Great. The body is a complex and wondrous thing and is, when working appropriately designed to stop cancers before they become a problem. But, do we mere mortals have any means to determine which cancers will be clinically unimportant and which WILL go on to become a huge problem, potentially a terminal problem. (Silence). Exactly.

In general, breast cancer in younger women tends to be more aggressive. It is also harder to diagnose via mammogram because of the increased density of the younger breast. Still….just because it is harder doesn’t mean that one shouldn’t look.

Congrats and long health to Amanda!

BTW my sister was diagnosed– at age 40 with Stage I breast cancer– she found a lump, had it biopsied, removed, radiation, chemo, the works. Then three years later diagnosed with Stage IV (they hadn’t gotten it all apparently). And now, 4 years later she’s gone back to work at the airlines because she can’t afford to not work, AND have health insurance. She is doing great, but seriously she doesn’t have the same kind of energy she had before… but I digress.

In reading the report, I’m struck by a couple of things …

I can buy the argument that there are certain risks to over-diagnoses. Specifically, that false-positives lead to unnecessary biopsies. I’m assuming there’s some harm that may result from those biopsies, but ‘not sure what exactly. I don’t see unnecessary anxiety as a real (or at least quantifiable) harm.

The recommendation against Breast Self Exams (BSE) surprised me as well. The rational for that is that research shows that BSEs are only 12-41% reliable in detecting a positive result (cancer). Clinical Breast Exams (CBE) are significantly better, at 40-69%. In that light, the recommendation kind of makes sense – women may incorrectly rely on their self-exams and, thus, not go in for a more reliable test. Or, at least, that’s the only explanation I can come up with for this recommendation.

The report says, “biennial screening produced 70% to 99% of the benefit of annual screening.” So… if it’s 99%, I’m totally on board with the recommendation to reduce testing to every 24 months. But if it’s 70%, sorry, get tested every 12 months. I.e. this seems a poor basis for making the biennial screening recommendation.

Overall, the report is certainly an interesting (if slightly technical) read. I’m certainly much less critical of the recommendations having read it than I was before. However I do think they could have gone a different direction, such as recommending better BSE/CSE education and training to help improve the reliability of these tests, rather than doing away with them altogether.

As for mammograms, I’m trying to educate myself on the idea that exposure to radiation increases the risks. I’ve had a mammogram and an ultrasound and both eased my mind tremendously.

I don’t think you’re grasping at straws to wonder if money is at the center of this somehow. I’m taking my video camer with me on the 3 day and plan to ask others what their feelings are too.

The part about no self-exams? WTF? What harm does this do? Are there women jamming doctor’s offices with false lump detection syndrome?

And how would a woman discover a lump, otherwise? Wait for her man to feel it? Was this a panel of men making this new recommendation? I really do not get this part, at all.

two of my mentors quoted here, like everyone else I know in the biz, in total shock…. drs. poller and keenan quoted within are personal friends and mentors:

http://www.postgazette.com/pg/09322/1014306-455.stm

although, i do blame your a’changin’ prezident…

http://online.wsj.com/article/SB10001424052748704204304574543721253688720.html

xoxo, yfgm