harvard.edu/?j=fe691672776604797112&m=febb15747d630d7a&ls=fdf61c747661027c71167774&l=fe57157677630c7b7217&s=fe4b1c777163037a711c&jb=ffcf14&ju=fe2c167576640d79721475&r=0

Gail Collins (NYT) wrote an editorial on this but I haven't read it yet.
ossobuco
 
  1  
Reply Thu 19 Nov, 2009 07:13 pm
@ossobuco,
I should add that the friend of friend who did find a lump on a breast check that turned out to be stage 4, never good news, was still in her forties. Just another anecdote - that could be a song.
0 Replies
 
Thomas
 
  2  
Reply Fri 20 Nov, 2009 11:19 am
The task force's full report is available online now.

You can read it here.

I notice that their language is much more guarded than what's coming through in the press. From their "summary of the recommendation":

Quote:
The absolute probability of benefits of regular mammography increase along a continuum with age, whereas the likelihood of harms from screening (false-positive results and unnecessary anxiety, biopsies, and cost) diminish from ages 40-70. The balance of benefits and potential harms, therefore, grows more favorable as women age. The precise age at which the potential benefits of mammography justify the possible harms is a subjective choice. [emphasis added --T.] The USPSTF did not find sufficient evidence to specify the optimal screening interval for women aged 40-49 (go to Clinical Considerations).

Source

I find it difficult to see how this justifies such a brouhaha in politics and the media.
0 Replies
 
Linkat
 
  1  
Reply Fri 20 Nov, 2009 11:46 am
@Walter Hinteler,
With my private insurance, I also do not pay anything for any woman over the age of 40 annually - it is normal coverage (at least right now).
0 Replies
 
 

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