Tuesday, November 17, 2009
New Mammogram Guidelines
I understand that guidelines are just that; guidelines. But I am absolutely appalled at the new mammography guidelines. The new recommendations:
Most women in their 40s should not routinely get mammograms.
Women 50 to 74 should get a mammogram every other year until they turn 75, after which the risks and benefits are unknown. (The task force's previous guidelines had no upper limit and called for exams every year or two.)
The value of breast exams by doctors is unknown. And breast self-exams are of no value.
How do they reconcile these new guidelines with the fact that breast cancer is the leading cause of cancer death for women under 50 and the most common cancer to affect women? They say the benefits of mammography are smaller in younger women. I was 43 when I was diagnosed. Mine was not found via mammogram, I found it myself. It was over 2cm and it was classified as aggressive. By finding it early, it had not had the chance to spread to my lymph nodes and I get to be alive.
My concern with waiting until the age of 50 is that people will think that breast cancer isn't something to worry about until you turn 50. But the fact is, cancers found in younger women are more aggressive. If those women who are carrying around breast cancer without knowing it waited until they were 50, they then have to battle late stage cancer instead of early stage cancer.
These guidelines are based on the fact that most women are not at high risk for breast cancer. Well, thank goodness for that and it would certainly be a good point if most breast cancer patients were people who had a family history. But in truth, 70-80% of women diagnosed with breast cancer have NO FAMILY HISTORY! Less than 10% of people diagnosed with cancer have the BRCA1 or BRCA2 gene mutation that predisposes them to breast and/or ovarian cancer. That leaves a huge amount of women who have no reason to believe that they will get cancer, but will.
One of the reasons for the guidelines is that mammograms don't always find cancer and neither do self exams. OK, I'll agree with that. If there was a better tool to replace these two, then I would say definitely tell people to not have mammograms until they are 50 and go with the new tool. But there isn't a better tool, so why take away the one that we have, even if it is flawed?
I will continue to tell everyone I know to have mammograms every year starting at age 40 and earlier if you have family history. I know too many amazing women who have been diagnosed in their late 30's and early 40's to be able to hide under a rock and pretend that it doesn't happen. It does. Let's not give people the idea that if you don't worry about it until you are 50 years old, it won't happen to you.
The new guidelines say that the benefit to younger women is small. Well I'm one of those younger women, and my life is worth the benefit.