The New Guidelines for Mammography
The U.S. Preventive Services Task Force issued new guidelines on breast cancer screening today that do away with the “every woman should have an annual mammogram starting at age 40” recommendation women have long heard from their doctors.
The new recommendations are:
• Screening mammography should not be done routinely for all women age 40 to 49 years.
• Women and their doctors should base the decision to start mammography before age 50 on a woman’s individual breast cancer risk and her understanding of the benefits and harms.
• Women age 50 to 74 years should have mammography every 2 years.
• More evidence is needed for the USPSTF to recommend for or against screening mammography after age 74 years.
The new recommendations also note that:
• The USPSTF recommends against teaching patients breast self-examination.
• Available studies do not provide enough information to know whether breast examination by a trained medical professional adds benefit beyond mammography.
• There is not enough information to know whether newer types of mammography (digital mammography) or magnetic resonance imaging are any better than regular film mammography results.
The USPSTF is a group of health care experts that reviews published research and makes recommendations about preventive health care, and it’s recommendations are considered the “gold standard” for clinical preventive services. This means that these recommendations are likely to be widely adopted and have the potential to broaden all women’s understanding of the benefits and harms of mammography as well as help them understand what we truly know—and how much we still need to learn–about breast cancer prevention and early detection.
Many doctors now advocate that women begin mammograms at age 40. But the fact is the decision to change the age at which mammography screening begins in this country from age 50 to age 40 was always controversial and was never unanimously supported. That’s because mammography is not as good a tool in younger women.
The studies also are pretty clear that whether you have a mammogram every year or every two years after 50 the results are about the same. In fact, most European countries do mammography every two years, with similar results to those in the U.S.
Furthermore, the use of breast self-exam to “find cancers at a curable stage” has never been supported by randomized controlled data.
Recommendations on mammography screening must also take into account our new understanding of the biology of breast cancer. We used to think that all cancers were the same, that they all grew at the same pace, and that there was a window when all breast cancers could be caught before they spread. We now know that there are at least five different kinds of breast cancer based on their molecular biology. Some breast tumors are so slow growing and are so unlikely to spread that they will never do any harm. Others grow and spread very quickly. The idea that they all can be “caught early” is wishful thinking. In fact screening is best at finding the “good ones” that might even disappear if left alone. Remember the reduced the mortality from mammography is 30% not 100%! If early detection always worked, the number of aggressive cancers we see would have gone down as a result of screening. But as a recent article published in the Journal of the American Medical Association made clear, that’s not what has happened.
The goal of breast cancer screening should be this: to find the cancers that have the potential to kill you, so that an intervention is necessary and can make a difference. We need to stop finding the cancers that will never do anything, and stop over-treating women who have them.
For this to occur, we need to do help women understand what mammography can and cannot do, and focus on finding the cause of breast cancer and preventing it altogether. I don’t want women going for mammograms they don’t need, or feeling I false sense of security because they have had one. I want them to have the opportunity to take part in the research that we need to go beyond a cure! That’s the reason we started the Love/Avon Army of Women. [armyofwomen.org]. And that’s why I need you and everyone you know to sign up today!
I agree that Dr.’s are too conservative in their treatment of unique breast cancer. I have had surgery for a tubular carcinoma less than 1cm no ductal involvement. The “protocol” involves radiation, although my cancer is lumped (pardon the pun) with other more agressive cancers. I am still debating to radiate or not or just tamoxifen. I start radiation on the 24th of Nov unless I come up with a rational reason it is really not a good idea. I understand the implications to the heart and ribs. Any thoughts?
Mary Lou,
I had no family history of any type of cancer. I was diagnoised with breast cancer at age 47 from a mammogram. My doctors said the mammogram saved my life. I went through surgery, radiation and am currently on tamoxifen. I would not change any of my or my doctors decisions.
The history of radiation on breast cancer has been very effective to prevent reoccurance. I wish you the best of luck!
