September 30th, 2010
10:14 AM ET

Mammograms effective from age 40, study says

Amid the controversy over the age at which women should begin having mammograms, a study from Sweden supports starting breast cancer screening at age 40.

That conclusion goes against the U.S. Preventive Services Task Force issued guidelines recommending against mammograms for women ages 40 to 49. The announcement of those guidelines sparked an uproar among advocacy groups. Later, the task force said it had communicated the guidelines "poorly," and emphasized that women should still be able to choose to have mammograms at age 40 - it just shouldn't be automatic.

A study last week in the New England Journal of Medicine suggested that mammograms are not as effective in women over 50 as previously thought.

Research presented this week in the journal Cancer compared breast cancer mortality in areas of Sweden where women 40 to 49 had been invited for mammograms against those in which women in this age group had not. There were 7.3 million people included in the group that had mammograms in ages 40 to 49, and 8.8 million people in that sample that did not.

Researchers founded about a 26 percent reduction in the breast cancer death rate attributable to mammography. In order to save one life, 1,252 women had to be invited to get mammograms in the 40 to 49-year-old age.

The benefit appeared greater for women 45 to 49 than in the 40- to 44-year-old group.

Dr. Daniel Kopans, professor of radiology at Harvard Medical School, said that this study should "end the debate" about beginning mammograms at age 50.

"The age of 50 has never had any, scientifically supportable, importance for screening. The death rate is decreased for all women who begin screening at the age of 40," he said in a statement.

But CNNhealth.com conditions expert Dr. Otis Brawley, chief medical officer of the American Cancer Society, points out a flaw in the way that the Swedish study was done: Researchers did not take into account overdiagnosis. About 15 to 20 percent of localized breast cancers will not metastasize and don't actually need treatment, he said.

But the study's conclusion is nothing new, he said. The American Cancer Society still recommends screening for women ages 40 and up.

Still, the numbers saved aren't as large as one might think: Assuming there are about 22 million women in their 40s in the United States, by the Swedish study's conclusions, about 1,800 women would be saved if every one of them were screened.

In Brawley's overview of the mammography situation, he points out that even if all screening, treatment and awareness methods were to be used by all women in the United States, 450,000 women would still die of breast cancer over the next decade.

Bottom line: We need a better test and better treatment, he said.

soundoff (65 Responses)
  1. Ed

    Mammograms – the same very thing that supposed to detect breast cancer, also causes breast cancer according to studies!
    There is a safer, more reliable test. It is called thermography. Check it out. And yes it is FDA approved. Not that it matters. Because the FDA is not out to protect the people. But I mentioned that because some people swear by these clowns, known as the FDA (fraudalent deception agency).

    September 30, 2010 at 10:52 | Report abuse | Reply
    • boocat

      Don't know where you got your info, but when I talked to the technician who gave me my mammogram, she told me that the radiation exposure is so low that your body does not even absorb it. The place I get my mammogram has the newest high tech equipment. I had asked her this because I was also scheduled for a chest xray and told her I did not want to get overloaded with radiation.

      September 30, 2010 at 12:00 | Report abuse |
    • Janice

      Thermography is an option – but not the same level as mammograms yet. Thermography only detects heat emitted by rapidly dividing cells which *may* indicate a cancerous or pre-cancerous condition. However what thermography can NOT detect is other pre-cancerous conditions such as calcifications. I know many high risk people who supplement mammograms with thermography....but it shouldn't be the ONLY test you rely on. Especially because there's no standard for training technicians who administer the test or the professionals who interpret it.

      September 30, 2010 at 12:26 | Report abuse |
    • Tim

      @boocat: I have a Ph.D. in Medical Physics and can tell you that there is radiation that is absorbed by your body during a mammogram. That's why some areas on the film are white, the x-rays were absorbed or scattered by material at that location. Everything is done to keep the amount of radiation as low as possible, but mammography will always have some radiation associated with it. I'm not saying your technologist was wrong, mammography is generally safe, even with a chest x-ray the same day.

      As for thermography, there are many cancers that thermography will miss, but it will detect most of the most dangerous ones. Thermography only detects cancers that are actively getting more blood flow than surrounding tissue.

