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<p>I suspect that every member of the panel that produced this report was appointed during the Bush administration. The average tenure of members is four years, but some serve longer. If this panel resembles others that I am a little bit familiar with, these reports take many months to finalize, and that is following a couple of years of sporadic meetings.</p>
<p>I don’t think Obama has been in office long enough to have had any input into the panel’s membership.</p>
<p>I’m not sure how you can say ZERO lives are saved through screening. . .or is it only one in 10s of thousands? </p>
<p>(Obviously, I am not a mammogram promoter and never bothered to get one myself.)</p>
<p>Some people do have cancer found through screening. Now we don’t know if they would have died if they weren’t treated until their cancer was discovered “by hand or eye.” </p>
<p>But there is a good chance that some of those with more aggressive cancers would have died (H’s cousin died of BC in her 30s. . .) had the cancer not been found and treated earlier through screening.</p>
<p>My sis does “believe” her life was saved by screening. If it’s your life, it is worth it.</p>
<p>Actually, I am hoping that this recommendation combined with better health care options for everyone will lead to a reduction in cancer deaths. Right now almost half of american women between the ages of 40 and 50 have never had a mammogram. Part of that number is due to the un- and underinsured, part of that is due to a scarcity of resources, particularly in rural areas. Maybe by concentrating our resources on those women most at risk instead of just on women who have access for what ever reason we will catch the most aggressive and deadly cancers.</p>
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<p>Huh, the article clearly states that the number ain’t zero…</p>
<p>As noted above, the number I have seen is 1 per 1,900. That’s not the number of cancers identified – that’s in the hundreds, including false positives. That’s the number of people in the screened population who live longer.</p>
<p>Kathleen Sebelius, Health and Human Services Secretary, just said that women should continue to get mammograms in their 40s.</p>
<p>The 1,900 screenings/one life saved or extended was the figure I saw.</p>
<p>Of course we all should. Did you see that Hologic stock was up today?</p>
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<p>What does that mean? The only people I know who seem to have trusting relationships with their doctors are seniors or others with chronic illnesses who are go to the doctor often. They’re the ones who know their PCP. I see my PCP every three or four years for a check-up. He doesn’t really remember me or know anything about me (other than what’s in the record). I don’t have any chronic illnesses and I don’t take any medicines. I get mammograms–usually every year, but a few times I’ve gone two years. To tie it back to the topic at hand–I don’t feel as if I could go to my PC and ask his opinion about my individual situation. I’m over 50 and I’d be happy to stop getting mammograms every year, but I’m probably at risk (my mother died of breast cancer–but it was when she was 78). I understand the basis for the panel’s recommendations and generally believe that decisions should be made on the basis of empirical evidence rather than emotion. However, I’m not sure my PCP can advise me any better than I can advise myself on this one.</p>
<p>By using data from randomized clinical trials, the USPSTF estimates that averting 1 death from breast cancer requires screening 1,904 women aged 40 to 49 years; 1,339 women aged 50 to 59 years; or 377 women aged 60 to 69 years.</p>
<p>Here is some good info about the data presented by USPSTF [Science-Based</a> Medicine The USPSTF recommendations for breast cancer screening: Not the final word](<a href=“The USPSTF recommendations for breast cancer screening: Not the final word | Science-Based Medicine”>The USPSTF recommendations for breast cancer screening: Not the final word | Science-Based Medicine).</p>
<p>Pay attention to the grading scale used and the level of certainty scale used by the panel.</p>
<p>And Sebelius is an expert because her background as Governor of Kansas involved a lot of medical research and/or data analysis?</p>
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<p>sunnyflorida and others:
In this age group, is there good overlap between patients who are identified as “high risk” and those who are found to have malignant tumors? If the overlap is very high, concentrating screening on high-risk patients might not reduce the number of deaths averted–denominator lower, numerator the same. </p>
<p>Exactly what are all of the risk factors?</p>
<p>Some one posted on the prior page about under & un insured women not getting mammograms. I tried a year or two ago to find a free or cheap mammogram for some low income women in my small town.</p>
<p>Despite Run for the Cure and Pink Ribbon this & that and lots of info all over about raising money for it, I could not find a free mammogram site or organisation in my state!</p>
<p>sunnyflorida, that Science-Based Medicine blog is great! Thank you for linking to it. The discussion there – not so much the one yesterday as the series on screening issues a few years ago – is absolutely first rate. It does a really good job of explaining why so many people believe that screening mammography saved their lives, without any real effect on mortality data, but also why screening mammography does save lives.</p>
