A new government study has recommended that most women not get mammograms until they reach age 50. It also suggests that women stop doing breast self-exams. What do you think of the new guidelines discouraging mammograms for women under 50?
Responses texted to MPR:
I am a 16 year old girl, and if my mom had not had her routine mammogram when she was 41, she would be dead now. I don't know how i could live without her. -Michelle, Minneapolis, MN
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The age and frequency of mammograms should be decided by the patient and their doctor based on medical and family history. Also with higher rates of cancer every year it seems dangerous to recommend less screening when it has been proved early detection saves lives. -Sarah Fahey, Eagan, MN
Responses from the Public Insight Network:
Despite being low risk, I had a base mammogram at age 35 and yearly mammograms starting at age 40 as recommended by my doctor. This year my mammogram results appeared irregular and I went in for more tests. The end result was that at age 43 I was diagnosed with breast cancer. I underwent a mastectomy a short time later. Where would I be at age 50 without having had a mammogram? Quite likely six feet under. Is it not worth others to undergo a bit of discomfort and/or the possibility of a false positive so that lives like my own can be saved? -Jennifer Hartman, Los Angeles, CA
I was sent for one, but because I don't have health insurance (I'm a part-time community college instructor), I couldn't afford it. Frankly, I'm relieved the age limit has been moved upward. Now I can coast for 5 more years. -Jennifer Rueda, Hillsboro, OR
Recommendations for maintaining health are dubious at best--witness how Vitamin E, hormone replacement therapy, and calcium supplements were first vigorously recommended and now have been debunked by rigorous studies. It is always difficult to determine what to do as an individual. I recently read that colonoscopies, which are strongly recommended, miss about a third of colon and colorectal cancers. People must make the best decisions they can with the information they have--information that is almost always incomplete. -Carol Henderson, Minneapolis, MN
Agree totally. I am a physician. I have spent last few years discussing with friends the lack of data showing the benefit in women 40 to 50 with no family history, and ample evidence of harm in increased procedures. Ditto BSE. Because of official guidelines, none listened. Three of five required ultrasounds and one required biopsy, all normal. -Te Pazdral, Cambridge, MA
My sister-in-law discovered stage 1 Breast Cancer because of her yearly mammo - she was 45 and had no family history and none of the risk factors - she is thin and athletic and eats an extremely healthy, low fat diet and never smoked. The mammo saved her life. Even one life is worth saving. -Alice Potter, Westminster, CO
I understand the reasoning behind the new recommendations - that the benefit to a few is less than the harm of misdiagnosis of many. But I wouldn't want to be that one in whatever that does develop cancer in her 40's (like my sister). -Christine Hopkins, Oceanside, CA
If there is real evidence that mammograms in 40-year-olds don't find that many tumors, then it makes sense. However, I know of 2 women who had breast cancer before they were 50, one of whom who died of the disease. -Lynn Hoenke, Grand Rapids, MI
I think it is irresponsible. One of the reasons they are giving for reduction in number of mammograms is that biopsies are stressful. I have had one and it was very stressful, although it turned out negative. But how much more stressful would it be if you found out you had cancer that had gone on for a long time undetected? -Nancy Snyder, Muskegon, MI
I concur with the guidelines. Some people forget that irradiation itself is a cancer risk & should be balanced against other factors. Sex-related organs have less protection against cancer because of their generative functions; breasts are primarily fatty tissue which tends to collect toxins from the body. Put all this together and x-ray it every year for several years & the process may very well be more risky than the prospect of cancer. Doctors don't like to come right out & say that irradiation itself bears a certain risk because that would frighten women off, but it's true. YMMV: testing depends on one's personal profile. -Susan Williams, Lakewood, CO
I'm disgusted and outraged. It's another strike against womens' health care. Literally overnight, decades of teaching women the importance of breast care awareness was deemed irrelevant. It's a huge disservice to women who may have been on the fence about having this exam, and for families who have a history with breast cancer. -Susan Sheridan Tucker, Edina, MN
This is a paternalistic attempt to save the insurance companies money. Regardless of the protestations of the committee you can bet that the insurance industry will site these recommendation as a reason to stop paying for mammograms. Also I don't think GP physicians will recommend before 50 mammograms because they are not trained enough in the disease. -Janice Farringer, Chapel Hill, NC
Because I have "lumpy" breasts, i had my first ultrasound at 28 and my baseline mammogram at 36. I started annual screenings at 40, but am thinking about changing that schedule to every two years. I value my drs' opinion so that decision will hinge a lot on what they recommend. There is no history of breast cancer in my family so I'm not too worried. This will also help me to be more faithful with monthly self exams. -Tracey Dissel, Durham, NC
