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It is hard to believe but Christmas and New Years
are almost here. This is a great time to reaffirm your healthy habits. Resist
all the junk food that is going to pass your way during the holidays. Get out
there and start walking. At your holiday dinners use dessert plates instead of
dinner plates. That will help you to eat less.
It is also time to consider setting up your health screening. Read on! .
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What about breast cancer screening?
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 Recently the U.S. Preventive Services Task Force
made some new recommendations for breast cancer screening. They recommended
that regular screening with mammography should be done every two years in women
starting at age 50 and continuing through age 74. They also discouraged
self-breast exams.
This decision was made after looking at the rate of false positive diagnoses
with both self-exam and mammography in younger women. False positive diagnoses
tend to cause anxiety and cost money. What the task force did not mention is
that once things are fully explored most women find the results reassuring.
Although more false positives are discovered screening women in their forties,
more aggressive cancers that are potentially deadly are found in women in their
forties. In addition, women often find their own cancers when they do
self-exams.
I understand what is behind the task force's recommendations, however I find
them upsetting. Cost is certainly a consideration as is emotional distress when
it comes to false positive results. However, there is no health care provider
who would want to miss a deadly cancer. That is why radiologists tend to be
overcautious, as well as primary care providers. There is also a worry that one
might be sued for missing a potential cancer.
For all of these reasons, I plan on continuing to screen women with mammography
starting at age 40. I have found many cancers in women in this age group, as
have many of my colleagues. By doing regular screening we (in medicine) have
decreased the mortality for breast cancer substantially. Why would we want to
go backwards? I am very concerned that insurance companies will use these
recommendations to stop paying for mammography in women in their 40's and will
only pay for mammograms every two years in older women. Again I ask why would
we want to go backwards and allow women to die unnecessarily?
I hope that each woman will have a good discussion with her doctor to explore
the best ways to prevent breast cancer and the benefits and risks of screening.
I believe that with education and a true understanding each woman will make the
correct choice for herself.
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