Comments for Pulse of UTMC

Comment on Is 50 the new 40 for mammograms? by Suzanne Smith

Suzanne Smith — Fri, 20 Nov 2009 17:49:24 +0000

A routine mammogram for me lead to a fuller CT scan and finally a diagnosis of a potentially life-threatening cancer. I would not be here writing this today had it not been for my yearly mammogram on September 16, 2002–with not a trace of family history of breast cancer. I respect medical data and scientific study, but my concern now is that women’s options will be limited by the insurance industry. For those women who, in consultation with their doctors, still wish to have routine mammograms before the age of 50, will insurance no longer cover these tests? Will the scientific data tell another story in 5-10 years after women have stopped routine mammograms?

Comment on Is 50 the new 40 for mammograms? by Ernest Dubrul

Ernest Dubrul — Thu, 19 Nov 2009 18:43:46 +0000

Thanks for the link, Katie. This is the best column I’ve seen on the topic.

Note in the report that the recommendation for people under 50 and for self-exams is “There is insufficient evidence to recommend for or against the inclusion of the condition in a periodic health examination, but recommendations may be made on other grounds.”

The reason for this is because of lack of quality evidence. In all the literature, all the panel had to go on was “Opinions of respected authorities, based on clinical experience; descriptive studies and case reports; or reports of expert committees.” In other words, no data.

Sounds like there’s a grant waiting to be written out there, especially considering how many of the recommendations for a wide variety of problems are rated the same. Guess there are many grants possible.

Comment on Is 50 the new 40 for mammograms? by Michelle Giovanoli

Michelle Giovanoli — Thu, 19 Nov 2009 14:07:36 +0000

I agree with Karen who mentioned the cost of healthcare when these women present with metastatic breast cancer. The treatments for that outweigh the cost of a mammogram which is about $340.00. One course of treatment for metastatic breast cancer could cost about $24,000, not including the additional CT’s,MRI’s,Bone Scans, PET Scans that most patients are required to have once being diagnosed. (maybe one or all of these tests) Some patients need more than one course of treatment! One of my best friends was diagnosed through a screening mammogram, no family history. I cannot imagine what her life would be like in 13 years(she was diagnosed at age 37) had her Dr. not ordered that mammogram. She may not be here! My mother was diagnosed 5 years ago, no family history, I started my mamms @ 34! I would rather worry about a false/positive at 40 than metastatic breast cancer at 50!

Comment on Is 50 the new 40 for mammograms? by Katie Mihaly

Katie Mihaly — Thu, 19 Nov 2009 03:05:09 +0000

i thought this article was helpful for me to feel less worried about these new standards.

http://www.slate.com/id/2236028/

Comment on Is 50 the new 40 for mammograms? by Erin Borden

Erin Borden — Wed, 18 Nov 2009 19:56:48 +0000

I am personally outraged that people believe that this testing should be further delayed. Mammography, along with self exams, are the two leading ways to detect breast cancer in this current day and age. How else will women have peace of mind knowing that they are cancer free if these tests are put farther from their reach?

My job allows me to work closely with many different types of cancer patients, and the single most common thing that I hear is, “Luckily, they found the tumor before it got to be really severe.” Unfortunately, this also means that I have met women who had such horrible cases that they did not even live to see the year when they SHOULD have had their first mammogram at age 40. Delaying testing for women (and even men) only allows people to unknowingly live with this disease, and this will substantially decrease their prognosis when a diagnosis is finally made.

As with any sort of testing, there is of course, the chance for a false positive. But that isn’t because of faulty equipment or faulty patients, it is a common occurance that can happen with anything from a simple blood test to an experiment in a laboratory. Patients should always be aware of the possibility for a false positive, but in my mind a false positive is always better than not knowing of a problem in the first place.

Comment on Is 50 the new 40 for mammograms? by Kristin Kirschbaum

Kristin Kirschbaum — Wed, 18 Nov 2009 18:31:34 +0000

It is very important to realize that 75% of all breast cancer have NO family history !! – before making a decision against mammograms.
http://envirocancer.cornell.edu/FactSheet/General/fs48.inheritance.cfm

About the false positives: We need to spread the word (or better the exact data) that there are a lot false positives based on breast density. This will reduce the fear a little.

Comment on Is 50 the new 40 for mammograms? by Ernest Dubrul

Ernest Dubrul — Wed, 18 Nov 2009 18:30:10 +0000

Please read the report at http://odphp.osophs.dhhs.gov/pubs/guidecps/default.htm. It is nothing more than a revision of the odds for success in finding a true positive vs the pain/suffering/distress due to the exam and/or false positives. From survey and evaluating the published data, the odds for some groups of women have shifted in favor of foregoing the exam. Just as the odds of success of PSA tests and digital exams detecting prostate cancer in most men have changed.

I hope all the MDs and soon-to-be-MDs go back and review their statistics and probabilities courses so they can intelligently explain this to their patients instead of relying on personal experience and feeling.

Finally, the preponderance of conspiracy thinking and distrust of evidence in the postings about this subject here and elsewhere makes me really fear for the future of this society. When evidence and logical thought is ignored or distrusted, all that is left is fear, magic, and religion. And history clearly tells us what happens when those forces are in charge.

Comment on Is 50 the new 40 for mammograms? by Pamela Wawrzyniak

Pamela Wawrzyniak — Wed, 18 Nov 2009 18:30:06 +0000

I agree with everything the respondents here have said. I also wonder who sponsored these trials and I can’t help but wonder how the insurance companies are connected to these decisions. I’m sure they are pushing this also, God forbid they act with patient centered concern rather than padding their bottom line.

Comment on Is 50 the new 40 for mammograms? by Mary Perlinski

Mary Perlinski — Wed, 18 Nov 2009 18:22:12 +0000

Well, this so called Task Force has rattled the wrong cage and if this is a sign of what we have in store with national health care hiding rationing under the guise of recommendations, we are in for a bumpy ride. This is a wake up call for all of us.

Comment on Is 50 the new 40 for mammograms? by Karen Lowe

Karen Lowe — Wed, 18 Nov 2009 17:54:34 +0000

I agree with others who are concerned about the implications down the road with private health insurances using this as a guideline to deny all mamograms for people under 40. Is this the future of government health care? Is this really what people want. With all of the data available, I find it difficult to believe this is the recommendation. What will be the cost to health care when women start showing up with advanced disease. I dare say an ounce of prevention is truley worth the cost of a simple mammogram.