11/20/2009 2:30:44 PM #

The ACS should be contributing light rather than heat to this discussion.

What the task force is saying is that mammograms for women between 40 and 49 should not be "routine," but should take place when a woman feels they are necessary after consulting their doctors.

The recommendation wasn't well-written, but they've explained it sufficiently so that plenty of leaders in the cancer community understand it. You should join suit, instead of playing word games.

word2thewyz

11/20/2009 3:48:40 PM #

I know this is controversial and emotional, but I agree with one journalistic comment that there are multiple reasons women are ill-informed about breast cancer. The fault lies primarily with their physicians, the cancer establishment and the news media - especially the news media. I hope physicians-that-are-also-TV journalists start realizing that by abusing their positions of trust as doctors to lend credibility to hit-and-run stories, they cheapen both medicine and journalism. Instead of promoting their celebrity doctors, the networks (and cable) should use that precious air time to educate people on the evidence behind the USPSTF recommendations. Until coverage of breast cancer rises above the level of scary warnings mixed with heartwarming stories of cancer survivors, women are likely to go on being perplexed.

Gregory D. Pawelski

11/21/2009 2:43:15 PM #

I'll tell you why I'm perplexed.   I was diagnosed with breast cancer at 33, with no family history and no other (known) risk factors.  I found my lump during my monthly self exam, and it was visible on a mammogram.  And I know a lot of other women with similar stories.  I acknowledge that SBE's and mammography are not great screening tools, but A) they worked for me and B) they're all we have.

Elizabeth

11/23/2009 9:58:32 AM #

I do agree nor understand this change.  My breast cancer was found at age 37 on my first mammogram.  No family history, non smoker, and no lump could be felt at the time.  If I had to wait for a mammogram until I was 50, I probably would not have been around to have it or have the quality of life I do have.  I know I am not the only survivor with a very similar story.  I can only pray that these recommendations are reconsidered and doctors continue to educate women on breast cancer and suggest they get their mammogram between 35-40 year of age.

Amella (Mel) Shade

11/23/2009 11:30:09 AM #

I am concerned that the Preventative Task Force did not answer some important questions:

1) Should a discussion with the physician of the disadvantages and benefits of a mammogram for a particluar patient under age 40 be a new standard of care?  If so, what should the content of that discussion be? Is the 15 minutes managed care alots to an office visit sufficient for this conversation?

2)What are the characteristics of the patients aged under 50 whose lives were saved by screening mammograms? Specifically, which patients under the age of 50 are more likely to get breast cancer and therefore, should be screened?

3)Is there any value to having a baseline mammogram at a key point in a woman's life? Is there any value to a woman under 50 having a screening mammogram at longer intervals than once a year?


In 1992 I was diagnosed with stage 2 breast cancer at the age of 42. The cancer recurred. Due to excellent medical care, I am alive to write this email. Since I have several risk factors, if I had had a screening mammogram perhaps the breast cancer could been discovered sooner.

I was in a small breast cancer support group in Northern Virginia. Most of the members were under 40. Several of them succumbed to the disease leaving young families. Perhaps early detection would have saved their lives.

I think the Preventative Task Force reccommendation was not enough. It leaves women under the age of 50 without any tools for early detection. The task force should have added a loud call for better tools for detecting breast cancer sooner and have carefully crafted their message with a strong recommendation that physicians have a specific discussion regarding breast cancer screening in the light of the patient's medical and genetic history.

