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Thread: Experts question motives of mammogram guidelines

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    Re: Experts question motives of mammogram guidelines

    Quote Originally Posted by rivrrat View Post
    It's not just about the mammograms. They actually said women shouldn't be doing self-breast exams!!! That is patently INSANE.
    I don't think that is correct.

    What they said is that there is no point in having the physician teach breast exam techniques. I find this a really short sighted confusing statement, too, but what I gather is that they encourage women to know their bodies and check their breasts in the shower etc. They want women to have a yearly breast exam from a professional.
    Breast cancer is the leading cause of cancer death for women. The LEADING cause. Are some of you not getting this? And the government (and apparently some of you) are more worried about some false positives than actually catching the disease? How many false positives come out of pap smears? Quite a few I'd reckon since I've had several myself. But I would rather have 100 false positives than miss that ONE true positive.
    No one will stop you from having one if that is what you want. I am in the high risk category and I am convinced they are not much good and may be harmful.

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    Re: Experts question motives of mammogram guidelines

    After reading through the first 3 pages, here's my 2-cents worth (which might not be worth a damn since...well, I'm a guy)...

    I'm sure this new "guidelines" on mammograms is directly related to the health care reform issue and will certainly translate to fewer mammograms being covered under insurance, but I also believe that enough legitimate research has been done on the matter to warrant a reduction in mammograms for specific age groups among women. This translates to fewer unnecessary tests/screenings that have the potential to do more harm than good and probably don't change the rate of breast cancer detection substaintially enough to warrant performing the test in the first place.

    Now, if you want to call this rationing health care, so be it. I'd prefer to call it being responsible. So, women under 40, my recommendation (which I've also discussed w/my wife and daughters) is if feel you don't need to have a mammogram done, then don't do it. However, I'd highly recommend exercising caution and still perform self-exams especially if (the women in) your family has a history of (breast) cancer.
    Last edited by Objective Voice; 11-20-09 at 05:23 PM.

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    Re: Experts question motives of mammogram guidelines

    Quote Originally Posted by Objective Voice View Post
    After reading through the first 3 pages, here's my 2-cents worth (which might not be worth a damn since...well, I'm a guy)...

    I'm sure this new "guidelines" on mammograms is directly related to the health care reform issue and will certainly translate to fewer mammograms being covered under insurance, but I also believe that enough legitimate research has been done on the matter to warrant a reduction in mammograms for specific age groups among women. This translates to fewer unnecessary tests/screenings that have the potential to do more harm than good and probably don't change the rate of breast cancer detection substaintially enough to warrant performing the test in the first place.

    Now, if you want to call this rationing health care, so be it. I'd prefer to call it being responsible. So, women under 40, my recommendation (which I've also discussed w/my wife and daughters) is if feel you don't need to have a mammogram done, then don't do it. However, I'd highly recommend exercising caution and still perform self-exams especially if (the women in) your family has a history of (breast) cancer.

    No, because raising the minimum age for routine mammograms has been discussed and debated for years; I think I first heard about the controversy six years ago.
    It's just that more and more, women under 40 are being subjected to a lot of unnecessary, invasive, and disfiguring treatment for issues that wouldn't have caused any problem and would've eventually- after menopause- resolved on their own.
    It's a matter of over-screening and overaggressive treatment.
    Many people, including some of the top medical experts in the country, have decided that it's not worth it. Even if it save one life per 10,000, it's just not worth the unnecessary havok it wreaks on hundreds and hundreds of other young lives.
    As I previously stated, premenopausal breasts are typically full of dense, fibrous tissue, making it difficult for a mammogram to detect tumors even if they're there... but causing a lot of "masses" to show up on x-ray, which doctors then feel obligated to biopsy, when in fact these are merely cysts or areas of dense tissue and entirely normal- practically universal- in young women of childbearing age.

