Mammogram Testing Changes

Last updated on: November 18, 2009 at 3:38 pm by Scot McKnight

Mammogram Testing Changes 2009-11-18T15:38:10-06:00 Scot McKnight

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All is well, but Kris

recently went through her annual mammogram, the discovery of a change from last year with development of a cluster of microcalcifications, another mammogram and a consultation, and then a biopsy and a consultation with the radiologist to be given a
clean bill of health. Whew! As her husband, the days of praying and waiting and wondering
and worrying … some ups and downs … yes … a normal pattern for those who first learn of
potential cancer. And wonderful relief to learn that she’s fine.

But now we are told
… maybe it was all for nothing. In fact, when Kris first read these reports she was not too happy. Are these doctors putting women through too much needless anxiety? Or, is this just a rogue report and finding?

Some recent studies are suggesting major
shifting in the testing of women with mammograms. Some are saying no need for
tests before 50; others are poo-poohing the idea that self-testing does much
good … and this recalls a debate all the way to Congress about a decade ago.

Some say this is insurance companies
telling us that mammograms aren’t needed, and some pushback by saying insurance
companies don’t want to pay the fees. Others are saying science is showing more
today and … well, here’s stuff from The Washington Post...

What do you think about these changes? Any stories to tell?

One side, this is a
bad move:

“We can’t allow
the insurance industry to continue to drive health-care decisions,”
said Rep. Debbie Wasserman Schultz (D-Fla.),
who said earlier this year that she had undergone treatment for breast cancer.

The recommendations
also garnered harsh criticism from powerful medical groups including the
American Cancer Society — which says it will continue to recommend regular
mammograms for women older than 40 — and the Access to Medical Imaging
Coalition, which warned that the findings would “turn back the clock on
the war on breast cancer.”

“The only
conclusion I can come to is it’s economically motivated,” said Carol H.
Lee, who chairs the American College of Radiology’s breast-imaging commission.
“In this climate, when we are all paying attention to how we can decrease
the cost of health care, in my opinion that’s the primary motivation.”

On the other side,
this is good move:

But Ned Calonge, who
chairs the 16-member panel, defended the recommendations and denied that cost
or the debate over health-care reform played any role in the decision.
“Cost just isn’t a consideration when the task force deliberates,”
said Calonge, who is also the chief medical officer for the Colorado Department
of Public Health and Environment. Twelve of the task force members were seated
during the Bush administration, and the remaining four were chosen before
President George W. Bush left office, he said.

To conduct the
review, Heidi D. Nelson of the Oregon Health & Science University in
Portland led an analysis of data from more than 40 studies, including a new
British study involving more than 160,000 women and data collected from more
than 600,000 women in the United States.

In addition, the task
force commissioned an unusual study led by Jeanne S. Mandelblatt of the
Georgetown Lombardi Comprehensive Cancer Center and funded by the National
Cancer Institute that involved six separate teams of researchers analyzing the
risks and benefits of 20 screening strategies.

“I think anytime you use science
to kind of fundamentally change what people are used to, I think it’s a
difficult thing to grapple with,” Calonge said of the new guidelines.

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