To read about F's and my London trip, start here and click "newer post" to continue the story.

Tuesday, November 17, 2009

So what do we think about the new breast cancer screening guidelines?

I've had a few false positives. In 2005, when we were in Memphis, I had to get a diagnostic mammogram b/c the screen appeared to show "something" in both breasts. The report from the diagnostic mammogram + ultrasound was that there were "somethings" but that they were not cancer.

(BTW, there's normally a lot of stuff in there, so they do have to be read by experienced radiologists. And the tech told me that the reason women don't get mammograms before 40 is that the tissue typically isn't fatty enough to get a good picture before then. She said that mine hadn't turned to fat yet, but give them time, ha ha.)

The next year the screen was positive again, but this time when I went for the diagnostic, the radiologist said that she didn't see the need; she saw the stuff but it hadn't changed in the years I'd been having mammograms.

After we moved to Florida I delayed getting a mammogram, which was stupid given my mom's history of breast cancer, b/c I didn't want to deal with that again. I did have a screen last month, and of course, had to follow up with more views. Got the films from Memphis to compare but had to do it anyway. Once again, a clear report.

It's a pain in the butt (well, not the butt,) to have to repeat these things, but a screen needs to err on the false-positive side if it's to do any good at all. If the concern is that women are made anxious when they have a positive screen, then that concern is easily addressed if they are told at the time of the screening mammogram that X% have to get a second look, most of these don't turn up anything, so if it happens to be you, don't freak out. If the concern is that women are being irradiated and the data show that lives aren't being saved, that's probably a valid argument. If the concern is that it would save money to not do the mammograms, that ticks me off. And no one need argue with me that delaying mammograms until age 50 is only a guideline - it's a guideline today, a mandate tomorrow.

They don't start pap smears in the UK until age 25. Here, it's 21 or at onset of sexual activity, whichever is earlier. So is it that pap smears don't save the lives of young women under 25, or is it that the NHS can't afford to spend the money? Hello, government-run healthcare.


theolderepublicke said...

I sincerely hope that health care reform wouldn't prevent people from getting the preventative they need. Your concern, of course, is a legitimate one. Today's guidelines might become tomorrow's "cost-saving" requirement.

In my heart of hearts, I would like something that would guarantee at least the bare minimum to people who have nothing and that would leave others' access to preventative care unhindered.

But it's hard for me to know how to get that done without at least some line drawing. I guess it's a good thing I'm not a lawmaker :)

At any rate, glad to hear that it's all a clear report!

Laura(southernxyl) said...

Leaving alone the care that people get that they're happy with - that's the key.

I think there are a number of issues that need to be resolved. One is that we hear about "basic" health care and I don't know if there is any consensus as to what that is. Another is that assumptions are made about people's behavior that just don't hold up - if people had insurance they wouldn't use the ER for primary care, for instance. Another is that it's evidently human nature that if the government takes on limited responsibility for something in cases where people need it to, in a couple of generations people have the idea that they shouldn't or can't take any responsibility for it themselves, and we're further down the road to being a nation of improvident children.


"At any rate, glad to hear that it's all a clear report!"

Thanks for caring!