      MRI and ultrasound (my area of research) are also options, especially with new methods such as elastography, But mammography is still the best option for detection of breast cancer and will likely remain so for many years to come.

      September 30, 2010 at 12:39 | Report abuse |
    • Judy

      No, PLEASE do not use thermography. It is a totally unacceptable means of detecting breast cancer. It was debunked years ago. Breast cancer screening and diagnosis methods are found at this reliable site: http://www.cancer.gov/cancertopics/pdq/screening/breast/Patient/page3

      September 30, 2010 at 13:26 | Report abuse |
    • Bad Patient

      Exactly. We put my tumor right in the thing and it missed it. (NOT operator error and NOT dense tissue.) Another crock to add to your list is front companies/organizations that tell people they need a medical test every year or so...to keep money flowing into their pockets.

      September 30, 2010 at 21:01 | Report abuse |
    • Ceylon

      Really? Can you please cite the studies?

      October 7, 2010 at 02:25 | Report abuse |
  2. Donna

    The "better test" is MRI. Unfortunately i has a lot of false positives, increasing health care costs. It catches a lot of what mammography misses though.

    September 30, 2010 at 10:54 | Report abuse | Reply
  3. Chris

    It is funny, 1 life for every 1,200 scans. This thing isn't accurate. . .so how many false posititves? for every life saved 100 people are mutilated, scared, and made life worse? Or is it for every 1 life 200 or 1 life 300 mutilations?

    And think about it, 1 in 1,200. Spending the money for all those scans on research would be a better pay off

    September 30, 2010 at 11:19 | Report abuse | Reply
    • Sava

      I was one who ended up scarred and mutilated. They did ultrasounds,mammograms and then a needle biopsy. When the 1st 2 showed a "tumor" they did the needle biopsy. That did not yield enough tissue to say if it was cancer or not so was sent to surgeon who removed the "tumor" and the surrounding tissue. It turned out to be a cystic fibroid. BUT it is better to be safe than sorry as my husband keeps telling me. I still see a mutilated breast when I look in the mirror but he keeps assuring me he would rather have me that way that not at all.

      September 30, 2010 at 12:53 | Report abuse |
    • Ituri

      I don't know how common it is now, but years ago I heard of a new increase in "repairative" work being done RIGHT after the initial surgury. That is, if you have to have a breast removed even partially, before the surgury you also schedule a reconstruction for that breast, which a surgeon will do immediately, without you even waking from the sleep meds yet. If I ever had to have tough surgury, I would hope for a fast repairing too... but then, would that be covered by insurance? Not likely. Being mutillated is cheaper for them than letting their patients live normal lives...

      September 30, 2010 at 19:09 | Report abuse |
    • Ceylon

      Gee, Chris, maybe I was the "1 in 1200." My breast cancer was detected on my very first mammogram at age 40, and it turned out to be invasive. Hate to think of what might have happened if I had waited till age 50. If it were your mother, sister, or another woman you loved, wouldn't you want her to maybe be that "1?"

      October 7, 2010 at 02:33 | Report abuse |
    • Ceylon

      p.s., this isn't a "pay-off" this is people's lives!

      October 7, 2010 at 02:37 | Report abuse |
    • MtK

      I think you make a very good point. People tend to underestimate the downsides of increased screening. The risk for a false positive (the mammogram says breast cancer when there actually is none) is very real and people should be very judicious in their screening tests. It is important to use other information such as risk factors for developing cancer to help us guide our decisions. Women who have a family or personal history of breast cancer, who have ever had any other cancers, who have genetic mutations predisposing you to cancer may require annual or biannual mammography starting at 40, where a healthy person with no risk factors may not need screening until they are fifty. Making smart, informed decisions could help save a lot of people from unnecessary, expensive, and painful/potentially harmful procedures.

