"It also says women age 50 to 74 should have mammograms less frequently — every two years, rather than every year," reports Gina Kolata in the New York Times. "And it said doctors should stop teaching women to examine their breasts on a regular basis."
In what I feel will ultimately prove to be an understatement, Kolata writes that the guidelines "are likely to touch off yet another round of controversy over the benefits of screening for breast cancer."Many people are interpreting that to mean that a woman's age should be the only determining factor. I don't think the guidelines are based exclusively on age, but, to be truthful, I haven't seen much justification for the revisions beyond age. Some but not much.
Kolata writes that the "modest benefit of mammograms — reducing the breast cancer death rate by 15 percent — must be weighed against the harms. And those harms loom larger for women in their 40s, who are 60 percent more likely to experience them than women 50 and older but are less likely to have breast cancer, skewing the risk–benefit equation."
It seems to me that a number of factors, like family history, need to be considered. Age is one factor, and it is clearly the one on which critics are latching, but it isn't the only factor. And, while Kolata provides dramatic numbers that indicate the risk does increase as a woman gets older, the task force apparently did take into consideration other risk factors.
It underscores the importance of communicating with your doctor. He can't reach an accurate conclusion if he doesn't have all the facts.
Whether your family has a history of cancer or not, if you have questions, ask your doctor. Then, together you can decide on what is best for you — even if it doesn't fit someone else's guidelines.
Common sense is called for.
And if you're going to do your own research, I always point in the direction of the American Cancer Society's website.
The ACS is kind of busy these days, preparing for the Great American Smokeout this Thursday. But it did post a response to the new guidelines. And I consider the ACS a valuable resource on cancer. Any cancer.
"The American Cancer Society continues to recommend annual screening using mammography and clinical breast examination for all women beginning at age 40. Our experts make this recommendation having reviewed virtually all the same data reviewed by the USPSTF, but also additional data that the USPSTF did not consider."
Otis W. Brawley, M.D.,
chief medical officer,
American Cancer Society
In the weeks and months ahead, I expect the revisions to be discussed extensively. And I wouldn't be surprised if one or both sides in the health care reform debate use the findings in an attempt to score a few points with the public.
If and when that happens, I expect the ACS to be fully engaged in the discussion.
Cancer is far too serious to be reduced to a political football.
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