Response by American Society of Breast Surgeons
November 17, 2009
Dear Colleague,
The leadership of the Society authored the following press release last evening in response to the United States Preventive Services Task Force change in mammography guidelines.
Executive Committee
The American Society of Breast Surgeons
FOR IMMEDIATE RELEASE NOVEMBER 16, 2009
The American Society of Breast Surgeons is strongly opposed to the recommendations released tonight by the United States Preventive Services Task Force (USPSTF). We believe there is sufficient data to support annual mammography screening for women age 40 and older. We also believe the breast cancer survival rate of women between 40 and 50 will improve from the increased use of digital mammographic screening, which is superior to older plain film techniques in detecting breast cancer in that age group.
While we recognize that there will be a number of benign biopsies, we also recognize that mammography is the optimal screening tool for the early diagnosis of breast cancer in terms of cost-effectiveness, practical use, and accuracy. To restrict its use will mean that breast cancers will go undiagnosed for an unacceptable period of time. This restriction of mammographic screening defeats the goals of early detection, which often allows for breast conserving surgery and avoidance of chemotherapy.
The USPSTF also does not make a recommendation for mammography screening for women age 75 and older. Women in this age group are at the greatest risk for breast cancer and at the point where mammography is most sensitive.
We believe these recommendations effectively turn back the clock to pre-mammography days by making the diagnosis of breast cancer occur only when the tumor is large enough to be felt on a physical exam. The Society will continue to advocate for routine annual mammography screening for all women beginning at age 40. Mammography screening reduces breast cancer mortality and saves lives.
For more information contact the Society at http://www.breastsurgeons.org/.
The American Society of Breast Surgeons, the primary leadership organization for general surgeons who treat patients with breast disease, is committed to continually improving the practice of breast surgery by being an advocate for surgeons who seek excellence in the care of breast patients. This mission is accomplished by serving as a forum for the exchange of ideas and by promoting education, research, and the development of advanced surgical techniques.
Comments
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Bravo to ASBS! I had a surgeon who did not expect to find a malignancy even though the mammography showed something suspicious. But the biopsy showed two very small cancerous lumps. Thanks to my surgeon who excised until I had clean margins. One less breast later, I am now cancer free for over 5 years. All of this happened before I was 50. Sadly my surgeon did not know at the time he had late stage cancer and died before my three month checkup.
My life is worth the early detection of regular mammography, the effort to perform breast self-exam and the anxiety of being biopsied and waiting to hear. And thank you to Reach for Recovery the angels of the American Cancer society for sharing the gift of peace of mind.
I want my children's generation to be encouraged to perform breast self-exam and to have easy access to affordable mammography. I hope this hurtful and insulting report creates an outcry of the voices of people who know what life is like when you have a good prognosis due to early detection. Signed, a nurse
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Thankyoumammography...I totally agree with you!
IMO they should start giving mammograms EARLIER. At least one baseline at 35 and closer screening for those who have had a close relative who had breast cancer at a young age and are at an overall higher risk for having the cancer.
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And no doubt you believe that your income will be better because of all the unnecessary biopsies you'll be able to charge for. Follow the money.
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Transcend...I am following the money...all the way back to our government. What I would like to know is how on earth would anyone think that the goverment is in it to help them? (How many times does the government dip into the Social Security funds and then scream that the fund is going broke in the next breath?)
It is not co-incedence that this has shown favorable to cut costs the same time that the US government is takinging over our health care...or attempting to do so!
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IMO, no biopsy is unecessary.
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Surgeons are likely to make much more money if the recommendations are followed. In this case, there will be more advanced cancers detected. I'm sure one mastectomy goes for about what 5 surgical biopsies do.
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Biopsies are far more lucrative for surgeons than mastectomies.
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Money should not even be a factor. The only statistics that count should be the ones that show the mortality rate decreasing when knowledge and early detection are increasing! I'm glad the ASBS spoke up!
