Saturday, November 21, 2009

fuss about mammography guidelines

Old news, just another agency saying it again.

And you'd think a sniper was shooting 40 year old women at a shopping mall.

I don't understand why women are so devoted to such a lousy test. Mammography may save some lives - not often and usually in older women.

And the blogosphere is full of women saying they were diagnosed by mammogram in their 40's and would be dead if they hadn't been tested. That might be true for a few, but it can't be true for many. This is like basing health policy on shark attacks or lightning strikes. Most of these women would have found lumps a little later, had them biopsied, and been treated the same way months or years later, with the same excellent survival rates. Some of them would have been screened at 50 and the lesions that were present at 44 would have vanished anyway.

Commentators tell me that breast cancer is the greatest health concern of women. Only if they are illiterate or misinformed or responding too enthusiastically to marketing plans. Others have announced that women do not base health decisions on evidence or statistics. That's not true. I do.

I was 53 at diagnosis but I don't think that mammogram saved my life. I can't be sure, but I might have died of heart disease at 70 with the same DCIS in my right breast, not bothering anyone.

I've always looked at evidence and guidelines. I was skeptical about mammography. No skeptical enough to ignore it
completely, but I spaced them 5 years apart. I thought that was often enough and it turned out it was.

We have way too much breast cancer "awareness" and way too much screening.

The guidelines (which are not new incidentally) are rational, not rationing.


gail said...

Good to see you back blogging. I've been wondering what happened as I check back here weekly. How goes things?

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