Just saw a portion of an interview which aired in Washington, DC. I must say I am appalled at your stance. My wife is a 7 year survivor of breast cancer and her cancer was detected early at age 42 during a routine ANNUAL mammogram. I shudder to consider how far her cancer may have progressed had she been denied screening for 2 years. The costs to life and overall costs associated with less frequent screenings far exceed the occasional false positives and “unnecessary” biopsies. If there is something better than mammograms, then fine, but saying that less screening is better is an irresponsible stance. It is not easy to communicate as your detailed message as this post indicates. It is hard enough to get women to get check ups without confusing the issue. From working with Susan G. Komen, American Cancer and other advocate groups, I know how hard it is to communicate a simple message to help women understand the need for screening. You should take more care in what you say and how that message is spread.
Have you lost your freaking mind!! I am 42 and diagnosed. I sit with 23 and 27 year olds with stage 3. HOW DARE YOU!! May God help you sleep at night for the death call that you have just trumpetted. I pray you NEVER live through what I and the may women with me have lived through to see out children grow up! SHAME ON YOU!
Wow, your support of the USPSTF’s new guidelines is incredibly misguided, especially for a breast surgeon who has undoubtably seen 1000s of breast cancers in women under age 50 with no family history. Congratulations on helping set back all of the advances in breast cancer detection, treatment and survival a good 20 years or more. Your support of rationing of this important screening in women under 50 reeks of what our health care system will become under the current administration.
As a mammography tech I am deeply disturbed by these new recommendations. I have seen an increase in the number of women diagnosed with breast CA under 50. These women would probably be dead had they not had a mammogram.
First – Dr. Love should speak to the press and make clear her views on these new guidelines. Dr. Tim Johnson on ABC stated today that…”even Dr. Susan Love agrees with these new guidelines”… Maybe I’m reading this blog incorrectly, but I’m not getting that.
Second- maybe because these guidelines are so new there is alot of misinterpretation out there right now – will these guidelines become the “gold standard” or will doctors take a deep breath and consider each on a case by case basis?
I’m 48 and have had 5 mammograms since I was 41. All is well. I think if I had a history of breast cancer in my family I would feel alot more comfortable going every year. I personally know of 3 woman in their early 40’s with breast cancer and thanks to early detection they are being treated.
My fear is that these guidelines will be used as cost cutting tools for insurance companies – especially with the government getting involved with health insurance…
I find this government task force a frightening beginning to what our future holds if our government is allowed to have choices in our healthcare. I am a 43 year old female with three beautiful children and if it were not for the technology and early screening my cancer would not have been found at an early stage. THIS INFORMATION IS ABSOLUTELY MISLEADING AND HARMFUL!!!!!!!!!!!!!!!!!!
I am 35, no family history of any kind of cancer. Found a lump and was diagnosed w/ BC 10/5/09. I am furious at the recommendation o not teaching SBE. What a stupid thing to put out there. What harm could it do? Are people likeme expendable? My BC is triple negative, and is a fast growing and spreading cancer Luckily I found it before it spread, but I hate o think what would of happened if I hadn’t found it! Shame on this panel of “know it alls”
I wonder how my late wife would view this recommendation.
She was diagnosed with BC via a mammogram at age 40. no prior family history and she was a picture of health.
She died at age 45, but had five reasonably good years after diagnosis. This new standard means she would have learned of her disease much later and would have died under far more tortuous circumstances. This may save time and money, but it will not save more lives.
I had invasive ductal breast cancer in 2003, 1 cm, and had radiation and chemo. I refused Tamoxifen which is one of the worst drugs out there. Why they keep pushing woment to take that drug is beyond me. I refused and have been cancer free for over 6 years. I believe I had over kill and would never allow anyone to use radiation on me nor would I have more than a few lymph nodes removed. No one told me sentinal node biopsy could fail and since the dye didn’t go to any particular node, they removed 24 perfectly good nodes. Now I have lymphedema in my arm. I am a cancer TREATMENT survivor! For me the cancer wasn’t the enemy, the treatment was. I plan to go every other year for mammograms and I am comfortable with that.
Hi Dr. Love, know you from Boston, MA. well over 26 years ago. You were my doctor in removing a breast implant that didn’t work for me. Dr. Cady had contacted you. I went for my first mammogram at age 44, because I was having shooting pain in my breast. The doctor argued with me that I shouldn’t bother to get one.