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Transcend, I am not sure where you get your information, I know surgeons charge a great deal more for mast. than for bx. And don't kid yourself, a few bx don't equal out to one mast.
Not sure who the doc was that sent you to such a negative side of physicans, but do hope you will find another who can change how you feel about doctors.
Good luck with that.
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The cost for bilateral mastectomy: $2400. the cost of the bilateral stereotactic biopsy: $8,000. these are actual amounts paid to the physicians per the EOB (Explanation of Benefits) I received. Facts. I know I won't change any minds here. Everyone here has made up their minds about this.
No one's paying attention to the real report. They are buying hook, line and sinker the bu!!$h1+ spin that major financial stakeholders are spewing forth. Or, they're allowing themselves to be manipulated by political hacks - ignoring that the majority of the panel that put this out there was APPOINTED BY THE REPUBLICANS. Sheep - you're all sheep - you only listen to those who agree with you. You don't even consider that there might actually be another point of view that really, truly has merit. You are being manipulated by very smart people.
More research is needed. More research is needed. More research is needed. More research is needed.
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Long post gone into neverland. May have been subliminal message to myself.
Will just say, not all is as it outwardly seems, much behind the scene lobbying, who speaks louder and more effectively, costly technological advances who someone has to pay for (that's us through premiums etc), re-shifting by CMS of physician groups' payments (pity the surgeons and pay dirt for interventional radiologists), less surgery proponent emphasis over more (directed through reimbursements) and much much more, including the elusive most accurate, lowest cost scenario as well as societal cost analysis (where rationing issues play out).
A conundrum abounds, better fasten your seat belt as we're in for a wild, rocky ride ahead.
My best to you all,
Tender
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TranscendCa: Where in the world did you come up with this cost figure for a bilateral mastectomy? On what planet might such a surgery cost $2,400.? $2,400. is the cost of the SALINE SIZERS AND TISSUE EXPANDERS! That is sheer nonsense! My bilateral mastectomies, with tissue expansion, fills, implants, revisions and attendant procedures exceeds $100,000.!
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Also, we don't care under whose administration the panel was formed. There is not one single breast cancer expert on the panel! Republican or Democrat--what possible difference will that make to the women whose lives will be lost if these recommendations are adopted?
People have the right to express their beliefs/feelings/fears about these new recommendations without being called *sheep* for doing so. What nerve.
BTW Whippetmom...love the Jer 1:5 sig!!
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$2400 was the surgeon's fee - only the breast surgeon's fee. The reconstructive plastic surgeon's fee was separate (about $12,000). The OR & hospital costs were not included in the amounts noted. total cost of my surgery and reconstruction and including hospital fees mirrors your experience. Actually, about 75% of your cost - and that was for DIEP reconstruction.
This thread referred to the breast surgeon's fees - not total cost of treatment.
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I ditto with whippetmom on the cost of bilat mastectomy....mine exceeded $100,000...
We women have a right to speak our concerns on these new guidelines, especially given the fact that if these guidelines were in place last year, many of us would be fighting a lot harder for our lives, not to mention the increase in costs.
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Only thing that matters is EARLY DETECTION SAVES LIVES!
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$12,000 was a conservative estimate I came up with last year when I researched the breast surgeon's fees for performing a bilateral mastectomy - with a conjoined sum of $25,000 for the breast surgeon and plastic surgeon's portion of the surgery. But what does it matter? I could disprove your theory of the cost of an invasive surgery where breast tissue and fat and tumor are dissected, and the breasts are carved out like pita pockets, as being less than that of a procedure where a minute portion of a mass is performed via needle extraction in an office setting, but what will it prove? I just cannot fathom why someone would make such an unkind and insensitive comment to women here about being "sheep", when we are just trying to fight a vicious disease. I cannot understand going to a breast cancer forum and being cruel. It just makes no sense to me whatsoever.
