UP Ibalon Bicol: Changing the guidelines of mammography may increase breast cancer mortality

Changing the guidelines of mammography may increase breast cancer mortality

12/01/2009 | Posted by mesiamd | Edit Post

The US Preventive Task Force, a panel of experts, none of whom are oncologists, has recommended the following which has stirred much confusion and controversy:

1. Raise the age of first mammogram from 40 to 50 years old
2. Mammogram will be done every two years instead of every year
3. Stopping mammogram when a woman reaches 74 years
4. Patients and doctors may not do breast examinations

Mammography has been recognized as a vital tool in breast cancer detection. I believe a delay of 10 years before the first mammogram will miss cancer at an early stage when it is treatable with the best chance of survival. The panel thinks greater morbidity and mortality can be avoided if patients talk to their MDs on the cost-benefit assessment of the procedure. It is doubtful if this is true.

Those who advocated raising the age of taking mammograms ignored the successes in the fight of breast cancer which were achieved in last 10 to 20 years. About 15% of women in their 40’s are diagnosed with breast cancer from routine mammogram screenings. Since the use of mammograms in the early 90s there had been a 30% drop in mortality, about a third of which were women with ages 40 to 50. The procedure had been mainstay to early cancer diagnosis and treatment in this age group.

The change from a yearly mammogram to every two years will miss breast cancers at an early age. And halting the procedure after 74 years (at a time when longevity is getting longer,) can lead to more women dying of mammary tumors in their old age. The panel rules the number of patients falling in these categories is negligible and therefore can be ignored. Yet, in truth, looking at these "negligible" patients as expendable groups (not as individuals) is unfair and inhumane. What if it is you, your wife, mom, or sister who has the risk of having the disease?

Not recognizing the utility of breast examination to diagnose cancer goes against the grain of experience in medical practice. There are instances when during breast exams, patients are alerted of tumors that turned out to be cancers. Therefore, breast examination still plays a role in cancer detection.

I believe the lowering of the frequency of mammograms and the delay of conducting the routine procedure for women will adversely affect the gains in the fight against breast cancer. Women in ages 40-50 are the most productive and to preserve their life, they deserve a the best medical care.

Obviously, the new guidelines that are recommended are flawed. They come at a time when the pressure to lower the cost of medical services is among the hardest to tackle in the healthcare reform. Many doctors don’t agree with the recommendation of the US Preventive Task Force. Even the American Cancer Society and the American College of Obstetrics and Gynecology voice their objections to the proposed guidelines. =0=

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Labels: breast, cancer, guidelines, Health, Medicine, Naga Camarines Sur. Totie Mesia

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Changing the guidelines of mammography may increase breast cancer mortality

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