I insisted, and thank God I did, for I had cancer in my left breast. If i had followed the “NEW GUIDELINES” I would not be here emailing this note.I am shocked that someone like you, who has always been a strong voice for all women, would back this new direction on detecting breast cancer. I also had a friend, who was only 30 when she found out she had cancer. Her doctor kept putting off her having a mammogram because she was too young. By the time she had a mammogram, and surgury for breast cancer, it was too late for her, it had spread thoughout her body. She gave it a good fight, but lost, and left behing a little girl of 10, to go on without a mother. I have a feeling that big insurance company’s are behind this backward step. I will be an active voice against these new guidelines as will all women who had breast cancer well before 50 years of age. sincerely, geraldine hoyt
I’ve donated my last penny to Dr. Susan Love. She was all over the news yesterday when these new guidelines came out. She kept saying that new technology is needed for younger women. IT IS HERE. It’s called DIGITAL MAMMOGRAPHY. Per the ACRIN Trial, digital mammography IS better for women under 50. In particular, it matters more than ever which type of digital mammo machine you go on and all my research takes me to GE. All of their machines have tubes that can work whether your breasts are dense or fatty.
For Dr. Love to not make any distinction and agree with this is appalling. She is the only “expert” I heard all day agreeing. She has every right, as do I to 1) withdraw from her volunteer “Army” to be involved with any research she is involved in and 2) to never, ever donate to her again.
I am a fan of Dr. Love and given a copy of the Breast Book to everyone I know who gets a breast cancer diagnosis. I’m not sure what to think about the guidelines. I was diagnosed with breast cancer at the age of 40 directly as a result of having my first preventative mammogram. Initially the diagnosis was ductal carcinoma in situ but post lumpectomy it was found I had several small invasive tumors which were removed with a mastectomy. They had not yet spread into my lymph nodes. I firmly believe I remain cancer free and healthy today thanks to that early mammogram.
I was extremely disappointed yesterday to see Dr. Love support these guidelines on the evening news. I was 44 and a routine mammogram found BC. It was invasive lobular cancer and had already spread to 6 lymph nodes without ever forming a tumor anyone could feel. I would be DEAD if I had not had that mammogram. I, too, feel that the panel is calling my life expendable. False positives, while costing money and upsetting women, never KILLED anyone (to my knowledge). Shouldn’t we find a better alternative BEFORE discontinuing the accepted practice? This is a death sentence for many women.
I, too, am shocked that Dr. Love would support the new guidelines, especially the fact that the task force is against teaching patients to do breast self-examinations. I thought the Foundation is all about preventative measures! Personally, I believe a breast self-examination saved my life eleven years ago. I am concerned that the progress we have made over the last 20 years to help educate women on how to manage their own health will erode under these new guidelines. Dr. Love, we need you and the Army of Women to push back on these recommendations!
I am another breast cancer survivor who is absolutely apalled at Dr. Love’s endorsement of the latest guidelines for mammography. I am a twenty six year survivor, who was diagnosed at age 35 with invasive breast cancer. I also have a sister whose HER2 positive cancer was found during a routine mammogram. These new guidelines may save money and some false positives, but they won’t save lives! I guess we’ll have to advocate for ourselves with our physicians regarding mammography.
Add me to the list of those who are disappointed in the support. While not perfect, mammography does save lives. Everyone knows someone diagnosed in their 40s. I was diagnosed with IDC at age 48 through mammogram. My cancer, while small, did find its way into my axillary nodes. I have to believe catching it when we did has saved my life, although I guess we will wait and see. I firmly believe it was my only chance. There is no indication that removing mammography as a tool will result in finding a better one. It is more likely that insurance companies will use it as an excuse to deny the tool to those who want it, and will undoubtedly cost lives. Do NOT sit in your ivory tower and quote science, not understanding the real world ramifications of what you are supporting.