      December 3, 2010 at 08:57 | Report abuse |
  4. Pat

    I just heard yesterday that a friend has breast cancer. She had both the mamogram and MRI, nothing showing everything great, then 6 mos later she finds a lump. Bull crap on these expensive tests, they are not read right, or they are not doing what they are supposed to do. Always heard when growing up, not to get hit in the breast area, so what do we do with a mammo. squeeze it wonder why we wind up with cancer of the breast. Doesn't make sense to me. All we have working for us is a bunch of greedy people killing us with tests, so they can make their big bucks. You can't convince me that there is not a cure out there for all of these cancers, but God forbid if they put it on the market, all these cancer specialist and cancer hospitals will be put out of business.

    September 30, 2010 at 11:23 | Report abuse | Reply
    • Rachel

      Six months after your friends tests, she notices a lump, and you think the tests are bull crap? Why? Because it developed AFTER she had a screening? How is that the fault of the radiologist who read her films? How does that make the tests bull crap? Do you expect screenings to predict your future health, because they don't–they just check your health status at the time they are given. Perhaps your friend's diet is to blame, perhaps she is struggling with a lot of stress– both have major impacts on your health. There are studies that show women who are stressed out from taking care of family members tend to develop breast cancer more often than women who aren't. Obviously you are angry because your friend is facing a health crisis, and I can sympathize with you and her, but I think your anger is misplaced.

      September 30, 2010 at 12:05 | Report abuse |
    • JJFacts

      Pat, do you know what kind of breast cancer your friend had? Not all BC are the same. If she was triple negative, which means estrogen negative, progesterone negative and HER2 negative, that is a very AGGRESSIVE cancer and can develop very quickly over a short period of time. I was lucky, I had a slow growth cancer that was in my body before I was pregnant with my son and then proceeded to feed off the hormones that was abundant during my pregnancy. I was only 34 when I was diagnosed, but checking out my support group YSC for women under the age of 40 with BC, there are more and more of us out there that are getting BC. Mammograms do work, I think women should start being screened at 30, instead of 40.

      September 30, 2010 at 12:41 | Report abuse |
    • babydoc

      Pat - Despite what people think, some breast cancers do not show up on mammograms. Just the nature of the beast! Mammograms and x-rays are a picture in time. At the time of her screening, your friends study was negative. 6 mths later, positive. Most cancers are slow growing, but some are really aggressive and can appear in 6 months. Tough luck for your friend or anyone else who fits into that category. Good news - 85% of breast cancer is slow growing and detectable by imaging means.

      People should continue to get mammo's. Radiation dose very low and well worth the risk. lf you need to confirm that is read all the posts from women (and men) who have personally been affected by breast cancer and their support of screenings.
      I always find it humorous that people who worry about radiation risk dont seem to be worried about cell phone usage, they sit in front of their computers and big screen tvs!

      October 1, 2010 at 08:50 | Report abuse |
  5. SCY385

    You know what really irks me is that women have walked the face of this Earth as long as men. Yet, there never really seems to be clear and concise information when it concerns our health issues. Debates over this, debates over that. Why can't there be better studies and information so that women know how to save their lives? Or, are we just walking piggy banks for the medical industry?

    September 30, 2010 at 11:43 | Report abuse | Reply
  6. vette78man

    My wife received a routine mammogram at age 37 - and it showed inflammatory BC later staged at 3B - with no other symptoms or signs. She wouldn't be here today (7 years later) without the mammo. She would rather deal with a false positive and followup confirmation than not to know at all. Our son (now 10, but 3 at the time) has his mom. Give the mammograms.

    September 30, 2010 at 11:57 | Report abuse | Reply
    • Kathy

      Agreed. My sister and I both started getting tested in our early 30s because of a family history of the disease. My sister got breast cancer at 35, detected by the early mammo. Had she waited until 40 for the test, she'd be dead now.

      September 30, 2010 at 12:48 | Report abuse |
    • Allison

      I work in Oncology Research. Women NEED mammograms. Self breast exams and mammograms are the number way to detect breast cancer early. Do you know why breast cancer mortality has dropped so dramatically over the years? Because of better screening tools and being able to detect cancer early!!!! Amen to vette. This could mean a matter of life or death for women. In those with more aggressive cancers, it could add YEARS to their lives, which could mean the difference between being there for their child's graduation or wedding.

      The U.S. Preventive Services Task Force used statistics, not raw data, for their report. Which is NOT an accurate way to evaluate something like this!

