Mammogram Screening Vital -- Don't Put it Off

The new mammography guidelines have created massive confusion for women. First, remember they are one small group’s guidelines. The upset about them is much more widespread. I imagine that the panel tried to come to the best conclusions they could based on the data they had. I don’t doubt positive intent. However, many, with equally good intent, are outraged.

I am not a physician. But I personally know a couple of women who had breast cancer who were under 50. Most were discovered by routine screening. Others were found because the woman, or her spouse/partner felt a lump. It is very disturbing to me that those women would not have gone for screenings if they followed the current recommendations and would probably be dead. And, others would have died because the same panel doesn’t think women need to be taught self-examination of their own breasts.

If anything, I think women need to be better taught how to examine their own breast. I am 59 and once, a very long time ago, a gynecologist told me and let me feel a model that had spots that felt like a BB. So that was better than nothing, but I never felt confident that I really knew or that I could distinguish the general changing lumpiness from something I should be concerned about. I wish physicians had helped me learn and practice regularly in visits.

The panel recommends mammograms every other year for women 50 and over. I personally know probably 8 women who had cancer diagnosed in routine mammograms. One year they were clear, the next year, they were diagnosed. These were not women who skip mammograms – they did them regularly. At least two I know had cancer that was already invasive (had penetrated the wall of the duct and were in the lymph node.

Mammograms are not perfect, but they are a powerful tool for women to find cancer early, and get less traumatic treatment and help women survive.

I for one will continue to get yearly mammograms, and will encourage anyone 40 or over to get them regularly. I also make sure I have a physician give me a clinical breast exam. I’m a big believer in minimizing chances of a bad outcome and maximizing chances of a good outcome. Finding cancer early is a clear way to do just that.

House Passed SGR Fix

I am quite amazed that any governmental body has actually passed something instead of just talking about the same things year after year after year. A couple of years ago, I watched live proceedings of one of the House committees. The head of the committee, plus a leading member of the minority party, loudly proclaimed how more than talk has to happen, that legislation needs to be passed, and how absurd it is that the SGR hasn't been fixed. Guess what happened! Nothing.

I haven't read the bill yet, but just an attempt to fix it is good news to me. Do you really think a 21% cut to physician reimbursement when they have increasing expenses is going to help healthcare? It is scheduled for 2010 if something doesn't happen to stop it. We are going to lose good physicians who finally give up if that happens. Cutting reimbursement will make it impossible for some to stay in practice, let alone compete against growing hospital employed networks.