VERY sad & angry to hear that Dr. Love endorses this government crap! As a nurse I already see so many people wait a “few” years past the recommended age to get their annual screens. Now we have just given them cart blanche…emotional trauma of a false positive?? Give me a break!Have any of these experts even had one? Digital mammo are a great thing for younger women and should be the norm, not telling them they don’t need one until 50. I’d be DEAD if I had embraced these new guidelines and my daughter age 10 would have to grow up without her mother. If you want the health care offered in these foreign countries please move!
My reaction to the “new” guidelines Will insurance companies now have an out for women who wish to continue to follow the old guidelines and not pay for yearly mammograms for those age 40 and older. All these years we have been brainwashed with the information that the amount of radiation we receive is so minimal it will not be a problem now they are starting to change that opinion. Discussing the recommendations with your doctor is a very stupid statement When was the last time you had more then 10 minutes with a doctor!!!. They will not give a definitive answer and the decision will be thrown back to the patient. I am totally disgusted with so called panels decided what medical care I should be entitled to receive.
Dr. Love, you are wonderful. After my DCIS diagnosis, I read parts of your book and gained a much better understanding of my condition than any doctor was willing to give me (strangely, the doctor who recommended the book told me if I didn’t have surgery immediately, my DCIS would certainly become invasive). As someone who was operated on for low-grade DCIS, I applaud these new guidelines. I think, however, that people like you need more media exposure so that you can help the average person understand what it means to detect a cancer that may never become harmful. Please educate the world about DCIS. I would be the happiest woman on earth if I learned that I was the last woman unnecessarily treated for it.
I live in Canada where the Cancer Society recommends waiting until 50 for mammograms. This is indeed the same recommendation as in several countries in Europe. It seems like the US is the last hold-out here. May I just say that discussing individual patient cases without any medical history or details is of little value in this debate. The science is what we should be concerned about. Ignoring science in favour of annecdotal evidence is irrational and creates unnecessary hysteria. I very much doubt there is a world-wide conspiracy to doctor scientific evidence in order to trick women and increase the chance of them dying from breast cancer. We must keep the debate logical and scientific if we are to truly serve women.
I have to admit that I am stunned by your support of the recent recommendations to postpone mammograms for women until 50, which goes on to say that breast self examine shouldn’t be taught or encouraged anymore. As someone who recently had a child and is dealing with a very different breast than I once had,I believe now more than ever that I need to be reassured of the appropriate way to check my breasts. And as a black woman, who as a group tend to have more aggressive and therefore more deadly forms of breast cancer, I cannot fathom why you advocate later and more infrequent measures for detection. I understand the concern about false positives and unnecessary expenses, but what about the woman who is spared a mastectomy because her cancer was caught early enough to have a lumpectomy? What about the emotional cost and anguish of that woman and her family? I have yet to see similar suggestions for prostate cancer screenings, which expose men to a much more invasive diagnostic process and are just as emotionally unsettling for them and their families. How can you support the further erosion of women’s access and quality of health care?!
Our health care choices don’t have to be an either/or. Researching appropriate screening measures does not have to mean that research dollars should be taken away from your concern – which is finding a cure for breast cancer. Why can’t they BOTH be studied, without sacrificing women and our health care options along the way.
I’m very disappointed by your support for these recommendations and I’m waiting for health insurance companies to cling on to this as another way to reduce their health care overhead at the expense of women.
Thank you Dr. Love. For years, I have agreed with this. I was dx 6 years ago (at age 52) with invasive ductal. I’d never had a mammogram and found the lump myself.
I DO believe in self-exams, but not clinical exams. Every woman should learn how to do this and do it well. I told all 3 doctors the quadrant my lump was located in and still, none of them could find it! And it was EASY to find. That’s why a woman should NOT rely on a doctor (who is totally unfamiliar with her breasts) to do this exam. Women have been getting over-radiated for years and I do believe it causes SOME of these cancers.
On Aug. 31, 2009, at age 58, I went for my yearly mammogram. I never worried about having breast cancer, no cancer in my family, in perfect health and last year’s mammogram was fine. On Sept. 18, I was diagnosed with Lobular Invasive Cancer, estrogen positive, which is a slow growing cancer. On Sept. 30, I had a bilateral mastectomy and the removal of several lymph nodes. Even though the largest cancer lesion in my breast was less than 2 cm, the cancer had already spread to my lymph nodes. I am having chemotherapy and will have radiation after my chemo is finished.
