New Breast Exam Guidelines

From the San Francisco Chronicle :

"Radiation causes 1 death for every 2,000 women screened annually starting at age 40, according to a study published in 2005 in the British Journal of Cancer. Another study shows that each mammogram increases the risk of breast cancer by 2 percent."

This is the reason the study group has recommended women less than fifty years old not have regular breast x-rays. The x-rays will cause roughly the same number of cancers as they find.

Now how to put that into a clever cartoon.......







































"Radiation causes 1 death for every 2,000 women screened annually starting at age 40, according to a study published in 2005 in the British Journal of Cancer. Another study shows that each mammogram increases the risk of breast cancer by 2 percent. Mammography also saves women's lives, so that's why it's a trade-off.

This is reason the study group recommended women less than fifty years old not have regular breast x-rays. The x-rays will cause roughly the same number of cancers as they find.

I agree with merkin on this. We have to find ways to more efficiently use health care dollars, and finding out what works is one of those ways. Just doing a lot of tests doesn't mean better care, you have to order the tests appropriately.

The PSA test in men is similarly controversial, as it should be. In the case of breast cancer screening the government should stick to it's guns. If their data shows that the current screening guidelines are flawed, they shouldn't hesitate to recommend new guidelines.

This issue is far from resolved, mainly because the many people with an entitlement mentality as well as those leftists with a blatantly political stance on this (claiming to act on behalf of "women," etc.) have yet to cease their howling.

It's no surprise that a few Republicans have already moved to seize this themselves, for obvious reasons: This is, as one legislator said, an introduction to rationing and denial of care on "appropriateness" (and later, on cost control) grounds. (It was an easy matter to seize this, given the sound intellectual basis.)

Lost in this is not only the details the first two posters have noted, but others, related to what the group presenting the case for changing the criteria for screening had mentioned, too: "false positive" test results. "The solution here seems to be primarily research into improving test results, rather than rushing to limit or reduce screening at lower ages and at earlier stages of disease," we are still waiting for intelligent critics to say. (I suspect we'll wait forever, given the nature of the critics and their statements to date.)

The other thing that was lost in all the shrieking was that this was a proper, generalist approach, from an epidemiological and a public health standpoint, which extends to all kinds of preventive screening and other measures, for all kinds of diseases.

A side issue truly neglected is consideration of unnecessary or excessive testing in cases like this versus "defensive medicine" and related excess costs arising out of our excessively litigious environment (the need for tort reform).

"Just doing a lot of tests doesn't mean better care, you have to order the tests appropriately."

This is true of preventive care as well. It's not the magic solution (nor affordable) that proponents believe.

Thanks for the quote...

Now why wasn't that information released along with the new guidelines. They got it all backwards.

"Because radiation causes 1 death for every 2,000 women screened annually starting at age 40, we have changed the mammogram guidelines too..."

For those who remain curious:


The USPSTF recommends against routine screening mammography in women aged 40 to 49 years. The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account, including the patient’s values regarding specific benefits and harms. This is a C recommendation.

The USPSTF recommends biennial screening mammography for women aged 50 to 74 years. This is a B
recommendation.

The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of screening mammography in women 75 years or older. This is an I statement.

The USPSTF recommends against teaching breast self-examination (BSE). This is a D recommendation.

The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of clinical breast examination (CBE) beyond screening mammography in women 40 years or older. This is an I statement.

The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of either digital mammography or magnetic resonance imaging (MRI) instead of film mammography as screening modalities for breast cancer. This is an I statement.


http://www.annals.org/content/151/10/716.full.p...