Last night CNN reported breaking news on the new government task force guidelines for mammography screening. Just so you know, I am not going to write about the details of how the conclusion was drawn, leaving that to others to analyze. What I am about to say is purely anecdotal.
Seems that instead of getting a baseline mammogram at age 40 and annually thereafter, you are now advised to get your first screening at age 50 and then only every two years thereafter. So the new guidelines proclaim. I object. Why? Because I was diagnosed with a hell of a malignant tumor in my right breast at age 42. Considering that the task force also suggested that breast self-exam is pretty much worthless and needn't even be taught anymore, then I wonder, how are we supposed to achieve early detection?
Alright, to be fair, my tumor came on so suddenly and was so large that I didn't need a mammogram to find it. But self-exam confirmed that something was terribly wrong when my breast began misbehaving and the lumps and knots that I could feel with my hand convinced me it wasn't the usual engorged, dense non-malignant breast that flared up from time to time and then settled down on its own. Unfortunately, my doctor didn't agree with me and sent me home to watch that malignant tumor grow so big in the next thirty days that I had to put frozen peas on it to keep the swelling down. He didn't even order a mammogram until his thirty day "waiting period" was over. If he had, I may not have grown the 18 cancerous lymph nodes that required me to have a stem cell rescue, a type of bone marrow transplant. You may be thinking that mine was just a case of bad doctoring and has nothing to do with the new mammogram guidelines. But I don't agree. Mammograms are not the solution to everything, and certainly not perfect, but it is the primary diagnostic tool we have right now for early detection. And, by golly, we better use it, more than every now and then.
Women get mammograms primarily because very important and high visibility organizations tell them they are necessary including when to start screening and how often. Let's not forget that it would be surprising if even one woman in America really wanted to get up in the morning and go in for her annual mammogram. It hurts, it's scary to think of what a bad report could mean, and most of us would use just about any excuse we could find to talk ourselves into skipping it altogether.
Some have asked me, for example, why I didn't demand a mammogram when I first showed my raging tumor to my gynecologist. Foolish as it sounds now, I figured if he wasn't all that worried and was willing to let me go home for thirty days and watch it, then it must not be that serious. And I wanted to believe that more than I could ever report in this blog. It delayed my knowing I had cancer for thirty days but left me with a far more dire diagnosis that many thought I couldn't possibly survive. As I write this over fourteen years later, I still feel amazed that he didn't personally walk me next door to that imaging center and insist on having them flatten my ailing breast like a pancake on that little hard plastic slab to find the rampant cancer rather than giving those vicious cells free access to my body for another month.
My point is that the new guidelines will most definitely give lots of women that one excuse they were looking for to stop their annual screening in their forties altogether and delay them by an extra year once they turn fifty even though the American Cancer Society and Susan Komen Foundation are sticking with the original guidelines. I would be willing to wager that in five years or so, once the data is accumulated, these guidelines will be changed back after it is discovered, hopefully, that losing even one life unnecessarily to breast cancer because the opportunity for early detection no longer exists in the absence of mammograms and self exam, is absolutely unacceptable. It is startling to know that the task force seems so comfortable using American women as guinea pigs in their experiment to see if they can cut down on all those unnecessary tests and scary moments that never turn into cancer. And it is also important to note that these guidelines apply only to women with no special risk factors such as family history or genetic predisposition. Did I mention that I had not one single risk factor when I was diagnosed?
It is hard for me to believe that anyone is applauding this turn of events, besides maybe insurance companies, which is curious in itself when you think about it. But I guarantee that cancer is throwing one hell of a party over this news. No mammograms, no self-exams. Cancer just won the Powerball lottery and picked up a "get out of jail" card all in one day.
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