This amazes me (in a bad way)! As I understood the news program I heard, the study found there weren't enough cancers found to justify the mammograms starting at 40 and breast self-exams. Any woman in those categories who has been diagnosed early and treated isn't going to think it wasn't justified. I personally find it reassuring to have had the mammograms and to have done the self-exams. -Terry Wagner, Aloha, OR
My grandmother died of breast cancer at the age of 56. My best friend died of breast cancer at the age of 43, she was diagnosed at 36 and it was already too late. My major concern is not so much the mammogram recommendation as the recommendations regarding self exams. Apparently I will have too much anxiety if I do self exams. Given the history - I will have much more anxiety if I don't. I think it is dangerous to suggest that self exams are not important. -Angela Speck, Columbia, MO
I think it is absolutely the worst idea I have heard in a long time. I have a 47 year old friend diagnosed with breast cancer a few months ago. When they found the cancer it was stage 4 and in the lymph nodes. Now it has spead to other organs with a dismal prognosis. Why in the world would these guidelines change now? ...after finally educating women on breast health. The is not good news for women. There is a trust factor here. If what we were told for 15 years is not good advice, shouldn't it have surfaced sooner or at least be questioned? -Brenda Vaughan, San Antonio, TX
I find this confusing and problematic. The new guidelines do not recommend mammograms or even self-exams. Are our ob/gyn doctors exams supposed to be the means of discovery for women under 40.? The doctor interviewed on All Things Considered discussion yesterday was speaking from statistics -- collectively we're all at lower risk between 40 and 50, collectively there are 2 times as many biopsies given after home exams. How is that aggregated picture balanced against individual histories of people who are at risk? -Sarah Herr, Tucson, AZ
I think that each woman should have a personal treatment plan based on her history. However I have come to believe that for women with fibrocystic disease annual mammograms cause repeated tissue damage that may actually aid in the development of cancer. So I would agree that reducing the frequency would be beneficial if and only if MRI is available in the off years. -Adelle Popolo, Orlando, FL
In the 1990s. a physician wrote an article in Atlantic Monthly in which he was highly critical of routine mammogram practices. Although not a physician, I am a scientist. His viewpoint was compelling to me. When I began taking HRT, however, a yearly mammogram was a price I was forced to pay in return for HRT prescriptions. The new guidelines liberate me by allowing me to do what I have wanted to do for years--treat routine mammograms as a "less is more" procedure. -Jennifer Clark, Washington, D.C.
I am 38 years old, and I went for my annual check-up yesterday. While there my doctor brought up this report, and suggested that I go ahead and get my first mammogram now because she is worried that by the time I am 40 insurance companies may not be willing to pay for them. -Leigh Robbins, Charlotte, NC
I think you have to use your head. If you have a history of cancer in your family or engage in risk-taking behaviors like too much caffeine and smoking, then you should get a mammogram once a year. If you do a self-examination once a month or so and have no hereditary risks or behavioral risks, you should decide for yourself. People don't take enough responsibility for their health; they blame it on the other guy--or McDonalds. I decide for myself what's right for me and you should, too. -Susan Kirkland, Burnsville, NC
I've been fine so far. In fact, I asked my Dr. last year if I could start getting them every other year and she said that at my age, it's more important than ever to get them every year. I'm 67. But I'm wondering about the insurance aspects for those women under 50 who wish to get a mammogram regardless of the guidelines. -Ann Swaney, Traverse City, MI
I am 61 years old. When I was in my 40's, one "baseline" mammogram was recommended; annual screenings were not recommended until 50. I started getting regular mammograms at 50, every year at first, then every other year. My doctor has been OK with every other year. I have not had any issues after my screenings, however, last time I was called back to have a sonogram. -Mary Sanada, Carson City, NV
My mother died at 62 of breast cancer which had metastasized. One sister had breast cancer in each breast and had removal and reconstruction. Her daughter had cancer in one breast and had a mastectomy and elected to have the other breast removed. A second sister does not have breast cancer issues but her daughter just had a mastectomy and also elected to have the second breast removed. All of us had breast cancer before fifty. It seems to me that the recommendations of the federal health panel do not have those women with the breast cancer gene in mind. Those with the gene, typically develop breast cancer well before fifty years of age. -Clara Alexander, Denver, NC
While I understand the reasoning at a macro level, individual women will die as a result. Are the lives of those women less important than the overall cost? I know how I'd feel if I or my loved ones were one of the women who'd die. -Barbara Skoglund, North St. Paul, MN
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