What do you think of the new breast cancer guidelines?

On Monday, the federal Department of Health and Human Services’ Preventive Services Task Force recommended — among other departures from long-held practices — that women wait until age 50 to get routine mammograms.

Perhaps because this comes in the wake of the Stupak-Pitts amendment that severely limits a woman’s access to abortion, this does not set well with everyone.

Here are the new recommendations. Tell me I’m getting all conspiracy-theorist and I will at least half-listen, but we all know women whose breast cancer was first detected while those women were in their 40s.

And here’s a bit more on the topic.

51 responses to “What do you think of the new breast cancer guidelines?

  1. The timing is just an unfortunate coincidence, isn’t it? I am not a doctor, but I will continue to advise my under-50 friends to continue to get an annual mammogram.

  2. …even if it’s not covered by their insurance anymore.

  3. I had three friends in a row diagnosed in their early 40s ten years ago. Two of them are still alive. I wonder if the record would have been that good without mammograms?

  4. I have 2 friends who developed breast cancer in their 40’s and both are survivors. I’m sorry about your sister-in-law, dj, and your friend, Songbird. Early detection is key to survival and so I can’t imagine why these new guidelines would be a good idea for women’s health.

    “According to American Cancer Society statistics, in 2009, approximately 40,170 women will die from breast cancer. The CDC calculates that mammograms can reduce breast cancer mortality by about 20 percent in women aged 40-49 and by 20-35 percent in women aged 50-69.”

    This is just wrong, in my opinion. It’s trading lives for money.

  5. My aunt was just diagnosed. The American Cancer Society is recommending people stick to the old guidelines. I think this would hamper the efforts of insurance companies to stop covering them.

  6. I have a family history of breast cancer – my maternal grandmother passed away from it while in her 50’s, so this is an issue close to my heart. I can’t wrap my head around the recommendation for doctors to stop teaching their patients to do regular self-exams. It seems totally counter-intuitive.

  7. I am GLAD they finally admitted that exposing every single woman to x-rays every year from age 40 regardless of their actual risk was NOT accomplishing any reduction in mortality from breast cancer. Anyone with “the gene” (as evidenced by a mother, aunt or sister who had breast cancer at a young age), might want to get mammograms starting in their 20s.

    Those of us without that gene, not.

    I looked it up. The “average age at diagnosis” is something like age 71 for this disease, and that average includes those with the gene for it. Since women with the gene start getting a very aggressive and untreatable form at very young ages, that tends to skew the average, and the mortality statistics for the young ages.

    Non-menopausal women without the gene who gave birth in their younger years, nursed their babies and didn’t take birth control pills for decades on end have no reason to subject themselves to radiation every year to test for something they are very unlikely to get for another 30 years, if ever.

    That is why they issued the new guidelines.

    • For real? Then why advise women not to do self-exams? And my understanding — and I may have dreamed this — is that the risk of exposure during a mammogram isn’t huge. And I promise I remember reading that family history isn’t that influential…ah, but now I’ve just gone to read that that’s not true, that family history can play a part.

    • So is the idea that no one gets breast cancer between the ages of 30 and 70 so why screen?
      It’s cancer we’re talking about here, if you don’t catch it in time you DIE. A long, terrible, agonizing death. No thank you. The decision to get a yearly mammogram is not a societal decision it is a personal decision. Who looks at the stats and says, I *probably* won’t get cancer so I just won’t even check.
      As far as I can tell, the ACS is the only dog in this fight without a monetary interest so I’ll listen to them.

  8. According to The National Cancer Institute’s SEER statistics review:

    A woman’s chance of being diagnosed with breast cancer is:

    from age 30 through age 39 . . . . . .1 in 233
    from age 40 through age 49 . . . . . . 1 in 69
    from age 50 through age 59 . . . . . . 1 in 38
    from age 60 through age 69 . . . . . . 1 in 27

    To me, it looks like someone made the decision that screening is worthwhile if the odds are 1 in 38, but not if they are 1 in 69. I do believe this boils down to dollars spent on screening and procedures, but I don’t have all of the facts. I am concerned that it could lead to reduced coverage through insurance plans.

