Newzapalooza

I'm leaving a post on this side of my blogs because it relates to my recent mammogram. Last week I had my first mammogram to get a baseline reading. My doctors have recommended in the past that women need have their first screening between the ages of 35-40 so it can be compared to future tests.

Then this week the government bureaucracy told American women to hold off on having mammograms until we have reached the age of 50.

The American Cancer Society is stunned by the news, of course. However, the Susan G. Komen for the Cure , and Susan G. Komen herself a cancer survivor who lost a sister to breast cancer, is now taking a similar position as the government, which is adding to the confusion and noise of this Information Age:

Other highlights of the new USPSTF recommendations include the following:

•For women between the ages of 50 and 74 years, the USPSTF recommends mammography every two years (rather than every year).

•The USPSTF notes that there is insufficient evidence to assess the benefit and harms of screening in women over the age of 74.

•The USPSTF recommends against teaching breast self-exam.

Although the USPSTF’s position on breast self exams may also be perceived as controversial, there has never been clear evidence that breast self-exams reduce breast cancer mortality.

It should be noted that the recent discussion regarding mammography recommendations is focused on women at average risk of breast cancer. Women at increased risk as a result of family or personal history may need to begin screening at a younger age, and may benefit from screening with breast magnetic resonance imaging (MRI) in addition to mammography. Women who have questions about the screening schedule and approach that’s right for them are advised to talk with their physician.

Unbelievable. We women have been told for decades that breast exams are important! Women in their 30's and 40's are getting breast cancer at increasing rates! Cancer is spreading like wildfire!

A couple weeks ago when I had my first consultation with my doctor, he asked me what I thought was the biggest killer of women. "It's cancer, of course," I replied. The doctor told me, no, it's actually atherosclerosis. Simply put, it's heart disease. But that's not the message pounded into us women constantly: do monthly self breast exams and have regular mammograms beginning when you're 40.

So then I met my nurse practioner yesterday for an annual physical and she was just as perplexed. She said she still advocates that women, who are in their 40's, continue to get mammograms every two years. She also told me that the majority of her patients who are currently undergoing breast cancer treatment are in their 40's. Now how does this jive with the government message?

What timing for this bit of healthcare news.

The independent government panel of doctors and scientists has insisted that the cost of such preventive testing was not a factor in its assessment of breast cancer screening.

"These recommendations have nothing to do with any kind of analysis that addressed cost effectiveness," Dr. Diana Petitti, vice chairwoman of the panel, told CBS News in an interview Tuesday.

"Cost effectiveness was not a part of the discussion. Cost was not uttered in the room," she said. But costs were referenced at least three times in the panel's report when assessing common types of breast cancer screenings, including clinical breast examinations, film and digital mammographies, and magnetic resonance imaging -- or MRIs.

"Digital mammography is more expensive than film mammography," the guidelines note, while MRIs are "much more expensive" than either film or digital mammography

How many of you know of someone who has had breast cancer or have supported the latest "Race for the Cure" fundraiser? Who isn't familiar with pink ribbons? An aquaintance of mine, who is in her mid-30's, just went through breast cancer treatment earlier this year and is on the road to recovery. She is in a high risk group; her mother had ovarian and breast cancer and died ten years ago, while her sister is a five-year breast cancer survivor.

Cancer screening does involve radiation, and it has been said that increased radiation exposure could increase the risk for breast cancer. MRI's are costlier and also involve radiation. But with the messages we hear constantly from our doctors, media, government, and advocacy groups, it can get downright confusing when they suddenly decide that what was once so important - vital! - to a woman's health is now not really important because of, uh, fewer lives really being saved in the age 40 group vs. the age 50 and older group. And it's maddening.

Until there is some clear evidence -- and not anything having to do with cost analysis by a government bureaucracy -- I cannot be convinced that mammograms are not needed at a younger age. Especially after years of hearing the opposite.