Breast Cancer Test Balloon

| Comments (0)

November 17, 2009 | Comments

Stop the presses, ladies! And stop those self-examinations. Yesterday a government panel – the U.S. Preventive Services Task Force, part of the U.S. Department of Health & Human Services – which influences Medicare and the insurance industry, announced a change in recommended guidelines for breast cancer prevention practices.

For years now, the American Cancer Society has recommended that women begin annual mammograms at age 40, accompanied by monthly self-examinations at home.

The new guidelines: Begin mammograms at age 50 and repeat every two years. And those self-exams at home? Forget them. In fact, those techniques, said this panel, should not even be taught anymore. Previous recommendations, they claimed, have led to too many false alarms, which lead to too many unnecessary biopsies (and thus, though not officially announced but certainly implied, unnecessary payouts for said biopsies).

While I have yet to hear any official fallout from this, I have conducted my own little fallout myself. I personally know three women whose breast cancer was identified in the early stages – and before they had reached age 50 – because of mammograms and self examination. All three are still with us today, grateful, I’m sure, that they were subject to the previous guidelines, as under this new set, they would be gone. Indeed self-examination, in particular, deemed of “no value” by this panel, was the very key to the survival of a family member of mine. No value, you say? She would beg to differ, and so would we, her family.

But I have a feeling that the survival of the women in my life, and yours, who survived because of genuine preventive practices, is of no concern to this government panel, or any other government panel we are likely to see in the future. Let’s be honest and substitute the phrase “cost-cutting” for the word “preventive” in this task force’s name, and think about what this group is recommending.

What I gleaned from reading the new guidelines is that too few lives are saved by earlier diagnostic intervention. My question back at them, then, would be: So whose lives will we be sacrificing? Will it be mine? My daughter’s? Your daughter’s? Our moms’?

I suppose we should get used to this, though, folks. Perhaps this was simply a test balloon floated to see what kind of response an announcement about restricting proven life-saving diagnostic tests would garner. For months now we have been told that this is the direction we must take in the name of fairness and health-care reform. We have heard plenty about the magical cost-cutting powers of prevention, too, but we apparently have to accept that there will be casualties along the way. Hope and change come with a price, you know.  Yes, they do. But sorry, I’m not buying.

You see, no matter how many lives, how many women, they deem an acceptable loss, it’s too late. I will not accept these guidelines because I know all too well that those previously in place save lives, pure and simple. They saved the lives of women in my life – and I am sure the lives of women in your life, too, women who are with you today because of early mammograms and self-examination.

This panel, and, I suspect, the agenda that drives it, would call our survival stories anecdotal evidence. I would, in turn, call that bean counting. And I would call it unacceptable.

Betsy Siino | Comments