    Routine mammograms in women over 50 save lives.
    There's simply not much evidence whatsoever to support the idea that routine, yearly mammograms in women under 50 save lives.
    If a young woman is in a high risk group or has some sort of troubling symptom, then she should and will have access to mammogram screening.

    Also, depressingly enough, it is now coming to light that manual breast self-exams do nothing to aid in the detection of tumors or save lives.
    I'm talking about statistics here.
    Anecdotally, a beloved mentor of mine found a lump the size of a pea in her breast while taking a shower a few years ago. I posted about this at the time it happened. It was cancer; she underwent treatment.
    She wasn't able to beat it, though; it metastasized, and I just heard last week that she's not expected to live until Christmas.
    She was in her 40s at the time she discovered the lump.
    So, anecdotally, I guess we can chalk that one up to "found cancer via breast self-exam"; statistically, however, her case supports the idea that self-exams are worthless as a diagnostic/ screening tool, because it did not save her.
    The cancer was already well-advanced by the time she felt the lump.
    Last edited by 1069; 11-20-09 at 08:48 PM.

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    Re: Experts question motives of mammogram guidelines

    Here's a pretty good article about it, just came out today in the Wall Street Journal:

    In Cancer Testing, Less Is Now Better - WSJ.com

    And here's another, related issue; the American College of Gynecology and Obstetrics- the leading authorities of women's health- are now suggesting postponing cervical cancer screening until a later age, and having less frequent cervical cancer screening.
    The group no longer recommends annual PAPs for most women.

    Doctor's Group: Delay Pap Tests Until 21

    I think the whole mammogram controversy stems partly out of this: it has been indisputably proven that early and frequent cervical cancer screening didn't save lives, and led to overaggressive and unnecessary invasive treatment, sometimes leaving healthy young women unable to bear children, when in fact no treatment was needed. Mild dysplasia (abnormal cell changes in the cervix) is so common as to be practically universal in adolescent girls, usually due to hormonal changes or infections. It typically- in nearly all cases involving very young women- clears up on its own within 6 to 18 months, without treatment.

    Women are overscreened and overtreated in this country. In other industrialized nations, recommendations for later PAPs at intervals of 3 to 5 years are the norm, and in these countries the rates of cervical cancer are no higher than ours, although their rates of aggressive treatment of common, benign, potentially "precancerous" conditions of the cervix are much less.

    Testicular cancer is a fairly common cancer, more common in young men than in older ones. It is, in fact, more common than cervical cancer, in the industrialized world.
    Yet nobody's recommending that all young men- beginning in adolescence- report to the doctor for annual testicular cancer screenings, where the testes are examined via ultrasound, and any suspicious areas biopsied.
    These screenings are done only if there's some problem or symptom, or if the patient requests it.
    Last edited by 1069; 11-21-09 at 12:58 PM.

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    Re: Experts question motives of mammogram guidelines

    Quote Originally Posted by 1069 View Post
    No, because raising the minimum age for routine mammograms has been discussed and debated for years; I think I first heard about the controversy six years ago.
    It's just that more and more, women under 40 are being subjected to a lot of unnecessary, invasive, and disfiguring treatment for issues that wouldn't have caused any problem and would've eventually- after menopause- resolved on their own.
    It's a matter of over-screening and overaggressive treatment.
    Many people, including some of the top medical experts in the country, have decided that it's not worth it. Even if it save one life per 10,000, it's just not worth the unnecessary havok it wreaks on hundreds and hundreds of other young lives.
    As I previously stated, premenopausal breasts are typically full of dense, fibrous tissue, making it difficult for a mammogram to detect tumors even if they're there... but causing a lot of "masses" to show up on x-ray, which doctors then feel obligated to biopsy, when in fact these are merely cysts or areas of dense tissue and entirely normal- practically universal- in young women of childbearing age.

    Routine mammograms in women over 50 save lives.
    There's simply not much evidence whatsoever to support the idea that routine, yearly mammograms in women under 50 save lives.
    If a young woman is in a high risk group or has some sort of troubling symptom, then she should and will have access to mammogram screening.

