New breast exam guidelines gaslight women out of life-saving health practices

The story of Stephanie Spielman, wife of Ohio State University and NFL star Chris Spielman, mother of four children, who was a 30 year old woman 12 years ago who gave herself a self-breast exam and discovered a lump that she then had examined and screened, died of breast cancer today at age 42.

Her story represents the stories that I dread will become absolutely the norm and her story represents the stories that other women who are unhappy with the new guideline recommendations about breast cancer screening dread.  That, under the new recommendations, a 30 year old woman will either not perform self-breast examinations which otherwise would give her something with which she could go to a doctor and ask for more screening, or that if she does ignore the new guidelines (which argue against self-examination: “[the task force] discouraged doctors from teaching breast self-examination” – yes, you read that right) and go ahead and do self exams, that when they then go to their doctors and ask for the screening, the doctor will require some ridiculous threshold before he or she will approve or recommend the screening. And that even then, the woman’s insurance won’t cover it since the guidelines say that it’s imperfect and not recommended for women under 50.

That passivity will be approved and routine.  That women will not trust themselves to know their body, that they will not bother because the system does not want to bother – because the system is so concerned about the harm of anxiety and over-biopsying.

I’ve read the guidelines, the reports and the very carefully worded explanations written by people I trust and admire.

But I am trusting my instinct on this and I am telling you – disapproving of self breast-examination and suggesting that women will have to walk in with such a threshold of concern for what they’re feeling about their body absolutely makes me irate at the thought of what a set back this is for women – for humans, for patients – to be in control of their health.

And the utter disregard for the human toll these illnesses take on everyone around the one diagnosed with the breast cancer.

Anxiety sucks. I’ve been there done that for years with shadows on films and MRIs that required additional testing.  And while I have a “family history” we don’t have the gene – and a very small percentage of women do have the gene mutations currently known to be responsible for a very small percentage of breast cancer.  My Gale score isn’t high enough to get me into most clinical trials.

From the New York Times:

While many women do not think a screening test can be harmful, medical experts say the risks are real. A test can trigger unnecessary further tests, like biopsies, that can create extreme anxiety. And mammograms can find cancers that grow so slowly that they never would be noticed in a woman’s lifetime, resulting in unnecessary treatment.

Over all, the report says, the modest benefit of mammograms — reducing the breast cancer death rate by 15 percent — must be weighed against the harms.

Screening in the 40-49 decade results in a 15% reduction in fatalities? I’ll take that over reducing the harm of anxiety and overbiopsying anyday.