    • That’s precisely where this looks to be headed. If the government says ease off of those mammograms, insurance companies get to ease off of their coverage. Dammit. I am that conspiracy theorists I feared I would be.

  9. Radiation can be cumulative in effect. My mom has had breast cancer twice, and had a masectomy. That makes me statisticlly much more likely to get breast cancer. However, she took birth control pills, I never did. I stopped eating soy when I heard it was a phytoestrogen. She didn’t stop until her oncologist told her to stop.
    I personally am relieved. Lots of breast cancers are caught by the doc at your annual exam.
    And I know someone who died at 24 of breast cancer – I didn’t start having mammograms then.
    I had a weird lump and had mamograms and ultrasounds of my beast for ever 6 months for 2 1/2 years. That totally totally sucked, I was exposed to a lot of radiation. (Its cumulative, kids!) and the ultrasound is the only thing that ever showed the lump.
    I’ve had docs tell me that breast self exams don’t usually help with early detection that much. (And also to do it on the same day every month.)

    Maybe this will get women to do more preventative medicine, like stop with the estrogen supplements! (including soy cheese, soy yogurt, soy every thing. Tofu is okay because its fermented. The rest – you are dosing yourself with estrogen.)

  10. Have they found this yearly radiation to be problematic? My daughter has been getting multiple xrays every year for two years or so, no one’s ever said it might give her cancer. Is there a proven correlation between cancer and the levels of radiation you get from x rays?

    • I hope Jac can answer that. All I know is what I read on the World Wide Information Superhighway.

      • When I was a kid, we’d go to G. Fox (local department store, for those not in the central CT area) to get our shoes. In order to make sure they fit correctly, the shoe salesperson would view our feet, in the shoes, through an X-ray machine! There was of course no protection provided to the salespeople or the customers. This was in the late ’40s – early ’50s — I wonder what the cancer rate is/was among the sales reps and kids so X-rayed.

      • My Dad mentioned that he used to do that, too. I believe those xrays were probably more powerful and damaging than most xrays used today.

      • ‘Twould be an interesting bit of research for some bright-eyed researcher.

      • We used to roll droplets of mercury around on our school desks as kids and now we know that was harmful. What’s done is done. If anything will kill me it’ll be from the Yard Guard that my Mom accidentally sprayed all over my little 4 year old body one time thinking it was bug spray for humans. I can just imagine what toxins were in that. Cynical, we’re both still here, so we’re tough enough to endure that stuff from way back.

        • Mercury on school desks. I believe I have heard of this strange ritual. Was it science class?

          • Either that or we broke one of the old thermometers with mercury in them (they don’t even make those anymore) and thought that mercury had really cool physical properties. It clumps into a ball and can be rolled around. If you get two mercury balls close together, they’ll hop toward each other and make a bigger ball.
            (kids, don’t try this at home)

      • And isn’t it interesting as to who IS still here and who isn’t? We might take as good care of ourselves as we can (or are willing to), and yet some of the most careful are stricken with horrible health issues, and some of the least careful live long and prosper.

        I got out of my car 0n a campus the other night and immediately smelled some sort of herbicide or pesticide; we’re bombarded with exhaust fumes constantly (why do people even WANT to eat out at curbside at trendy restaurants in the summer?); I just saw a headline that says that nearly ALL canned goods contain some BHP — oy.

    • You could ask the doctor about it. It depends on how much and intensity etc. I think it’s reasonable to question especially when it involves a growing child. Then you have to consider the pros and cons. The advantage of the information gathered via xray may be worth any risk. You could ask if there are safer ways of monitoring the situation. (Not sure what you’re dealing with)

      There are more reliable ways of identifying cancerous cells. A few years ago, the day after a routine mammogram, the radiologist called and said they’d like to investigate some suspicious looking areas further. So I went in and they did a small paddle mammogram (more sensitive). Then they did an ultrasound. Ultimately, everything was ok. But, I found out that there are more reliable ways of detecting. It’s just more costly.

  11. I’m a 16 year breast cancer suvivor. I found my own lump and can’t imagine that I would still be here if I hadn’t. We need a million woman march on Washington. There are way too many old white guys running the show down there!!!

