After decades of educating the public about the importance of early detection, the new guidelines are indeed confusing and controversial. In the new guidelines, the recommended age for annual screening mammography was increased from age 40 to age 45 for women "of average risk for breast cancer."
I envision a world in which we live without fear of losing our breasts or our lives as a result of what we've eaten, touched or breathed because the environmental causes of breast cancer have been identified and eliminated.
We need to refocus our resources and attention on the two things that really matter: (1) stopping men and women from getting breast cancer in the first place -- primary prevention; and (2) preventing metastasis if they do.
Physicians have an ethical responsibility to truthfully communicate the current scientific facts with their patients. Additionally, they need to listen to and respect patients' preferences even when it may collide with their own preferences.
All of the scientific evidence points to that strategy being more effective than a ritual search for cancer through breast self examination and mandatory annual mammography. It is time to move forward, for women's sake.
An intriguing new study found that the vast majority of deaths from breast cancer occur among women who didn't have routine mammography. The paper's method is flawed, and conclusions limited. But sometimes an imperfect study can hint at real insights.
Mammography will remain a controversial issue because it is an imperfect tool involving ionizing radiation. Let's move beyond this method that is decades old and move forward with an early detection method for breast cancer that will not increase a women's cancer risk at all.
Given the toll treatment can take, every woman should be able to make her own decisions about her health care based on her values and priorities -- and to do so women need access to independent evidence-based data to inform their decisions.
Who is the real you? The happy, focused, vital woman who made the drastic choice to "mutilate herself" and then move on? Or the physically intact, "natural" woman who lives in dread of the next round of surveillance?
Mammography specifically, and cancer screening in general, is often something of a muddle. We should acknowledge the trade-offs, work toward better screening methods, and in the interim -- muddle through.