      September 30, 2010 at 12:55 | Report abuse |
    • Susan

      I agree that it is so important to start @ 40. I went every year and now that I am 53 I have Stage 1 breast cancer. I went thru the chemo and radiation and I consider to be one of the lucky ones. The mamo is what picked up my breast cancer. If I did not go on a regular basis, who knows where I would be now.

      We as women need to take care of our bodies. No one but you can do that. No matter what anyone says. Pls take care of yourselve.

      September 30, 2010 at 13:15 | Report abuse |
    • Ceylon

      Amen to that. I totally agree. I may not believe 100% in Western medicine, but I believe that a mammogram did save my life. And I welcome differing views, but I am living proof that some of the more cynical posts on this site are not accurate.

      October 7, 2010 at 02:51 | Report abuse |
  7. cleat

    funny how these screenings- since your president made them "free", are now being discouraged more and more by know-it-all health panels....glimpse of things to come? "...oh, no, you dont need that screening" (read: obamacare don wanny pay for it)"

    September 30, 2010 at 12:01 | Report abuse | Reply
    • bcnow


      September 30, 2010 at 12:13 | Report abuse |
    • BeatADeadHorse

      double yawn . . .

      September 30, 2010 at 12:57 | Report abuse |
  8. cleat

    the "death panel" thing was a little over the top back in the obamacare passing times...not really likley...until now. Who needs death panels, when your access to quality HC will be non-existent. Just saw the "panels" saying cancer drugs cost too much to use- they say is it really worth it to keep you alive for a few more months...kinda sounds like they are deciding your fate. dunno bout you, but I would appreciate any extra time i could get.

    September 30, 2010 at 12:05 | Report abuse | Reply
  9. bcnow

    My routine mammogram on August 17th revealed a mass that I, nor my OB-Gyn, had felt in my July yearly exam. My breast cancer surgery was on September 9th and the surgeon was able to remove the cance (with clear margins) and conserve most of my breast. I'm recovering and overall things look very positive. Get your tests...it can save your life! BTW..It is a well-known fact that women under the age of 50 have a lower survival rate for breast cancer than those over 50. Perhaps a lack of mammograms that would have caught the disease early could be part of the cause.

    September 30, 2010 at 12:11 | Report abuse | Reply
  10. ron

    My mother was dead from breast cancer at age 32 that was 53 years ago now tell me how far we have come after spending billions of dollars on research.

    September 30, 2010 at 12:14 | Report abuse | Reply
  11. Tandberg

    To gain perspective on this contentious isue, I recommend a superb book by Gerd Gigerenzer, entitled "Calculated Risks". He devotes a chapter to Breast Cancer screening, and ALL the attendant risks. He is not an MD, but rather the Director at the Max Planck Institute for Human Development in Berlin. His specialization is how people perceive risks, and how they respond to them.

    "In order to save one life, 1,252 women had to be invited to get mammograms in the 40 to 49-year-old age." This is in fact the "Number Needed to Treat" facet of the risk, which he whole-heartedly recommends. The previous statement, "Researchers founded [sic] about a 26 percent reduction in the breast cancer death rate attributable to mammography.", reflects the Relative Risk Reduction facet, which is what most pharmaceutical companies trumpet, but which can be very misleading in the case of low overall incidences in the target population.

    September 30, 2010 at 12:27 | Report abuse | Reply
    • Asmun

      Stage 4 usually lasts less than one year. I have heard of one ropsen who actually beat it-more than 5 years out. They told her she was a walking miracle though. I am sorry for your loss.

      April 14, 2012 at 16:33 | Report abuse |
  12. Mike

    My wife, at age 36, got a mammogram and they found calcifications that had not yet turned into a tumor. She has been through her operation and the cancer has not spread anywhere else. I wonder where it would have spread if she had waited until 40, 45, or 50!? She is going to live a long life, because her Dr recommended a Mammogram and she took the advice. Mammograms work. And if you haven't been through this, I'm sorry, but you just don't understand.

