mammography machine picture via http://www.cancerquest.org
A government task force claims that women don’t need to have routine screening for breast cancer until age 50. (See the AP story here.) But the American Cancer Society recommends routine mammograms for women 40 and over.
The government task force’s reasoning? Because the “anxieties” caused by mammography, false positives and biopsies do not decrease mortality.
If the federal government is so concerned about women’s anxieties, how about more jobs, affordable child care, lower tax rates, clean air to breathe, and an end to discrimination?
I can control my own anxiety about having my breast squished by a mammography machine, thank you.
-Bridget Crawford
Just who is this government task force? Probably a bunch of men… Why havent they given the people an updated stating that men should only be screened for testicular cancer when they turn 50?
CD Dorsey
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I think this is kind of ableist. Some of us really do suffer from anxiety, and we can’t control how it affects us. Not to mention that there is classism, racism and sizism in not acknowledging that going to the doctor for anything at all can be very anxiety-producing for those of us who are routinely abused by doctors.
If the medical procedures are causing us more harm than good, then what’s the harm in recommending that they change the guidelines?
Thank you, kataphatic, for your comment. What I meant to convey is that I don’t want the government (or my health insurer) to decide for me that the risk of anxiety is greater than the benefit of early screening. That’s for each of us to decide for ourselves, in my view.
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I think the fault lies more with the AP article, with its emphasis on women’s anxiety – and I’m with Bridget Crawford on that 100%! – than with the recommendations themselves. What I recall from my reading when this first emerged several weeks ago was that early discovery of some kinds of cancers didn’t necessarily lead to better outcomes; more specifically, that those cancers discovered by mammogram or self-exam among that age group were more likely to be slow-growing ones that would not warrant treatment. This seems rather counter-intuitive to me, until we consider that there are real costs to treating cancer, as we all know, monetary costs being only one – and some would say the least of them.
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Deidre Bowen has an interesting take on this issue (The New Breast Cancer Screening Recommendations, Women of Color and Where We Get Our Research) on the Seattle University blog at http://seattleulawfaculty.wordpress.com/2009/11/18/screening/.
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I just posted a long commentary on this on my blog. It includes opinions from the Boston Women’s Health Book Collective that says these recommendations make sense from a feminist health perspective.
I haven’t forgotten how many decades women were given hormone replacement therapy on a mass scale before any real research was done on the impact. Is it better for women to have later, fewer mammograms, or is it better for insurance companies, and/or the Obama health care initiative? Watching what is happening with abortion isn’t exacly confidence inspiring. Hmprescott’s post (see directly above) assets that National Women’s Health Network issued a position paper recommending against screening mammography for pre-menopausal women in *1993.* Why is the medical establish suddenly worried about this now? Doesn’t mean this isn’t a good change on balance, but if the timing made more sense to me, and the media spin was less patronizing, I might feel more confident that this is in women’s best interests.
@Ann — I think it’s just bad timing. I’ve also heard similar things about prostate cancer screening from physicians across the pond.
Well, today’s NYT broadcast a recommendation for rolling back cervical cancer screening too: http://www.nytimes.com/2009/11/20/health/20pap.html?_r=1&scp=1&sq=cervical&st=cse
Supposedly the timing of this too is a coincidence. I’d like to see some hard data that this will improve women’s health, not just blather about “anxiety.” I’ve watched two family members die of cervical cancer, so this one is quite personal.
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I Blame the Patriarchy has a pretty good post about this issue here:
http://blog.iblamethepatriarchy.com/2009/11/19/american-boobs-used-as-political-football-part-472/
At the bottom, in tiny font, are these trenchant words: “Everyone should have access to free genetic testing to determine whether they have the breast cancer mutation. If you’ve got the mutation, your chances of tumoring out before age 50 are, like, 80%. Currently that test costs like 4 grand, and good luck getting your insurance company to cough up for it.”
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From the Pandagon comment threads on this topic, by “Mythago”:
I’m sure there’s also a concern that the medically-sound differentiation between testing schedules for women in high-risk groups vs. low-risk groups is going to be utterly ignored by insurance companies. Hey, doctors said that women only need mammograms when they’re 50, so screw you, 45-year-old female who has a family history of women getting breast cancer in their 40s!
AMEN SISTER. No physician I’ve spoken to about this thinks it is wise for anybody to accept this new “dispositive conclusion” as some kind of absolute truth. Women have a long history of being exploited by the medical industrial complex, and I seriously doubt that has come to some magical end while the costs of the Obama health plan are being crunched.
There is a lot of information that the media (and probably male doctors) are leaving out.
First, mammography is radiation. In small doses, radiation doesn’t necessarily cause harm. But repeated exposure can potentially CAUSE cancer.
Second, breast cancer in young women is usually extremely aggressive and grows very quickly — too quickly to be caught in routine annual monitoring.
Case in point – myself. I started having annual mammograms in my late 20s because my mother was diagnosed in her 30s. In March 2006, at age 33, I had a routine annual screening mammogram. All was well.
7 months later, I found a tumor in my right breast that was nearly 5cm. A premenopausal breast tumor grows too fast to be caught in an annual mammogram.
Now, of course, the footnote that the media never picks up on is — had I KNOWN I had a brca1 mutation, I probably wouldn’t have been satisfied with a clean mammogram. However, I didn’t find out about the brca1 mutation until mid-way through chemotherapy, and it did me little good at that point.
So I think that the condescending tone about “anxiety” over false-positives is troubling, but the powers that be aren’t being completely honest about the mortality rates and the very scary truth about breast cancer in young women.
(I’m fine now).
Sarah Deer
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