Wednesday, November 18, 2009

Controversy du jour

Breast cancer screening. 

It's been interesting watching the uproar.  Once again the American populace is demonstrating its inability to understand simple English -- a recommendation is not the same thing as a requirement -- and its capacity to contradict itself.  Last week the airwaves were still full of bloviation about rationing if the government gets involved in health care so we must trust the private sector; this week the airwaves are full of bloviation about the evil, evil insurance companies and how they'll use the new guidelines as a reason to deny services.  (Of course, a few people are ranting about this being an example of what we can expect under Obama-care, irrationality in action.)

The airwaves are also full of people rattling off their personal anecdotes, some of which actually serve to confirm that the new recommendations might be spot on.  Women, for example, who argued for sticking with the annual mammogram while simultaneously describing how they found their cancer accidentally, i.e., noticed a lump, and then had a mammogram -- so the mammogram saved their lives.  Which is probably true, but it wasn't an annual screening mammogram; it was one they asked for after noticing something that for them was abnormal.  (The most prominent example of that particular experience is probably Congresswoman Debbie Wasserman Schultz.)  Good Morning America just gave air time to a woman in her 20s who's arguing for annual screening because a mammogram found her cancer, totally ignoring the fact that young woman was not yet in the age group affected by the recommendations. Obviously, routine screening was not what found her cancer. 

I'm not a big fan of using anecdotal evidence myself -- the plural of anecdote is most definitely not data -- but if I were, I'd trot out the handful of breast cancer sufferers I've known and point out that not a single one of them had her cancer detected by early screening, either mammogram or routine breast self exam.  In several cases, a sexual partner noticed something odd, in others, the woman herself spotted something while showering or putting on deodorant.  Oddly enough, none of the cancer survivors the MSM have trotted out so far have named routine screening either. . . they all went for a mammogram after noticing something didn't seem right, not before. 

So should we stick with annual screening and pushing BSE anyway?  I don't know.  I'm enough of a nerd that I did the research for myself years ago (family history, various risk factors, comparisons with survival rates here and in Europe where the screening schedule is different), and decided no way in hell was I putting my tits in a vise as often as my doctors were recommending.  Two years apart?  Heck no, I've decided three sounds good.  But that's me.  My body, my life, and my choice to avoid a test I view as (for me) an uncomfortable waste of time.  Someone with a different family tree and risk factors might look at the available evidence and make a different decision.  But whatever decision anyone makes, it would be nice if it could be made dispassionately and not colored by MSM-generated hysteria.

UpdateScience Based Medicine has a good post up now on the topic.


  1. I agree with most everything you state. My sister-in-law died in 1978 at the age of 26, from breast cancer. Had the doctor worried more about a long life, than cosmetics (no radical mastectomy performed), I feel she would be here today. My worry is the insurance companies that adhere to the advice of this panel.

    Congresswoman Wasserman-Schultz stated today, that she has been informed that one insurance company will no longer cover the screenings for those under 50, following this new tenet.

    I'm not sure how other insurance companies are going to change their policies at this time, but I should hope that a mammogram is now going to be considered a non-covered procedure.

    Kathleen Sebelious has had to come forward now to assure people that preventive measures still need to be taken, and that this panel's advice is not gospel.

    Bad me, I haven't had a mammogram since I turned 40 - now I'm almost 58 - oops! I had the "technician from hell" who managed to cause me enough pain for a lifetime.

  2. correction: "mammogram is NOT going to be considered".

    sorry about that.

    word verification: strap
    (as in strap your boobs down. LOL


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