Shift in breast advice

We learn with horror that the panel that rejected the 2002 U.S. Preventive Services Task Force recommendations for annual mammograms in women from age 40 was a panel of bean counters. Their concern was with spending, not with health care. The 2009 panel did not include radiologists or oncologists.

If a breast biopsy does not reveal cancer, it is not unnecessary, save perhaps in retrospect. Biopsy is the definitive test for malignancy and for other lesions as well. Borderline lesions of the breast exist, often providing signals for close follow-up. Early biopsy following the introduction of mammography reveals lesions likely to enjoy favorable prognosis.

Death from breast cancer in American women has decreased substantially since the advent of mammography. Breast cancer does develop in women under 50 and over 75 who lack special risk factors or who are unaware of their risk factors.

David S. Jacobs, M.D.
Overland Park

Gail Collins’ column “Breast-exam advice just the latest medical shift” (11/20, Opinion) identified one of the big problems in health care: figuring out what actually works and what simply benefits medical technology and drug companies.
 
Several years ago there was a long piece in The New Yorker about back problems. The author was a doctor, trying to figure out what to do about his own back. He quoted studies and questioned why some issues hadn’t been studied. The article took up half the magazine, told you everything you could possibly want to know about back pain, and came to no conclusions.

 We don’t deal well with ambiguity, but as the world, including medical care, becomes more complex, there are fewer simple answers.

Rae Ann Nixon
Kansas City

Comments

[kcstar_is_one_sided]

So I am ti assume that rebel mama is for this. LEMMING. There were no oncologists on that recommendation board. Smells to me like....rationing.

[Kee]

R A T I O N I N G.

Don't care how many smoke grenades you throw at it.

[rebelmama]

If you have complained about the high cost of our health care, you cannot rail about studies that revise recommended tests without your hypocrisy showing. Everybody has heard of someone who would have been caught in the new revisions, but should recommendations be left as is, ad infinitum, because once upon a time they were what they were? Of course not. We have data, let's use it, let's analyze it, let's make reasonable decisions based on it, but don't discount it just because it's a change. Or because "bean counters" came up with it.

[Kee]

Sorry Doc, you don't call the shots any longer under government ran health care.