The reason I spend my time here on these forums is for the comradery and friendship I have found, but the reason I stay, is to help women get through an important aspect of this disease. I am here to help and inform and nurture and care for these women. Some places on this earth should be hallowed and sacred and I just feel that a breast cancer forum is one of those places. There are ways to express an opinion without castigation. I know a lot of people are angry about this disease and their lives in general and it comes out viciously at times in the written word. I am so very sorry that there are wounded souls out there. But on another note - I am a sheep. I am happy to be a sheep. I have the most glorious Shepherd to follow....
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Just for the record, there was no surgeon involved with my stereotactic biopsy (since it is not a surgical procedure), so no surgeon profiting from it. Of course that would not apply to other types of biopsies. Out of curiosity I took a look and it looks to me like my insurance paid about $2000 total for my stereotactic biopsy (mine was right breast only, though, not bilateral). I think TranscendCA may be comparing apples (surgeon's fee for a surgery) to oranges (total cost of nonsurgical procedure).
We should all look at various reports/positions critically and consider their sources, of course, and I think that many of us do. Our personal experiences also factor into our views of course -- whether we feel that our lives were saved by a mammogram, whether we feel we were overtreated, etc. We do not always come to the same conclusions, and that is OK. Discussion and debate is healthy. But it is hurtful and inflamatory to call all of the women on this board "sheep." I agree with whippetmom, we should focus on fighting our mutual enemies and treat each other with respect.
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TrancendCa--Question is a biopsy only worthwhile when cancer is found? A biopsy is needed when something in mammography, ultrasound, or MRI is deemed suspicious. It should be considered a good thing when a biopsy comes back b9, instead of an unneeded test.
I had to return for more pictures a few years ago, and yes it was stressful for a few days, since my mother died of bc, but it was way more stressful to hear I actually had bc 4 years later in the other breast. To me the argument that there are too many false positives is fallacious, whatever happened to the idea that ruling something out is a good thing?
KEW
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Whippetmom - I am also proud to call myself a sheep following the most glorious shepherd!
Thanks for eloquent response. I am here to not only give support when I can but also to receive support. To read angry, negative, attacking responses is not good for anyone. We have enough stress in our lives just going through daily rituals, let alone having BC so we need to play nice. I am not saying we must all agree with one another but we need to simply agree to disagree and leave it alone.
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oh transcend, it must be beautiful weather up there on that pedestal.
We're sheep because we only listen to people who agree with us? So....what does that make you? It seems to me that you are discounting all the opinions that do not follow your own line of reasoning. We will not all agree about the merits of and the true reason behind this study/recommendation that has been put out. But disagreeing doesn't and shouldn't result in name calling and devaluing the women on this site.
In the words of my high school softball coach: Grow up or Go Home.
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The so-called richest country in the world, is now putting money before life. IMO - what a tragedy and a sign of the times. Illinois has a policy that no woman will be denied a mammo if she cannot afford one. Will all of these women be denied a mammo before the age of the 50? Scary to say the least.
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First of all-TRANSCENDCA-after all that I have been thru because of bc I sure as hell resent you calling me a sheep. This is not the place for politics. As we all are probably aware-bc is striking women at earlier and earlier ages, no longer is it an old womans disease. I just heard that they are also recommending pap smears be started at 21 and done every 2 years. I find this all unbelievable. I have never bought into the hype that womens health issues are not given enough attention but I must say this is leaning me towards feeling that way.
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SHEEP???? How horribly insensitive. I am hurt for all of us who have been struck with the insidious disease. My daughter is only 24 and I am worried for her. Early detection saves lives ... it is THAT SIMPLE. I don't know what has made TranscendCA so bitter ... I will pray for her. This forum has always been such a source of strenghth for me. When I read her words it was like a punch in the gut. Too bad.
Love and peace to all of my breast cancer sisters. xoxo
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Hey stop the sheep shi*! lol My niece dressed up in a sheep's costume for Halloween and she dressed her baby daughter as little lamb! lol
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