    Also, depressingly enough, it is now coming to light that manual breast self-exams do nothing to aid in the detection of tumors or save lives.
    I'm talking about statistics here.
    Anecdotally, a beloved mentor of mine found a lump the size of a pea in her breast while taking a shower a few years ago. I posted about this at the time it happened. It was cancer; she underwent treatment.
    She wasn't able to beat it, though; it metastasized, and I just heard last week that she's not expected to live until Christmas.
    She was in her 40s at the time she discovered the lump.
    So, anecdotally, I guess we can chalk that one up to "found cancer via breast self-exam"; statistically, however, her case supports the idea that self-exams are worthless as a diagnostic/ screening tool, because it did not save her.
    The cancer was already well-advanced by the time she felt the lump.
    Sorry to hear about your friend! Are you in a medical field? In retrospect, I wish I had looked at my mother's medical records and asked many more questions. She had breast cancer, then colon cancer and finally kidney cancer. The whole experience was extremely surreal because the first sign that she was sick, again, was that became unbearably atypically depressed. They did tests and gave her an M.R.I. -or was it a Cat scan?- anyway they found nothing, initially. Months went by before they found cancer again and started pumping her with chemo.

    What I understand is that neither breast nor colon cancer typically metasticizes to the kidney. My suspicion is that all of the chemo and radiation she received for the first two cancers, set her up for a brand new cancer. Sorry for the digression but I am convinced that the way we have been screening for and treating cancer will one day look to us the way bloodletting does, today.

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    Re: Experts question motives of mammogram guidelines

    Quote Originally Posted by underdog334 View Post
    The reccommendation was based on a cost-benefit analysis,which means that the panel had to arrive at the dollar value of a woman's life.
    No it wasn't.

    There was no consideration of cost whatsoever.

    The only consideration was risk of undetected breast cancer vs. risk associated with mammograms. Pure science.

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    Re: Experts question motives of mammogram guidelines

    Quote Originally Posted by apdst View Post
    The rationing begins.
    1. Rationing happens all the time, even in private insurance. Can you go get any test you want as often as you want and get it covered? No. You can't get a mammogram once a month paid for by your insurance, even if you or your doctor thought it was necessary. Stop pretending like rationing doesn't already happen. We don't have unlimited resources.

    2. This panel is merely making a medical judgement. It has no enforcement power.

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    Re: Experts question motives of mammogram guidelines

    Quote Originally Posted by misterman View Post
    1. Rationing happens all the time, even in private insurance. Can you go get any test you want as often as you want and get it covered? No. You can't get a mammogram once a month paid for by your insurance, even if you or your doctor thought it was necessary. Stop pretending like rationing doesn't already happen. We don't have unlimited resources.

    2. This panel is merely making a medical judgement. It has no enforcement power.
    In the words of Joe Wilson....YOU LIE!

    It is in the bill, it was discussed on This Week, and is in the bill, but keep telling yourself this, if it makes you sleep better at night.

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    Re: Experts question motives of mammogram guidelines

    Quote Originally Posted by Jackboot View Post
    In the words of Joe Wilson....YOU LIE!

    It is in the bill, it was discussed on This Week, and is in the bill, but keep telling yourself this, if it makes you sleep better at night.
    If you're going to call me a liar, you damn well better post the exact language where you think it's in the bill, with a page number.

    You can find the full text of the bills here: THOMAS (Library of Congress)

    If you don't, that makes YOU the liar.

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    Re: Experts question motives of mammogram guidelines

    Quote Originally Posted by misterman View Post
    If you're going to call me a liar, you damn well better post the exact language where you think it's in the bill, with a page number.

    You can find the full text of the bills here: THOMAS (Library of Congress)

    If you don't, that makes YOU the liar.
    Sure, Rep. Blackburn walks you through it here......

    U.S. Congressman Marsha Blackburn

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