Charlotte Plaxico

11/23/2009 12:39:13 PM #

The news about mammograms is not brand new information based on one study that just came out. The recommendations that the Preventive Services Task Force (PSTF) released is based on research that experts have known about for some time. http://cancerfocus.org/forum/showthread.php?t=3008

Gregory D. Pawelski

11/23/2009 3:34:04 PM #

I agree- shame on ACS for trying to inflame and capitalize on this controversy.  The Task Force makes recommendations to medical providers, not to patients.  And why not point out the health disparities and why we should be concerned with minority women with higher death rates.

publichealthtype

11/23/2009 3:37:48 PM #

I recommend the article in the Washington Post today www.washingtonpost.com/.../AR2009112301801.html. It addresses the questions of several of the posters.

publichealthtype

11/23/2009 11:14:59 PM #

Why do most MD as well as the ACS continue to spew lies about thermography.  This technology has been FDA approved for 25 years as a screening tool for breast cancer.  No radiation so you can start screening women in there 20's without risk of harmful radiation or such false positives.  Why wont MD's do some reading of the 800 peer reviewed scientific research on thermography?  Stop saying mammograms is all we have.  It is NOT early detection and most cancer are there for 8-10 before a mammograms indentifies a tumor.  I say thank god for this report we might actually finally save some lives.

atticus

11/27/2009 11:37:40 AM #

So why are you stoking the fires of this already controversial change instead of pointing to more sound less expensive cancer prevention options like vitamin D?

Sol

11/27/2009 2:15:03 PM #

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Kaká

11/30/2009 1:37:58 AM #

I am a 43 year old 2 yr breast cancer survivor, a digital mammogram detected calcification so I was referred for an ultrasound that showed my two tumors clear as day. They had rechecked my mammograms for 4 years, if I had had an ultrasound sooner would my stage IIB cancer been found sooner? My best friend was just diagnosed, at 44. She had had her annual mammogram a few months back, it was fine. She felt a lump and had an ultrasound, again, tumor, easily seen. I'm glad a mammogram lead me to find my cancer, but I wonder if rather than mammograms should we be getting annual ultrasounds? starting any screening at 50 is too late, I'm certain of that, I have so many friends who were dignosed with breast cancer in their early 40s.

Tara Treppiedi

12/6/2009 8:02:30 AM #

According to these guidelines I wouldn't be here typing this letter.  Diagnosed at 42 with breast cancer:lumpectomy and radiation.  Diagnosed with recurrent cancer 2006:bilateral mastectomy, no chemo(because it was caught early).
Both cancers were found on mammograms!!! but maybe if the first wasn't found at age 42 there would have been less money spent on me because I wouldn't have had that bilateral mastectomy, reconstruction 14 years later.   Just look at the money I could have saved my insurance company...you can't resusitate a dead body.
Thanks Dr. Pettite...hope you and your family remain cancer free...I truly mean that because anyone diagnosed with cancer and survives appreciates not only there life but all other lives. And thanks to mammograms I am alive!!!!
thank you,
nanci kuehner

nancy kuehner

12/8/2009 3:52:57 PM #

The recommendations that the USPSTF had released is based on research that experts have known about for some time. Dr. Herman Kattlove, a retired medical oncologist, did research on mammograms in the early 1990's. For the last seven years before his retirement, Kattlove had served as a medical editor for the American Cancer Society where he has helped develop much of the information about specific cancers that is posted on the ACS website. On his personal cancer blog, Kattlove writes: "Studies that have been published are pretty clear that mammography is effective in older women, but for those under 50, the benefit is awfully small. This is why we can't look at how early we can detect the cancers, but whether this detection saves lives. There is little proof that mammography in women under 50 saves very many lives. There are exceptions of course. Women with a strong family history or other risk factors should be screened early. But each year, for every 100,000 women under age 50, only 40 cancers are diagnosed and only 7 women die of breast cancer. On the other hand, nearly 4,000 of these women will have abnormal mammograms because of some other reason like scarring or cysts and they will get more mammograms (and more radiation to the breast), and often, an unnecessary biopsy. Even though an occasional likfe is saved by the procedure, it wouldn' be worth it for all the side effects the other women would experience. But the American Cancer Society avoids looking clearly at the data and continues to recommend screening for younger women. ACS doesn't want to enrage its donor base and Congress doesn't want to upset constituents."

Gregory D. Pawelski