When Your Only Tool Is A Mammogram, Everything Looks Like A Breast

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Mammogram
Credit: askanmd.blogspot.com

If the American Cancer Society recommends mammograms every two years for normal-risk women over age 55, does that mean the Obama administration doesn't care about poor people or females?

That is the provocative suggestion in a New York Times editorial. The authors, who claim to be closely affiliated with the American Cancer Society, say they no longer will be due to the new guidelines. But as Dr. Gil Ross, American Council on Science and Health Senior Director of Medicine and Public Health, argues in a Science 2.0 piece, their logic is not sound. It is a warmed-over 'if we can save even one life it is worth it' rationalization, but if that is really true, why not issue mammograms twice a year for every young female beginning at puberty? Deaths from breast cancer would certainly plummet but studies have shown so would unnecessary surgeries and, yes, health costs would balloon, reducing funds for other critical health issues.

"But those who will suffer most from these cancer society recommendations will be women from underserved communities who do not have the means to pay for their own breast cancer screening if insurers follow the new guidelines and stop providing yearly coverage," the Drs. write, which does make it sound like the American Cancer Society is putting dollars before health, and that is just not the case. As evidence that the old way is better, they write "a 2014 study that followed more than 7,000 Massachusetts breast cancer patients demonstrated that, sadly, of all the women who died of breast cancer, 65 percent had never had a mammogram and 6 percent hadn t had one in the preceding two years."

Which means that 94 percent of those who died did indeed have a mammogram within the preceding 2 years, making the case that the overwhelming cases would have been caught just fine.

The evidence disputes their beliefs. A recent study in New England Journal of Medicine by Dr. H. Gilbert Welch, Dr. David Gorski, and Dr. Peter Albertsen, found that mammograms didn't identify the cancer at an earlier stage prior to symptoms appearing. The mean age for diagnosing women ages 40 and above remained at 63.7 years.

The ACS seems to be following the science as new data becomes available. That is exactly what they should be doing.