Talks of Mammogram Screenings AFTER 50

[dr.mel_PT]

http://www.nytimes.com/2009/11/17/health/17cancer.html?_r=1

Have you heard about this? Basically, they are advising that mammograms start after 50 and are gotten once every 2 years, unless of course you have a family history of it. They claim the harms outweigh the benefits for getting the screenings starting at age 40.

I'm sorry but isn't early detection key? And just because breast cancer doesn't run in your family doesn't mean you won't necessarily get it; with all the hormones & additives in our foods now awadays, I don't think it's a coincidence that more and more people are diagnosed with Cancer. My dad was diagnosed with tongue cancer this year; he never smoked, doesn't drink, and doesn't use any chewing tobacco or anything like that, plus it doesn't run in our family, so he was in the 4% who could get this. Good thing they found the cancer right away so he was able to get rid of it; God forbid we had waited 2 years for a diagnosis!!

What's also really concerncing to me is that they are telling women not to bother with self-exams? What is the point of that? To keep women from finding something that the insurance company has to shell $ out for? This is so sad.

 

[BuffyR]

It's all quite confusing. I'm interested to hear other women's take on this. I'm 45 and have been diligent in getting my yearly mammogram since I turned 40. I was just about to schedule my yearly when this new study came out. I went ahead and scheduled it anyway. I have an appt. with my gyno. next week and intend to address this with her.

 

[baylian]

and now Pap Smears after 21. I know girls that had reproductive cancer at ages 8 and 15.

Just wait . . .it's only going to get worse.

This is so wrong!

 

[Liann]

A number of women I know who have fought breast cancer had it in there 30's and 40's. Just because some study comes out where a bunch of "scientists" decided we don't need screening or self exams until we are 50 is not going to change how I schedule things. In fact, I've already had a mammogram and they have already found cysts in my breast. They were ruled benign, but heck if I wont keep a close eye on it. I heard no oncologists were involved in this study. Don't know if that is true, but in my mind it's all $$$ related somehow not health related.

 

[BuffyR]

and now Pap Smears after 21. I know girls that had reproductive cancer at ages 8 and 15.

Just wait . . .it's only going to get worse.

This is so wrong!

I have always had the understanding the 21 or two years after a girl becomes sexually active is the appropriate time to begin Pap Smears. Are you advocating Pap Smears for girls beginning at 8? Your post is very confusing.

 

[Gayle]

Don't know if that is true, but in my mind it's all $$$ related somehow not health related.

ITA!

 

[dr.mel_PT]

I have always had the understanding the 21 or two years after a girl becomes sexually active is the appropriate time to begin Pap Smears. Are you advocating Pap Smears for girls beginning at 8? Your post is very confusing.

I've actually heard age 18 or as soon as a girl becomes sexually active. I don't mean to jump on you but why would you wait 2 years after having sex? A lot can happen in 2 years....

 

[Liann]

A lot can happen in 2 years....

Especially since cervical cancer has little to no symptoms until the cancer is wide-spread. Why risk it?

 

[baylian]

I have always had the understanding the 21 or two years after a girl becomes sexually active is the appropriate time to begin Pap Smears. Are you advocating Pap Smears for girls beginning at 8? Your post is very confusing.

NO - my point is - cancer of the reproductive organs can happen way before 21!

My theory is as soon as they are sexually active or at 18. But what do I know - I have a son!~

 

[BuffyR]

I've actually heard age 18 or as soon as a girl becomes sexually active. I don't mean to jump on you but why would you wait 2 years after having sex? A lot can happen in 2 years....

I'm not an expert, I was just relaying what the recomendations are. A pap smear is a test for cervical cancer not for STDs. For the record, I think anyone who is sexually active and having unprotected sex should be tested for STDs whatever the age, but, I don't think that changes the recommendations for the age to begin pap smears.

