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Posted on 12.03.2009

No Mammograms? Just Blame It On The Communicators.


Now the U.S. Preventive Services Task Force (USPSTF) says it never really MEANT to recommend that women between the ages of 40 and 49 not get mammograms, despite its very clearly articulated press release on the subject.  The task force claims it was a poorly written communication.  What, they didn’t read it in the first place?  They didn’t happen to notice that it very clearly stated they were “RECOMMENDING” a change in when women get their first mammograms? As a breast cancer survivor, along with my sister, I am outraged that the Task Force denies its recommendations aren’t cost-driven.  How absurd.  Of course, they are.  I don’t actually mind that the recommendations are cost-driven…but they should “fess up.” Let’s call it what it is…an insensitive re-analysis of old data with an eye toward saving money, not lives. I support evidence-based medicine, and if there is research proving that certain slow-growing malignant tumors won’t kill you so you don’t need to treat them, I’m all for that.  The problem is, the science doesn’t yet exist to inform women (before they know they have a tumor), whether the tumor (that they don’t know they have) is fast-growing or slow-growing!  That’s a rather important detail. Don’t even get me started on the Task Force’s recommendation that physicians no longer teach women to do breast exams.  I guess the intention is that an undetected tumor won’t drive a woman into her physician for a diagnostic test…because that might be a waste of money.  And then there were the Task Force’s patronizing comments about the angst and anxiety caused by false positives.  Let me just say that the idea that young women I know and love who might NOT get their annual mammograms concerns me much more, not to mention what it will do to their families if they have cancer and it goes undetected for up to ten years.  The appalling thing is that the Task Force admits that women between the ages of 40 and 49 die from breast cancer…just not enough women to warrant the test. It seems logical that the intent of the study was to take a new look at data, make some kind of determination and then communicate with women and healthcare professionals (I didn’t say health plans) about the findings.  Since it was a new look at existing information and not a new clinical study, the entire point was to communicate new conclusions.  I find it mildly amusing that only after the media and the public put up such a fuss, they want to change their song and blame it on a mis-communication. I’m not sure I buy it.  You?

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