Susan Love Defending New Guidelines
Comments
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I've heard and read all sorts of apologists for the Task Force and for people like Dr. Love. Here's what I think...
The U.S. Preventive Services Task Force itself states that breast cancer mortality rates have been decreasing since 1990 by 2.3% per year and by 3.3% for women aged 40 to 50 because of screening (mammograms).
According to the U.S. Census Bureau, there were 22,328,592 American women between the ages of 40 and 49 in 2009. One in 69 women in this age group will be diagnosed for breast cancer. That's 111,643 American women who will be diagnosed with breast cancer before the age of 50. The report states that mammograms avert 3 deaths in every 1,000 women screened. That means that up to 66,986 women under the age of 50 who would have died, will not die if they get mammograms. The report then makesa giant leap to recommend against getting mammograms, failing to consider the difference in outcomes from early versus later screening. Quality of life following cancer treatment is affected by the stage of the cancer and the degree of treatment required (lumpectomy vs. mastectomy, lymph node dissection which can cause life-long discomfort and disfigurement).
The bottom line as far as I'm concerned is not that the Task Force is indelicate in communicating their conclusions nor that angry people have overreacted, but that the recommendations fly in the face of the conclusions and the research cited in the report. -
P.S. I was diagnosed by mammogram screening when I was 51. Even after they knew where the tumor was, the doctors could not detect it through external exam. I was diagnosed with one invasive tumor and a significant amount of DCIS. I was treated with lumpectomy, chemo and radiation -- thankfully I did not have lymph node involvement. I was diagnosed during my regular annual mammogram -- which I actually had 18 months after my prior mammogram. I believe that my health and prognosis would have been much different if I had waited (had to wait) six more months prior to be diagnosed. BTW -- I had no commonly mentioned risk factors -- no family history, no birth control pills or hormone replacement theraphy, no smoking.
There were comments to the Huffington Post Article that suggested that Dr. Love has a financial interest in a company that she started to replace mammograms with an alternative screening method. If this is true, I applaud her efforts to find another test, but I am skeptical of her criticism of mammos and reaction to true concern from those of us who were diagnosed by mammos.
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I have never really liked Dr. Love's 'tone'; ever since I read her book shortly after being diagnosed. I clearly recall reading her story about a Stage I woman who did all the treatments but died anyway, and thinking, "OK, I know that can happen, but this is really not very helpful to me at the moment!!!!!" I did join her 'Army' anyway because, OF COURSE, we need more research, better diagnostic tools, treatments etc. but now am going to look for something different because :
1. I can not understand why anyone would discourage self exam. It is FREE and that is how I discovered my fast growing cancer 6 months after a clear mammo and physical exam. If I had waited another 6 months; my treatments would have, no doubt, been much more severe and with a much reduced chance of success.
2. I can make a long list of survivors I know, both below and above the age of 50, who caught their cancer in an early stage through yearly mammograms. Since cancer is a LETHAL enemy, it is ALWAYS better to catch it early!!! Do you want to catch the terrorist at the airport, or wait until he is trying to light his underwear on fire in mid-air?!
3. I really resent the 'cut, poison, burn' rhetoric; It was not I (not the essential 'me' anyway) that was "cut, poisoned, burned' but the cancer that was trying to take my life! I was a full and willing participant in the battle to save ME with the best weapons available at the time!!!!
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Ruthbru--I like what you wrote and felt a certain familiar outrage.
Dr. Love is unknown to me. The resources I sought were more immediate to me. You made a very good point. We use the best weapons available at the time and those are self exam, ultra sound, mammography and MRI. What I remember of what I read about her here is that she challenged conventional thinking. I've always found that a healthy position to start from and so I come here to read what's up.
My diagnosis was similar to yours. My lump was found by self exam 10 months after my annual check up (ultra sound and gyn). I knew my own body and something was new. That finding sent me the next day to my gyn who sent me for another ultra sound. It was happenstance that the place I went to was closed for holiday and I went to another. I believe that the person who read my ultrasound had as much to do with saving my life as the technology itself. His finding was immediate. He escorted me downstairs to the mammography. That confirmed his finding and he said "This must come out". These tests went back with me to my gyn who made the call to the surgeon. I was 52 years old.
The subsequent road that I followed was hard as everyone here knows too well. I'd still walk it. I hope not to need to make this choice again soon. So far I am NED.
As for the development of better diagnostic tools, I'm all for them especially if they are more accurate and can direct the therapy better. I also suspect that if Dr. Love is pushing in that direction, the push has as much to do with the need for a big push to get past walls of policy built on foundations of nepotism. Science is not immune to that phenomenon. And somehow there are people who manage to retain focus on their interest to find a cure for cancer. It's amazing to me because I've all but given up on this world we find around us.
Best wishes to all as always,
Marilyn
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My BC was found at age 40 by my first mammo and mine was agressive/fast growing. Thank God there were no mammo 'guidelines' because I wouldn't have qualified with my age, no personal risk factors at all, no family history whatsoever.
My BS called me the "poster child" for early detection. She went on to say that even if I had had my first mammo 6 months to a year later, it would have been a completely different story.
And bravo Ruth, I too chose the 'cut' "poison" (didn't have to have the burn), I was an active participant too, caring less about a saggy, diseased breast and more about meeting my far into the future grandchildren. I wasn't interested in saving any breast.
I never liked the tone or the content of Dr Love's book either. To me, it had a cold, negative tone to it and I was happy to return it and find other authors who gave me the information, the research and the hope and comfort that I needed.
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