 

[Liann]

I'm not an expert, I was just relaying what the recomendations are. A pap smear is a test for cervical cancer not for STDs. For the record, I think anyone who is sexually active and having unprotected sex should be tested for STDs whatever the age, but, I don't think that changes the recommendations for the age to begin pap smears.

You are right Buffy, those are the current recommendations. In fact, I think it's even 3 years instead of 2 after having sex.

 

[dr.mel_PT]

I'm not an expert, I was just relaying what the recomendations are. A pap smear is a test for cervical cancer not for STDs. For the record, I think anyone who is sexually active and having unprotected sex should be tested for STDs whatever the age, but, I don't think that changes the recommendations for the age to begin pap smears.

I aplogize, I was just figuring a gyn appointment and pap smears go hand in hand, so if you're sexually active and go to the gyno to get checked out then you automatically get a pap. I could be wrong though.

 

[hiitdogs]

http://www.nytimes.com/2009/11/17/health/17cancer.html?_r=1

Have you heard about this? Basically, they are advising that mammograms start after 50 and are gotten once every 2 years, unless of course you have a family history of it. They claim the harms outweigh the benefits for getting the screenings starting at age 40.

I'm sorry but isn't early detection key? And just because breast cancer doesn't run in your family doesn't mean you won't necessarily get it; with all the hormones & additives in our foods now awadays, I don't think it's a coincidence that more and more people are diagnosed with Cancer. My dad was diagnosed with tongue cancer this year; he never smoked, doesn't drink, and doesn't use any chewing tobacco or anything like that, plus it doesn't run in our family, so he was- in the 4% who could get this. Good thing they found the cancer right away so he was able to get rid of it; God forbid we had waited 2 years for a diagnosis!!

What's also really concerncing to me is that they are telling women not to bother with self-exams? What is the point of that? To keep women from finding something that the insurance company has to shell $ out for? This is so sad.

Early detection does not necessarily mean better chances of cure. The recommendation for the change in mammograms does not have anything to do with rationing but more with the weighing the risk against the benefit.

I think it is hard for people to wrap their heads around this because it goes against everything we have been told for years. What they haven't told us though is that mammograms can in fact be harmful and cause cancer. Our bodies are exposed to radiation every year and whereas mammograms can detect some cancers there is a lot that is missed and women are still exposed to the risk of ionized radiation which increases your risk of cancer by 1 % for every exposure. Now, that doesn't sound like a lot but it adds up over the years according to Dr. Susan Love, undeniably one of the foremost authorities on breast cancer.

There is no doubt that we are overdiagnosing and overtreating.

Now, obviously people say, well, but if it saves just one life, it's worth doing it. But if the one life being saved comes at the price of 3 women getting cancer BECAUSE of mammography it becomes pretty questionable and risky. I believe it is an individual's choice to do what they feel comfortable with but only after they know all the pros and cons, and for years we haven't been told the cons.

I guess my question is if "early detection saves lives" then why are more women dying of cancer today than ever before? And why for Pete's sake - if we know that radiation causes cancer - do we use radiation emitting machines to screen for cancer?

Interesting article about the effectiveness and risks of mammograms http://www.naturalnews.com/010886_cancer_brst_cancer_mammography.html

Off to get my flame retardent suit because I am sure I will get flamed for this.

 

[dreamyjeanie]

Well the comment about having a pap after 2 years got me wondering what is recommended so I looked it up.
http://www.medicinenet.com/pap_smear/article.htm#tocb
According to American Cancer Society (2004) and the American College of Obstetrics and Gynecology and others recommended after 3 years. Wow, I always thought it was anytime after being sexually active. Who makes these recommendations?

As for the mammograms after 50, the little devil on my one shoulder shouts "Hooray" I can wait a few more years, but the angel on my other shoulder says "get this year's scheduled and don't be stupid". Although I have missed feelings about these findings, I do kind of agree. A lot of women find breast cancer on their own, not from the mammogram. Maybe the research studies should be focusing on better ways to detect it, like sonograms or other technology. Maybe mammograms aren't the only answer.

