Six years ago, the U.S. Preventive Services Task Force doled out a controversial recommendation: Change long-standing breast cancer-screening recommendations and advise women to wait until age 50 rather than 40 to start getting mammograms. The task force also said women should get the test every other year instead of annually.
Criticism was swift, and rightfully so. The call for the change died down until the same recommendations resurfaced this month. I’m hoping the recommendations die this time around, too.
The proposed change has big ramifications: If the recommendations are finalized, according to Avalere Health analysis, the move could deny coverage of biennial mammograms to some 17 million women, most of whom are covered by employer-sponsored plans.
The guidelines go against the advice of, you know, actual medical groups, including the American Cancer Society, the American Medical Association and the American Congress of Obstetricians and Gynecologists, all of whom say women should get annual mammograms starting when they’re 40.
It’s a topic I feel especially passionate about: My mother was diagnosed with breast cancer in her 40s after an annual mammogram. In some eyes, she was too early for averages, for predictions — and for a mammogram, should these new guidelines stick. Though her cancer was anything but just a one-and-done surgery — the cancer spread, requiring chemotherapy, radiation and years of due diligence — it would have been impossible to beat had she never gone in for her routine mammogram. That simple test saved her life.
Statistics are against irreverence: 12.4 percent of women born in the United States today will develop breast cancer at some time during their lives, according to the National Cancer Institute. That means a woman born today has about a 1-in-8 chance of being diagnosed with breast cancer at some time during her life. Incidences are on the rise, too. In the 1970s, for instance, the lifetime risk of being diagnosed with breast cancer in the United States was just under 10 percent (or about 1 in 10).
I’ll be clear that I don’t think mammograms are the end-all, be-all in breast cancer prevention. It’s not a perfect test; there are misdiagnoses and over-testing and excessive biopsies. Just as with any preventative procedure, there’s the question of “How much is too much?” But my medical philosophy fits squarely in the “I’d rather be safe than sorry” boat.
In the ongoing debate over mammograms and screenings, you’ll read things about how mammograms are generally unnecessary, especially for younger patients (read: under 50). One such headline in the Washington Post screams “Stop routine breast-cancer screenings. Science has shown they don’t save lives.”
I find arguments against preventive health measures often so absurd that I generally wouldn’t respond to them. But, in short, yes, there is such a thing as early- and late-stage cancers, so yes, early detection does save lives.
It’s also important to note that many women choose to forgo screening guidelines anyway. If they’re worried about the potential harm of a mammogram, as listed in the Post piece, they can avoid the test. But coverage under health plans is important for those smart enough to follow guidelines and get preventive care.
You can argue science, argue costs, argue that yearly tests and the possibility of further testing is too “stressful” for patients (yes, this is a real argument I’ve read against mammograms) all you want. But I would have grown up and lived most of my life without my mother, without my closest friend, and without my confidante and cheerleader had she not had access to a mammogram before age 50.
And her presence and existence in my life is worth a hell of a lot more than any kind of science, any kind of statistic someone could ever throw at me. And nothing is going to convince me otherwise.