UPDATE - 11/21/09
Well, I should have gone to the original report instead of listening to the news media. Today's Wall Street Journal says "We probably, in retrospect, could have been more clear." This from Dr. Diana Petitti, vice-chairwoman of the U.S. Preventive Services Task Force. "The task force is not against women having mammograms in their 40s."
Instead, she said, it is in favor of women in that age range deciding
on their own, after consulting with their doctors, whether to undergo
regular screenings. Similarly, they did not mean to deter women from
practicing self-examination. They merely intended to signal
primary-care physicians that they no longer need to teach women how to do it. Now there's a fine distinction.
On the one hand, it's easy to conclude that this is just a case of the
media sensationalizing a poorly understood scientific report. On the
other hand, if I were a conspiracy theorist, I could see this as a
trial balloon to see how easily the sheep go to the slaughter.
Apparently, the sheep are not so eager to lie down and die. Good.
Still, in my professional opinion, a bad piece of advice. I have been practicing human medicine more than 20 years. In that time, I have served many women who discovered a new breast lump through self exam, and ultimately saved their own lives by doing so and seeking appropriate care. To tell physicians we no longer need to teach female patients how to do a good, careful self exam is manure. Women (and their partners, if interested) can learn effective breast exam, and will do a better job of surveillance if they are using good technique. Uneducated women will not likely do such an effective job of surveillance. Let's continue in the spirit of patient empowerment and educate our women on the effective self exam of breasts. I also have had numerous female patients diagnosed with breast cancer before age 50. So, if a patient asks me should she start mammograms before age 50, of course I will continue to say she should. Women who are diagnosed early in the growth of a breast tumor have a much better survival rate and usually need less invasive treatment, so why wait? Yes, I understand the issue of false positives, but overall, I think most women would rather take the risk of false positive than take the risk of cancer diagnosis too late for effective treatment. I saw a news clip of this same Dr. Pettiti talking about this issue, and she said the new guidelines should capture "most" of the women who need diagnosis. Well, dandy! Who wants to volunteer to be one of the women NOT in the "most" category?? Who wants their mother/sister/wife/daughter to be left out of the "most" category? They should have left well enough alone. Breast cancer detection was getting done earlier, and survival rates were dramatically improving over the last years since we went to mammograms starting at age 40, and annually. Let's keep the human herd healthy.
Posted by: Sheila | November 23, 2009 at 11:40 AM