Why Kan’t Doc Zoe Write?

The release of the new government guidelines has sparked reaction from celebrities like Jaclyn Smith to Christina Applegate.

The guidelines released by a government task force claims that most women should start having routine mammograms at the age of 50 – 10 years more than the previous recommendation.

According to Jaclyn Smith, the former “Charlie’s Angels” star, “We’re going to be put back in the dark ages again. Women are just starting to not be afraid to self-examine and have regular check ups and now they’re saying to push it another 10 years.” She was diagnosed with the disease in 2003 at the age of 56.

Stars diagnosed between the ages of 40-50 age include Olivia Newton-John, Cynthia Nixon, Melissa Ethridge and Sheryl Crow. Christina Applegate, on the other hand, was diagnosed at the age of 36.

And then there’s Stephanie Spielman who was diagnosed with breast cancer at the age of 30. She passed away last November 19.

The release of the mammogram guidelines coincides with Congress’ attempt to overhaul the U.S. health system and slow the growth rate of its enormous cost. The reason why the US spends so much on healthcare is the the expensive diagnostic procedures. So, as their way to cut down the costs, they created a federal board to to come up with guidelines comparing medical procedures, such as mammograms.

What they hope to accomplish is to come up with a decision on what treatment works best regardless of cost.

The American Cancer Society, which recommends annual mammography beginning at age 40, expressed concern about about legislation linking the task force’s recommendations to insurance coverage.

“ACS Cancer Action Network is working with lawmakers to ensure that legislation guarantees access to proven preventive services, including mammography for all women aged 40 and over,” the organization said in a release.

To add to the confusion, are these figures:

The U.S. Preventive Services Task Force found that in women ages 40 to 49, one death is prevented in 1,900 women annually screened for the 10-year period. The guidelines are saying the Task Force has found this small difference, but it is not certain if that difference is worthwhile, leading to the change in guidelines.

On the other hand, The CVPH Medical Center Women’s Imaging Center in Plattsburgh gives us a different perspective. They average 50 mammograms per day and screens around 16,000 women for breast cancer annually.

“Over 60 percent of women who develop breast cancer do not have a family history,” Dr. Curt Snyder, a Plattsburgh radiologist said. “If we exclude people with average risk (of developing breast cancer), we will miss over half of the cases.” Regionally, 102 women were diagnosed with breast cancer in 2008, Snyder noted. Of those, 24 were under the age of 50, and 70 percent of the cases were diagnosed through annual mammograms.

(I know this isn’t a global statistic, but I think even a regional statistic can be significant in this case).

I wish to be more academic on this by considering all the facts before I conclude. However, it’s difficult to immediately adjust your way of thinking when in my years of practice, you have learned to conclude that early detection can save lives. I have met women – patients – who have developed breast cancer at an early age; I’ve seen women who have developed it quickly after their last check-up and evaluation; and I have seen how bad breast cancer looks on a woman because she couldn’t afford the diagnostics.

They say the bottom line is – it’s an insurance thing. Women can get mammograms at age 40, it’s just that it will not be covered. But then, how can you explain that to my patients who couldn’t afford anything to save their lives?

This post is tagged breast cancer, mammogram, mammography, women's health