Less Mammography in my future

[shootingstar]

Access to health care, making it available & affordable, promoting a culture of wellness saves lives (not to politicize the board).

If I was uninsured and a clinic offers free exams if I fear that if something is found I could not get care or worse would never be insurable in the future would I go?

Have wondered about this for a long time, Trek with respect to U.S. present health care system.

But that's another long, long separate discussion.

[Trek420]

Have wondered about this for a long time, Trek with respect to U.S. present health care system.

But that's another long, long separate discussion.

I'm not in the medical field, no training in it whatsoever etc. I do work in a busy call center where most of the folks I talk to are both poor and disabled and have done so over 13 years, so I've heard a lot.

Difficulties like being unable to get to preventative and after care appointments are common challenges. Some live in areas with no public transportation, one illness where suddenly you can't drive and preventative and after care is out of the question if you do not have an awesome support network. Others can't afford the time off required to do all that.

You'd be surprised the number of tales I hear of one disease or diagnosis, a lost job or being on disability and a spiral into poverty or maybe you wouldn't.

If I had $5.00 for every time I've heard "I used to be like you with a good job, never thought this could happen to me ...." I'd be retired .... and probably being an activist for this cause full time.

I'd really like to see figures on cancer survivorship by income level but you are right .... that's a whole 'nother discussion.

[nc tam]

http://www.acr.org/HomePageCategorie...TFDetails.aspx

The fact that this is from the American College of Radiology will automatically make it suspect for some of you. Just thought you might be interested in what radiologists think of the recommendations since radiologists are reading the mammograms.

And from the American Cancer Society:
http://www.cancer.org/docroot/MED/co...Guidelines.asp

As far as other possibilities for screening... ultrasound is very operator dependent and is too insensitive for microcalcifications, a common presentation of both in situ and invasive ductal cancers. MRI is too time consuming, requires IV contrast and has too many false positives (more than mammography in some series) to be a screening study. Researchers are working on all sorts of things. Only time will tell.

[SLash]

I'm not sure if this is allowed, if not I'll remove the link/post, but I think it tells a side of the story on the new mammography/self-exam guidelines better than anything else I have read (or written). The link is to a FB page (I know, FB ), it is the Young Survival Coalition fan page. It appears to be open to everyone because I logged out and tried the link and it worked. It starts about mid-page.

I think their stories and comments help us to understand why there is the outrage toward the new guidelines and also maybe help those younger than 50 understand the risk of following them. http://bit.ly/3S1Wy6

I hope this isn't viewed as political or something, but I think it is just too important a subject not to post this.

[Tuckervill]

Ultimately, the public needs to set aside automatic enthusiasm for screening and develop a new kind of savvy—one that balances hope with a certain dose of healthy skepticism and leads people to embark on testing only after considering a host of variables, both personal and scientific. As it turns out, in cancer screening, as in so much else, there really isn't a free lunch.

link

Pretty much sums up how I think about it.

Karen

[OakLeaf]

New meta-analysis on the risks of radiation - mammography more than doubles rates of breast cancer in high-risk women.

[KnottedYet]

I'm always a little hesitant to embrace met-analysis "results."

The farther you get from the actual research, the less faith you can have in your findings.

Summaries of meta-analyses even more so. Once this is published in a journal, peer reviewed, original articles are listed, and the students explain how they made the jump from "early cancer found by mammogram in women with a family history" to "cancer caused by mammogram;" then I'll be glad to read it. Tumors don't wear a little banner saying "I was caused by ---"

Original research is grindingly slow and frustrating work. (2 years down and results presented at an international conference, now the long process of getting published) But at least I know my data, and every single one of the subjects in my study, and exactly what I did, and how I came to my conclusions. I stand behind my results. If instead I had done a re-structuring and re-filtering and re-assessing book report of the published work of 5 other groups... well, I couldn't in good faith stand behind that.

The headline could just as easily be: "mammography more than doubles rates of early cancer detection in high-risk women." As time passes and technology advances it is inevitable that we begin finding cancers earlier in one generation than it was found in the previous generation.

Detection method does not imply cause. Kind of like if my Grandma never went to a dentist until she was 50, and they found a bad cavity and the tooth had to be pulled. She tells me I'm at high risk of cavities, so I go to the dentist every year. He finds a small cavity when I'm 30. Do I turn around and say that seeing the dentist early and regularly caused my cavity? Nope. But I could do a meta-analysis that would "prove" exactly that. And should I stop flossing my teeth and looking at my teeth until I'm 50, and then start going to the dentist? Nope.

[OakLeaf]

All points well taken.

But no one disputes that radiation causes cancer, and that there is no safe dose. The only question they're trying to resolve is the precise degree of the harm.

When I had my biopsy, I asked about the radiation dose. At that point I had decided to have it done, but I wanted the information so I could make decisions about future radiation exposure. The surgeon told me the radiologist would tell me. The radiologist told me the radiation physicist would tell me.

And the radiation physicist - I do not exaggerate - called me up four or five months later and tried to explain to me that radiation is actually good for me, because there's some village in Eastern Europe located on a radioactive lake where the cancer rate is lower than that of the entire United States. And despite my telling him several times that I wasn't particularly upset about it or interested in arguing costs vs. benefits, he never did give me the information.