<p>^^Yes screening can save lives, particularly for mammograms. (Other screenings, not so obvious.) But the REAL point is that this screening comes at a cost: not only for the mammo itself, but all the false positives that need to be further investigated & possibly biopsied. It’s no different than pap smears, which are recommended annually. If they were conducted every six months, for example, xx additional cancers would be found. </p>
<p>But, on a cost-benefit ratio…the question is where do you draw the line for insurance reimbursement? Where do you draw the line for the poor? According to many on this thread, the rich could pay for an extra mammo out-of-pocket, so I guess they condemn the poor to be that one death out of 1,900 who are unscreened?</p>
<p>“the rich could pay for an extra mammo out-of-pocket, so I guess they condemn the poor to be that one death out of 1,900 who are unscreened?”</p>
<p>Or maybe they’ll be the one saved life out of 1,900 who doesn’t get a radiation-induced cancer.</p>
<p>I’d like to know why the opponents of the new guidelines don’t support annual (monthly?) mammograms starting at puberty. What if you’re that one 25-year-old with an aggressive tumor?</p>
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<p>Sorry, I missed the data in the report that indicated the number of radiation-induced cancers. Could you point me to it?</p>
<p>This report seems to have ignored it, which is a terrible shame. But based on what we know about X rays and soft tissue, the number of cancers that are induced (or sped up) by the 30 or 40 lifetime mammograms that women currently get has to be greater than zero. We shouldn’t ignore that risk just because others have. This isn’t just a calculus with money and stress on one side and lives saved on the other. It is a calculus with a cost in human lives on both sides.</p>
<p>Also, we should consider the costs of the unnecessary treatment for the women who either had false positives or had cancers that would have resolved with no treatment, not just the monetary costs, but risk, inconvenience and anxiety resulting from getting treatment that isn’t needed.</p>
<p>Coming from a family that has an unbelievable amount of breast cancer (genetic mutation), I have always been an advocate of mammograms, sonagrams, and biopsies. We have known about our family history for over 50 years already, long before there was testing for the BRAC gene. My mother was one of 7 sisters, her six sisters all developed breast cancer before the age of 35. My mother never got it but at age 60 she was diagnosed with ovarian cancer stage 4. My sister was diagnosed with breast cancer at age 28 and 18 of my aunts daughters were diagnosed before they turned forty. Of my grandmothers two sisters, one died from ovarian cancer and the other from breast cancer. My grandmother was never diagnosed with either and died from a stroke at age 68. Many of my cousins had already had children prior to their diagnosis and now we are seeing the new wave of breast and ovarian cancer in the younger generation. My sister who was diagnosed at age 28 had a radical mastectomy and six months later another mastectomy, that was 32 years ago. When my sister turned 50 she was then diagnosed with ovarian cancer stage 4 and passed away at the age of 52. She left behind three children, one girl who has since tested negative for the mutation. I would like to add that my sister had only one remaining ovary at the time of her diagnosis because one had been removed shortly after her breast surgury. I was very young at the time and I can not recall the reasons for that surgury although I know it was non cancer related.
Our family is not of the well know Jewish clan that often is associated with this mutation.</p>
<p>I share this story with you because it was my mother that knew that there was a genetic link to our family history and it was my mother who insisted that my sister get that mammography at the age of 28. The doctor at the time, thought my sister should wait until she was thirty to have that base line mammography. I believe she would have been dead by then had she waited.
I hope you all realize that a life saved as a result of mammography, sonagrams or biopies is the life of the person and the family that has been saved. My sister was only 28 and she had three very young children, one only six months old. They would have grown up without their mother. As it was they all lost her way too young. It is trully a sad story for those kids because only thirteen months before my sister died they lost their father to lung cancer. He was only 52. </p>
<p>These new regulations are indeed frightening to me and I am offended at what they imply. I would also assume that there will be fewer woman not taking as good care of themselves in terms of exams and early detection. It is a horrible society that starts to consider the cost effectiveness of a persons life.</p>
<p>I might also add that my four children will all get BRAC testing in the next two years and my daughter age 19 will have a baseline mammography next month. </p>
<p>Americans need to wake up and recognize that this is a first move toward what will REALLY happen in government run medical care. Little by little we will have fewer and fewer tests covered until eventually they start dictating who will have surguries and progressive care. My family lives in Canada and they always felt confident that they could come to the states for care if need be. The Canadians are just as concerned about the direction of health care in the U.S as we are, because we were their safety net when they could not get the treatment they needed in Canada.</p>