    September 30, 2010 at 12:30 | Report abuse | Reply
  13. Sarah

    I support testing at younger ages. I am 35 and just had surgery to remove a gollf ball sized lump from my right breast after doctors suspected breast cancer. Thankfully it was negative.

    September 30, 2010 at 12:33 | Report abuse | Reply
  14. LR

    I was diagonised with breast cancer at 44 yrs and at 48 yrs. If I had the test done at 40 I would not have had to go through all that I did. And, if I did not have previous test done they would have never found it the second time because of the location. SO for all of you who think that the test are a waste, I would not be here today if it was not for those test!!

    September 30, 2010 at 12:34 | Report abuse | Reply
  15. Tandberg

    There are in fact two different isues in play here. The first issue is Public Health policy. The second is individual health, which of course is much more personal.

    From a PUBLIC HEALTH perspective, mass screenings of women in their 40's have little benefit. The number needed to treat, 1252, acknowledges this. Further, it does not state the age range in which the victims actually passed away. (It wasn't necessarily always in their 40's, I'm guessing, without actually having read the report.)

    From an INDIVIDUAL HEALTH perspective, the decision (screen or don't screen) should be left to the woman and her doctor, but don't be swayed by fear – understand the risks of breast cancer, understand the risks of screening, and understand the risks of false positives and false negatives.

    September 30, 2010 at 12:44 | Report abuse | Reply
    • Ceylon

      Oh, OK, so if I had been in my 50's and then it was too advanced to treat effectively and I passed away, that would be OK? Don't really understand your point.

      October 7, 2010 at 03:06 | Report abuse |
  16. Jeni

    I was diagnosed with breast cancer in November 2008 at the age of 36. My 3 year old son and I are really glad I started having regular mammograms since I detected a benign lump in 1999. Listen to your body!

    September 30, 2010 at 12:49 | Report abuse | Reply
  17. cammed03

    The issue here can be seen via 2 different prisms. One, if you think about the economic impact of screening at age 40 and the small amount of people who will benefit based on the amount of cost, mammography is not a cost effective measure. That is what the US Taskforce said in their report and they got jumped. But that was what they were looking at, the economic impact based on the benefit.
    The other look is the medical/moral issue. You need to get a large number of people and spent the money so one will benefit, but you were able to help someone. Some people say, this is a waste of money, but I bet the person who got diagnosed early and was able to underwent treatment (taht one in about 1,200) will disagree.
    The bottom line here is, we need to make a choice, we cannot have it both ways, there is no cheap way that will allow to screen everyone. We either accept the one patient who will have cancer and will not be detected and save money, or we continue screening everyone at an earlier age and spend money, allowing us to pick up those cancers that will develop at an earlier age.
    Anyone who believes that healthcare costs will decrease by reform is absolutely insane. It is an expensive business that in order to obtain a return for investment needs to charge high. Suppose you have a hospital, you get all the equipment you need, staff (pay, benefits, etc.), utilities, and start seeing patients. The only way to get a return for your investment and keep the hospital afloat is if you charge high. even by charging how they do today, a lot of hospitals still fail. If you cut the amount of money they can make out of the investment, capital will not be attracted to the business venture and it will go bankrupt. It is simple math. I explain it to my students this way, you can buy a used 1977 Chevy, rusted, not well maintained, but cheap. You will get the car you paid for. You buy a Lexus you need to pay the price for a Lexus. Will run well, have great maintence service at the dealer, and you can get great mileag. The same is in healthcare, you cannot expect the latest technology, the best medications, without paying. Yet, we complain about healthcare, but no one complains about Lexus not selling their cars cheap. The bottom line, healthcare will be expensive always, making it cheap will make service worse, and in the end patients are the ones who will suffer. Simple.

    September 30, 2010 at 12:49 | Report abuse | Reply
    • cleat

      yep- the point i made above. This stuff is not free- those machine are EXTREMELY expensive. qualified people to run them are expensive, (including THEIR health care plan- which is NOT free from their own hospital).
      I got a triple yawn above for my comment- my point was that they are trying to take AWAY screenings by saying "you dont need them til age xxx" its smoke and mirrors that the .gov mandates they are "free" now...dosent matter if they say you dont need them (cant have them...) I fully expect to see this more and more. ane we are the ones paying for it – in money and in our lives.

