Yearly Mammograms Do Save Lives
I received some really great news recently: My friend Ann with breast cancer is now cancer-free.
Her breast cancer diagnosis came quickly. An annual mammogram revealed a small speck of wrong cells, and within days she was undergoing a biopsy. Then came a surgery and another follow-up surgery to get all the surrounding cancerous “margin” cells. A round of radiation follows for safety’s sake.
With some irony, Ann’s scary ordeal happened during the buildup for the Susan G. Komen “Race for the Cure” in October, breast cancer awareness month. (Who could miss the signature pink “everything” from football cleats to soccer balls?)
At the same time, either by cruel design or clumsy coincidence, the government announced new federal mammogram screening guidelines: Women don’t need yearly mammograms, according to the United States Preventive Services Task Force (U.S. PSTF), a federal advisory group.
Apparently too many “false positives” were occurring which resulted in the re-screening of up to 61 percent of women. And, in a few cases, unnecessary biopsies. But the data also said that 42 percent of women who only have mammograms every two years also will be rescreened. So, if my math is correct, by having women skip a year of screening, only 19 percent of women are saved from being re-screened.
What woman cares about re-screening? The better question is, how many women were diagnosed early with breast cancer and treated successfully?
In a Sept. 29, 2010, New York Times article, “Mammogram Benefit Seen for Women in Their 40s,” Donald Berry, a statistician at MD Anderson Cancer Center, believes over-diagnosing is a problem and says, “We are finding cancers that would never be found if we didn’t look. Small wonder people think screening is great some of the cancers it finds were not lethal in the first place.”
But, as Boston oncologist Dr. Eric Winer said regarding a long-term European study’s findings on the over-diagnosis of breast cancers, “Unfortunately, we do not know which women would have done well without treatment, and which would develop a lifethreatening (and in some cases, life-ending) disease if the cancer were not treated.”
Practically every major health organization agrees that mammograms save lives: American Cancer Society, National Cancer Institute, Susan G. Komen for the Cure. The ongoing debate is largely over what age to start and how often. And, face it, it’s also about money. In December 2009 bankrupt California cut off free mammogram screenings for low-income women, making a mockery of its Every Woman Counts motto.
Donna Sanderson, executive director at the Sacramento Valley affiliate of Susan G. Komen for the Cure, said, “We know the eyes of the rest of the nation are looking at California. We want to make sure the right message gets out: This is not an appropriate way to balance a budget.”
Many are very nervous about what other health care rationing is in store for women under the vague, yet far-reaching Obamacare law.
For sure, statistics will play a big part in what care we’re allowed. According to a Sept. 1 article, “The Mammography Debate” (Susan G. Komen for the Cure website), the U.S. PSTF found based on eight randomized controlled trials “that mammography modestly reduced the risk of breast cancer mortality (death) in women 40 to 49. They found that to prevent one breast cancer death, 1,904 women 40 to 49 would need to be screened with mammography.”
Screening 1,904 women in order to save one seems worth it to me, but not to a percentages-over-people health care system.
We dread mammograms, put them off and grit our teeth through them. But because of them, women I know and you know are alive to see their children graduate, get married and have babies.
My friend Ann is glad she got her mammogram. She’s relieved that the technology, though far from perfect, clearly discovered what might’ve ended her life had she followed federal guidelines and waited another year to get screened.
