Breast Cancer - Experts Needed

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If I were more timely on writing, I would have railed against the news on Monday that the US Preventative Services Task Force recommended that women should delay breast cancer screening until 50 years of age, rather than 40, and, astonishingly, that they should not be taught self-exam methods.  This news plays nicely into public fears (and my own) of government rationing of health care services, as this is a government appointed group that does have influence over policy decisions.  Rightfully, the public and a number of congresswomen took exception to this, and their recommendations would seem unlikely to have any impact on policy for now.

Today, Dr. Timothy Wilt, a member of the panel, indicated today that “cost is not considered at all.  This is about providing high-quality health care for the individual [and] providing the information they need to know to make an informed decision.”  Hogwash. 

Their recommendations clearly indicate that women needn’t concern themselves with breast cancer until they’re 50.  Reports indicate that their study is based on the same data that the American Cancer Society and The American College of Radiologists evaluated with the conclusion that these activities are essential to save lives.

Anecdotes are a wonderful thing.  Take any issue and someone can be found with a personal story that justifies a position or makes it seem plausible.  Politicians do this all the time.  When it comes to breast cancer, there are likely millions of women who could point to the benefits of the current screening protocols.  Anecdotally, my wife is one of them. 

The major emphasis of the Task Force's conclusions was the unnecessary mental anguish, if not physical, that women experience who are inaccurately diagnosed.  An astounding 15% of women in their 40’s detect breast cancer through mammography.  If any case should be made, it would be that digital mammography (rather than film) should be expanded to ensure even more accuracy in testing.  Instead of moving forward, they recommend going backward.  Why?

Having been through the mental hurdles of breast cancer “just” as a spouse, I can relate to how difficult it is for someone who is diagnosed with breast cancer.  Incorrectly… well, obviously less so.  But, I would imagine that after finding out that one does not, in fact, have cancer that there must be a loud sigh of relief... followed by some dose of anger.  Reasonable?

The Task Force includes 19 members, none of whom reportedly were Oncologists.  Data is a collection of numbers.  Sometimes, it's trash in, trash out. Regardless, it’s well known that the same data can often be used to support diverse or contradictory conclusions, depending on the intent of the person using it. 

I admit I'm leaping tall buildings in a single reading between the lines, but I can’t help but think that at least a couple members either experienced a misdiagnosis or were close to someone who was.  To "protect" women from the same pain and suffering, someone must have wielded enough intent and persuasive power to reinterpret the data.  It seems the only sensible reason why a panel dedicated to preventive care would come to the conclusions they did in the face of an abundance of good results. 

Given the gains that breast cancer has made in recent years in visibility and funding, it's just hard to imagine a responsible entity suggesting a reverse in direction.

"Save the ta-tas" makes for nice bumper sticker and a more... prominent...T-shirt, but it's saving lives that matters.


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