      September 30, 2010 at 16:12 | Report abuse |
    • Ceylon

      Bottom line: women are not Chevys.

      October 7, 2010 at 03:09 | Report abuse |
  18. Sarah

    I was diagnosed this year with Stage IIA breast cancer at the age of 26. My doctor told me that if I hadn't found the lump on my own I would have been dead by the time I had a baseline mammo done at age 40. I support doing baselines at an earlier age but realized that something else needs to be developed that is better. Breast MRI's are not advanced enough and the ultrasound I had first didn't show anything.

    September 30, 2010 at 13:07 | Report abuse | Reply
    • Corina

      Nope! The Yarmulke isn't in the Bible, and as you've seen, they come in all different rcoluos, styles, sizes etc. I'm curious about why a yarmulke and not, say, a shirt or ribbon, but no, I don't think you'd offend anybody unless that was your intention.

      April 14, 2012 at 15:26 | Report abuse |
  19. Rich

    Last year my wife turned 40 and had her first mammogram and it came back with some questionable looking areas so they followed up with a second and then an MRI and the results came back positive. She went through all the treatments and I can say she has a clean bill of health, but this was a case of if would have waited until 50 it would have been to late. Also there was never any cases in her family history and I can also say when it comes to eating a good diet she does that also which means this can effect anyone no matter how you eat or if there was never any histroy in the family. Yes it is expensive treatments but when it happens to your family the cost does not matter you just want everything to come out with a happy ending.
    I cannot judge what people say or write but I would think if you give a negative reaction you may never have been effected by it or maybe you have and did not have a positive outcome which I am sorry for. But nothng in life is perfect and would we ever have expect it to happen to our family no but it did and we dealt with it and continue to move on.

    On October 8-10, 2010, she will be walking 60 miles over the course of three days in Washington DC for the Susan G. Komen 3-Day for the Cure

    September 30, 2010 at 13:09 | Report abuse | Reply
  20. Susan Lewis

    The wife of a dear friend found a lump, failed the gene test, and ended up with double mastectomy & both ovaries removed. She was 35 at the time. Any woman with breast cancer in her family, sisters, mother, grandmother or aunts, needs to be screened every couple of years starting at 18. That's reality. Problem is, nobody gives a "bleep" if it's killing women.

    September 30, 2010 at 13:15 | Report abuse | Reply
  21. kklennon

    I think it is important to realize that BC is also on the rise for MEN. Yes – MEN! We can no longer just talk about women when discussing this topic.
    I am female and a 15 year survivor and was diagnosed when I was 39 – Doctor said I probably had it for 6 years prior to that! No family history, no smoking, no drinking, wrong age group etc. I think Mammograms are the least of our worries. By the time the go in and take care of the issue, you have had more mammograms, X-rays, CAT Scan's MRs and blood drawn than is probably the legal limits but – you move on.
    At some point – we need to put our research and dollars into what causes this in people – not just how to cure it.

    September 30, 2010 at 13:18 | Report abuse | Reply
  22. DrB

    As a physician, it saddens me to read the cynical comments about the medical industry. We are obligated to follow the most current medical guidelines, which recommend we discuss the risks and benefits of screening for breast cancer in women in their 40s and help them make their own decision on whether to test or not. The vast majority of us really do care about your health, believe it or not.

    September 30, 2010 at 13:27 | Report abuse | Reply
    • Bad Patient

      I tend to believe that from front line health care professionals. I get more suspicious when I think of pharmaceutical companies controlling medical schools and what my doctor knows or doesn't know, corporations that hide useful information from the medical profession, professional organizations and licensing boards that protect their wages over our health...to the point that the ratios are not only dangerous, but people suffer and die. I'm sure it's just a short matter of time and pharmaceutical companies will have access to databases with our medical records. And probably everyone else. Insurance companies come up with useless stuff and we just have to spend more money to get it thrown out. The way they rate doctors is crazy stupid. It's just one big crock.

      September 30, 2010 at 21:12 | Report abuse |
    • Bad Patient

      Helicopters crashing, physicians being pulled to multiple hospitals at the same time...the whole system has real issues.

