Negative Response from MSKCC

LISAMG · November 2009

"Memorial Sloan Kettering Cancer Center's recommendation is to start screening annually at age 40 for women at regular risk for breast cancer and those recommendations are not changing."

"I am horrified at this report, which seems like an attempt to generally pull back from breast cancer screening for women. It is an attack on multiple levels with the withdrawal of screening for women in their 40s, a cutback for screening for women 50 and older, and a statement that medical professionals should refuse to encourage women or train women to do any breast self-examination. The data that USPSTF include in their report is essentially unchanged from data that they used seven years ago to encourage women in their 40s to be screened and to encourage annual screening mammography."

"In addition, the report affirms that mammography screening done annually saves more lives than screening every other year and affirms that screening with mammography in women in their 40s saves lives. The rational that they have for withdrawing this level of care from woman is that is causes too many call backs and biopsies. It is a rational that they say in their assessment of risk/benefit comes out as excessive risk. The benefit is that the likelihood of dying of breast cancer is decreased and I don't see how any of the risks that they state outweighs that benefit."

- David Dershaw, MD
Director of Breast Imaging at Memorial Sloan-Kettering Cancer Center

CaSux · November 2009

Dr. Dershaw has a financial interest in keeping the standards as they are now. I don't know what the right answer is - but I do know I can't respect the opinions of someone who is at risk of losing 50% + of his income if the new standards are adopted. Don't tell me that there haven't been high-level meetings about the financial impact of the new guidelines on the Breast Centers. Vast investments have been made in these profit centers. Cancer is big, big business.No doubt they're congratulating themselves at the success of their scare tactics. Crisis averted. Profits secured. Here we all are, mass hysteria - helping them with their message.

Colette37 · November 2009

transcend...

In the end it should be up to the WOMAN and her DR. Not some taskforce which give no guidence for women who are in a high risk group. I asked for a mammogram when I turned 35 because my Mom had breast cancer under 50. I am now sitting with a 3 B breast cancer diagnosis and fighting for my life because I was REFUSED a mammogram 2 years ago and told to wait till I was 40! I have had numerous Dr. tell me that a 10 cm tumor would have been seen WITHOUT A DOUBT on a mammogram 2 years ago since it takes about 4 to 6 years to get to that size!

CaSux · November 2009

colette - nothing in these guidelines would have changed your story. You are at high risk. You should have been screened. You had a bad doctor. I am at high risk. I was first screened at age 27. I had a good doctor who recognized that high risk required high vigilance. These guidelines do not forbid screening before age 50. They say that for women without added risk factors, screening may begin at age 50. For any individual woman, talking with your doctor and understanding your individual risk factors is key to getting the care you need at the time you need it.

I agree, it is up to the woman, not the doctor, about whether she is screened. Your doctor should have listened to you. I wish you had a doctor who listened to you. I am praying for you.

Colette37 · November 2009

Transcend...yes, they do. This gives the impression that only women 50+ have to be worried about breast cancer which is not true. It gives the impression that lumps are nothing to be worried about and not looked into because they don't want women doing self breast exams. I was NURSING my 7 month old when I found the lump..I lost track about how many times I was asked if it was mastitis or a plugged duct (this was my 3rd child, and I knew what those felt like, but I still had to explain)

And then you have the insurances to deal with who have a different opinion and follow what this "Task Force" states is the standard of care! They don't care about history and only want the cheapest guidelines that they need to follow...and Dr. will follow. Many Dr. don't keep up on changes within the medical feild and end up following the insurance directions to a "T".

JanMarch · November 2009

There are plenty of women who don't fall into the high risk category that are diagnosed with breast cancer before 50. This time last year I never would have dreamed that I'd be participating in a breast cancer discussion forum - I was one of those without added risk factors. When I turned 40 I skipped getting my first screening mammogram. When I turned 41 I still didn't particularly want to do it, but I did because my doctor advised me to and so did my mom. Well, wasn't I surprised to find I had a 1.7 cm invasive tumor in my left breast. I'm grateful that I was encouraged to get screened and I wish I had gone the year before when I had turned 40 - who knows, maybe it wouldn't have been invasive at that point and I wouldn't be sitting in the oncologists office every six months worrying about what my blood tests are going to reveal. I can guarantee that if I'd waited until age 50, well..... I doubt I would make it to 50.

Anonymous · November 2009

The government REALLY needs to stay OUT OF OUR HEALTH ISSUES! They can't even manage medicare and medicaid - and now they want to manage our health issues! They are out of control and they need to back off! Damn...I am so angry about this! As if we don't have ENOUGH to worry about!

iodine · November 2009

Ya know one of the things that chaps me, on top of the recommendation, is the suggestion that mammo and bx, etc, shouldn't be done because we poor women get anxious???? Gee, do you think guys sweat a PSA test for prostate? Are 40 year old women so fragile that a little anxiety is preferred over not diagnosing a cancer?

Would love to have some stats on PSA testing and guidelines for that with cost vs lifesaving.

Sydney6 · November 2009

TranscendCa - When I went for my mammo last October on the bottom of the report it said my lifetime risk for breast cancer to age 90 was 13.2%! I was not at high risk for breast cancer. I thank God these recommendations were not in place a year ago. I am 46 years old - 45 at the time of diagnosis. Also, I went to MSKCC for a second opinion and was told it was an excellent pickup on the mammo by the radiologist in my area. The radiologist, who read my report, his mother had breast cancer. A few week after the 1st biopsy I had to have a MRI guided biopsy and this same radiologist held my hand through the whole thing. I am thankful that there are compassionate, qualified radiologists. Who knows who's going to be the unlucky one? Do we only vaccinate the children we think will get an illness. No, we try to protect all of them.

I complained to my husband one day about the price of a prescription I got for this terrible itch I've been having and he said, "If it works isn't it worth it?" That is now how I look at things. Before this year I seldom I went to the doctor and when I did I used to complain about paying the deductible and the out of pocket expenses. After a year of cancer treatment I figure I am way ahead.

Anonymous · November 2009

Perhaps the government run "board" should visit the website titled:

Young Survivor Coalition - especially the forum titled "REMEMBRANCE"

http://www.youngsurvival.org/bulletin-board/

Negative Response from MSKCC

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