  12. As a woman, albeit over 50 by 7 years, who was diagnosed last year with breast cancer, I’m appalled by these new guidelines. My cancer was detected through a mammogram a mere week after my annual gyn exam, where no lumps were felt (by me, either).

    I also, unfortunately, know a thing or two about radiation from two decades earlier when I had the “good” cancer – Hodgkin’s disease.

    My numerous doctors pretty much agree that it is likely this latest cancer was caused by my radiation treatment from the Hodgkin’s. They are seeing tons of secondary cancers these days from radiation. Although every doctor I have spoken to recently admitted they knew secondary cancers were a possibility, I was never informed of that at the time. After my initial fury over that I realized I was actually glad I didn’t know that…for 20 yrs I enjoyed living my life, feeling “protected” against other cancers by the radiation!

    I’ve had a double mastectomy and 3 surgeries, an infection, and face more surgeries for reconstruction. But I’m alive, getting better each day and am going to be a granny early Feb.

    I still believe, weighing all the options, mammograms save lives. Trust me, the anxiety over really having cancer is far worse than the anxiety over a misdiagnosis.

    • Good Lord, Janely. What a lot of health issues. I’m sorry to hear that, but happy you’re here, and happier still you’re going to be a granny! I need to read more on secondary cancers. I guess I knew that was a possibility, but really don’t know enough to know what to think.

    • Sherry & Janely, thank goodness you made it through. I have a friend who, in her 40’s, found a lump (and it was malignant) after a mammogram missed it and another friend, at 50, who was discovered to have a malignant mass through a mammogram. They are both survivors, too. Mammograms aren’t perfect but they do save lives.

      The more I read about the value of ultrasound examinations, the more I wonder why they aren’t used more. They are apparently especially more useful in detecting problems in younger, denser breast tissue. I’m no expert, but it seems they can detect things that mammograms can’t, especially the nature of lumps. However, mammograms may be better at detecting microcalcifications (I’m not certain about that).

      • It strikes me that if it’s more expensive to use ultrasound (this is what I heard at my last mammogram, actually) but it’s more effective in detecting the Bad Stuff, we should find a way to use it. I mean, it’s lives, right? And mammograms are — let’s be honest here — uncomfortable at best. I complain about them every time I go.

  13. I sit once a month at the Chemo lab while my mother gets chemo for her cancer. Woman after woman cones in and sits for their chemo. Yesterday I saw 3 young women barely 30 there for chemo. At least 2 were getting Doxil breast cancer chemo. That must say something. The gov’t is comprised of men who think they know what’s best for everyone. How arrogant? Maybe they will have different opinions when it begins to happen to their daughters and their favorite niece. Dare I say, or maybe while they are caressing their young misstresses breast who they profess to care for, they find a lump. Maybe then they will change their minds.

    • I sat with my best friend Sherry while she got chemo. She would dress up and put on makeup for the first day, and over the course of the week, she warned me that she’d stopped even changing from her jammies. It was brutal, watching what those chemicals did to her. My thoughts are with your mother, Susan, and with you, as well.

  14. I caught part of this on NPR “On Point” today and want to hear the rest. There was a great discussion going on with some experts on these new guidelines and mammograms. Here’s a link (audio won’t be available until 3pm):

  15. Just thought I’d mention that cancer is the second leading cause of death in women. (a close 2nd to heart disease and far ahead of #3 stroke)

    Breast cancer is the most common form of cancer in women.

    Breast cancer is the second most deadly form of cancer in women. (2nd to lung cancer)

    The latest plan of “cross your fingers ladies until you’re 50” isn’t good enough.

  16. I’m with you, DJ. It’s another scheme to deny health care to women. Mammograms cannot possibly be as expensive as surgery, chemo, and radiation, but maybe they’re next, who knows?

    I had microcalcifications (aka LCIS) several years ago, discovered by a mammogram. I was over 50 at the time, but I don’t assign much meaning to that one way or another. An ultrasound and an MRI were done to confirm–both are, I suspect, more expensive than a mammogram–maybe they’re next on the chopping block, ya think?

    My last mammo was digital. My oncologist said it’s much more accurate than film.

    I wonder how much it costs to do a PSA?

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