      September 30, 2010 at 21:13 | Report abuse |
    • Bad Patient

      They try to give you the worst drugs first so you have to come back multiple times. You try to escape a crappy doctor that isn't helping you at all (fearing for your life), and they will all try to send you back to that one.

      September 30, 2010 at 21:16 | Report abuse |
    • Bad Patient

      Some of those guidelines are still pretty half-baked.

      September 30, 2010 at 21:19 | Report abuse |
    • Bad Patient

      Front companies/organizations are used to raise money and they pump out the worst quality information like it's gospel...largely serves only to make us more sick and spend more money. Our health care system has issues. Don't let them lie to you. It has problems. (Some are better than others, but it's VERY hit or miss.)

      September 30, 2010 at 21:23 | Report abuse |
    • Bad Patient

      I believe that there are good people there, working hard, but some of these problems have been around for 40 years. I don't think they can solve problems that don't belong to them, but they don't work very hard to find the cause...more about making new drugs. Rather than cover for the toxic environment that we now live in...they should have chased this down up front and we probably wouldn't be dealing with the things we are now. Corporations covered too much from us. That's wrong and should be stopped.

      Note how many hospitals have closed in the past 20 years. We have real problems.

      September 30, 2010 at 21:29 | Report abuse |
  23. cleat

    I believe you Doc- but how are you going to give tests when the .gov says they wont pay till your 50, and then only every 5 years?...all because your "most current medical guidlines" tell you so.
    I get this now with my usless dental program...a cleaning every 6 months- maximum. I cant even go in one day early before 6 months. I fully expect to see more and more of this as the "free" medical from your .gov gets more and more broke.
    (please note I think doctors should be well compensated- for their effort/time/money in school and liabilities)

    September 30, 2010 at 16:17 | Report abuse | Reply
    • Doug

      I'm curious, do you even notice the various contradictions built into your anti-Obamacare rants? You complain that when the government gets involved in healthcare, they will limit what services they pay for. As evidence, you cite the fact that your dental plan limits the number of cleanings it will pay for. This is true of all dental plans (government and private), so how does this implicate the government?

      The simple reality is that if other people are going to pay for your health care (be it the government or a private health plan), they are unlikely to pay for treatment that the medical establishment deems unnecessary. It has always been an issue with private health plans that they try to refuse payment for legitimate treatments. Do you really think that a for-profit health plan is going to be more generous with their treatments than a government-run health plan?

      More to the point, none of this is rationing, because no one is preventing you from getting additional treatment. You always have the choice to schedule an additional dental exam, and pay for it yourself. So in other words, you are ranting that government-run health care would be terrible because it might only pay for some (but not all) of your medical care, while at the same time acknowledging that private insurance companies already do the same thing.

      And finally, your rants seem to reflect a complete lack of understanding of Obamacare. This is not a single-payer system (where, as you earlier stated, the government pays for your screenings). Most people will still be insured under private insurance, so your arguments are completely irrelevant for the vast majority of Americans.

      September 30, 2010 at 17:46 | Report abuse |
  24. ncwiseguy

    a breast is an thing of beauty. the body, mind, and spirit to which it is attached is even more beautiful and most precious. how dare the medical community cut people off from the screening. it s safe to say that the world of medicine really doesnt know what is right and what is wrong. be on the safe side..........screen, screen, screen!!!