Jean

 

[nancy324]

The best doctor I ever had (he's too expensive for me now!) told me about 15 years ago to start having mammograms at age 40, have them every other year until age 50, and then start having them annually. This was at a time when most practitioners were recommending annual screenings after 40. I no longer remember why my doc thought less was better, but that's exactly what I did, and I'm fine. Every bit of advice he ever gave me worked out very well for me, and he helped me with some real problems. All I can say is, I trust him implicitly. Obviously, his recommendation was based upon my personal family history, etc., and might not be right for everyone.

 

[Sheila S]

...
Off to get my flame retardent suit because I am sure I will get flamed for this.

No flames from me. You did a good job of introducing the risk-benefit angle.
Here's an article from today's LA times that gives more examples:

Cancer screening: What could it hurt? A lot, actually

Sheila

 

[toughYrun]

Obviously, his recommendation was based upon my personal family history, etc., and might not be right for everyone.

And therein lies the rub.......for individuals there cannot exist a one size fits all approach to health care. I have no problem with the new recommendations as long as they remain recommendations and do not become rules. One of the greatest fears I have when it comes to changes in my personal health care is that the relationship with my MD will no longer be personal because I will have become nothing more than a budget item.....

 

[BuffyR]

The problem is we now have an insurance company between us and our docs. Often times my doctor will recommend something, but, my insurance company won't approve it. Very frustrating.

 

[Shadowpup]

The only reason I am here to make this post today is because in 2001 I found a lump in my breast through a self examination.

I was 39, and in the 'no risk' (less than 2 percent risk category), a healthy woman with no family history of breast cancer, never smoked, and rarely ill. I spent almost three months seeking to understand what this meant. After a series of tests that all read negative (a mammogram, an ultrasound, and a needle biopsy), and being refused even basic information about cancer - I was finally able to persuade my third doctor to remove the lump. I suspect he did so because I was clearly anxious, and it was the easiest way to get me to stop pushing for care.

He called me two days later to tell me that I had breast cancer, almost stage II, and to urge a mastectomy (I went for an alternate approach, spending over a year in treatment, but that's another story).

I am a scientist by training and profession. I very well understand the risks and benefits involved in breast cancer. As manager and chief scientist of a multimillion dollar project involving decisions around false positives, false negatives, and expensive testing - not in the medical profession - I also very well understand costs and benefits, and making hard choices. And, in my case, the mammogram was wrong - it was the self exam that saved my life, and even at that, it also required a stubborn refusal not to be brushed off as an anxious female.

But I also know that if the recommendations of this panel are followed, many women will die who might have lived. I'd've died around 2003. Or perhaps 2004, since I'm pretty stubborn

The solution for the anxiety that many feel when falsely diagnosed is not to refuse information or screenings (my first three doctors refused to give me breast cancer literature because they were so certain that I had only a cyst). The cure is to teach people to look squarely at risk factors and learn how to make good decisions. The cure for the expense of early detection is to advance the research and technology development that makes the screening itself less expensive, and to teach women how to do breast self exams, and to help our population understand how diet and exercise can reduce their risk factors.

Well, we'll each make our own decisions here, and I am not seeking to persuade anyone of anything. This is not an easy issue. But I will continue to urge all of my female relations and friends to do self exams, and consider regular mammograms.

We are worth it.

 

[hiitdogs]

I think one of the things that I liked best about the German insurance system - now that I have lived in the US for over 13 years - is that the insurance really had not much of a say about the treatment as long as the doctor recommended / approved it. The same for all insurances because of government regulations. And we still had a choice of hundreds of insurance carriers - private or public health insurance companies.

No one stood between me and my doctor, not the government and sure as heck no greedy insurance company!

Thanks for posting the article Sheila! I couldn't agree more with it.