    September 30, 2010 at 17:04 | Report abuse | Reply
  25. Olivia

    DrB: If you think all doctors are discussing the risks vs. the benefits of the benefits of mammography with their 40-something patients, think again. I can tell you from personal experience that they do not, and many women, like myself, don't learn about the risks until after their peace of mind and sense of well-being has been taken by mammography. I had my peace of mind taken from me at the age of 41 in 2009, months before the USPSTF recommendation to move screening to age 50 and when the mammography debate became much more out in the open. Recently, I told my doctor that I wished that physicians would discuss the risks, and he blew up at me, said he had to take a "paternal" approach with his patients, and that too much information would "confuse women." And he said that he wouldn't want to "discourage" women from screening, presumably by helping them make an informed decision, because they might come back and sue him later if they didn't screen and then got cancer. In addition to being scarred and mutilated by benign biopsies, women also have their risk of breast cancer increased (supposedly minimally) by a medical procedure that they never needed but of course had to have after their peace of mind was stolen by the mammogram. (Incidentally, hospitals here advertise mammography as a way to achieve "carefree peace of mind.") Also, studies suggest that up to 30% of the "cancers" detected by mammography would have remained indolent and never would have caused any harm or needed treatment if they hadn't been detected. To screen or not to screen is a personal choice that only an individual woman can make. However, you have to take charge of your own health and educate yourself because you can't trust your doctor to help you make a truly informed decision. The pamphlets put out by my local hospital only tout mammography's benefits and say nothing of risks, such as unnecessary biopsies or radiation exposure. It's almost October, so let the targeting of women for highly profitably screening industry begin! (If you do decide to screen, be aware that 80% of biopsies are benign. The radiologist report may also basically say that you may or may not have cancer, so come back for a 6-month follow up as many times as it takes, which means more stress, more radiation exposure, and more psychological damage. Learn the BIRAD scale.) Take care of yourself and do what's right for you.

    September 30, 2010 at 17:05 | Report abuse | Reply
    • Tandberg

      AMEN!!! Olivia, if that's your doctor's attitude, you'd best get yourself a new doctor. All these issues are in Gerd Gigerenzer's book that I mentioned above. In their defense, many doctors think that their patients expect them to have all the answers, and they often don't. Many doctors struggle to find a framework to describe risk clearly to their patients, and patients often want to get an absolutely-certain answer, which is a chimera. The second chapter of the book is entitled "The Illusion of Certainty". He also recounts some of his conversations with MD's, which are eye-opening. Highly-recommended reading.

      September 30, 2010 at 18:41 | Report abuse |
    • DrB

      I hear ya, Olivia. I just meant it's sad that you all think there's such a financial incentive behind screening. Like I get a hundred bucks from the hospital every time I order a mammogram. It doesn't work that way. I do agree that patients should make their own, educated decisions. I am only a consultant for them to that end, whatever medical issue it might be.

      September 30, 2010 at 21:00 | Report abuse |
    • Hosam

      Aw, this was a really nice post. In idea I would like to put in niitrwg like this additionally – taking time and actual effort to make a very good article… but what can I say… I procrastinate alot and by no means seem to get something done.

      April 8, 2012 at 13:42 | Report abuse |
  26. Ituri

    Don't EVER let them talk you out of vital screening based on an age group. My mother had to push and push to get a regular screening when she was 42, even though it was suggested she get them from 40 on. She had no symptoms, and guess what they found? Malignant, fast growing, vicious cancerous tumor. She's lucky it was the "grows in on itself" type and not the "grows out in arms" type. They told her she would be fine, no symptoms, only 42... but because she pushed, she's alive and healthy today.

    When they started talking upping the screening age to 50, I nearly had a meltdown. How many lives does screening have to save to be "worth while" to these number crunching obliviots? 10? 100? 10,000? My mother makes 1, what is that worth?

    September 30, 2010 at 19:14 | Report abuse | Reply
  27. momto4

    I found a lump at 39. Everyone could feel my lump but neither mammo or ultrasound could find it. Turns out it was cancer. Mri did pick it up but not all of it. What we thought was a 1-2 cm lump was 6.5cm. For me, that was my entire breast. Not a big fan of mammos, but am a big proponent of listening to your body.

    October 1, 2010 at 05:51 | Report abuse | Reply
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    November 13, 2010 at 09:31 | Report abuse | Reply
  29. MtK

    This is a response to Ituri. I do share your frustration with insurance companies always trying to weasel out of paying for health care, however, this is one area that the people are protected. The Women's Health and Cancer Rights Act (WHCRA) of 1998 stipulates that any insurance company covering mastectomies must cover breast reconstructive surgery. http://www.cancer.org/Treatment/FindingandPayingforTreatment/ManagingInsuranceIssues/womens-health-and-cancer-rights-act

    December 3, 2010 at 09:06 | Report abuse | Reply
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