I feel fortunate that my team of doctors worked very quickly in removing the cancer. I hate to think what condition I would be in if I waited to have my mammogram next year!
Dr. Love wants to “focus on finding the cause of breast cancer and preventing it altogether”. That’s good but what do we do in the meantime? If the regular mammogram is not a good diagnostic tool, why not use ultrasound, digital mammograms or MRIs?
Seems to me the new guidelines also save money for the government’s health care systems and health insurance companies!!! It’s really shameful!!!!
Instead of abandoning mammograms as a diagnostic tool, we should be increasing access to other modalities, such as MRI and ultrasound. These combined with state of the art, digital mammography, BSE and clinician exams can be used together to diagnose BC while it is early stage haveand easier to treat.
Yes, there are cancers that are missed by mammograms. Let’s concentrate on improving diagnostic tools. Dr Love and others have said some cancers may be indolent and not require much if any treatment. By all means,look for ways to determine which cancers can be left alone through clinical trials etc. But until medical science has those answers, I’ll take my mammogram.
I am outraged at this. Two friends and myself were diagnosed at age 47,46 and 45.
We are ladies who do our best to follow directions on health care. Given these new guidelines, I’m not sure we’d be around to follow any directions. Dr. Love, surely you can’t agree with this??? As said before, IT’S A SHAMEFUL PROCLAMATION!
As a breast cancer survivor, I am appalled by the suggestion that unless a women is 50 years old, that you don’t get a mammogram or do self-exams. I was diagnosed at age 43. I have no family history of breast cancer in my family. I exercise regularly. I do not smoke. I do not drink. If it wasn’t for the self-exam, I would not have known that a new lump was in my breast.
I don’t care how many doctors you get to support this study, it is incredibly irresponsible to send the message to young women that they are not at risk. They ARE at risk.
Unfortunately, this study will influence health insurance companies, lazy doctors and already scared women.
Shame on all of the researchers.
Dr. Love. With all due respect, I am so disappointed in the fact that you support these guidelines. I watched you on Good Morning America and was shocked at your statements. I am a breast cancer survivor and I have read your books. Unfortunately you have lost all creditability with me if you support these findings. This study was funded by the government and is way off base. If you think that the insurance companies are not going to jump all over this you are mistaken. They will make it even harder for women to get mammograms paid for by their insurance. And as far as the radiation. Really???? I would rather have radiation from mammograms than from the radiation that I had for my treatment. I still have scars from that and it has been 6 years. One more think. Women with dense breast can be helped by mammograms.
I would think that it would be more important for young women to get yearly mammograms since they are usually the age group that have the aggressive types of breast cancer. At 56 and a 6+ year survivor I am OK with every other year, but I was told my daughter should start 10 years earlier than I was when I was diagnosed, which would be 39. Has that changed too? I don’t put much value in statistics, I look for common sense and there doesn’t seem to be much of that with the new guidelines.
I was diagnosed at the age of 38 with no family history of breast cancer. There are many girls in my family and I am the youngest of 6 girls. I had absolutely no risk factors and did everything right not to get breast cancer and I still got it! I had an 8 month old baby that I stopped nursing and felt a thickening that my doctors dismissed. After my persistence, my doctor finally agreed to a mammogram 3 months later.
The radiologist reading my mammogram told me, to be thank full for digital mammography or else my micro calcifications would not be seen by traditional films due to my dense breast tissue. My cancer was caught very early but it also was very fast growing and aggressive since it was hormonally negative and her2+++. This type of aggressive cancer is much more common in younger pre-menopausal women then it is in older post-menopausal women. Early detection and a digital mammogram saved my life!
I am shocked and angry with Dr. Love’s support of the new task force guidelines. My breast cancer was found by routine mammogram long before it would have been detected by BSE. I was in my 40s with good health and no family history of any cancer. These new guidelines tell us that fewer mammograms will reduce the harm of false positives, anxiety, and unnecessary biopsies. Are women so fragile that they can’t deal with a few procedures in order to possibility save their life? Women who are afraid to know the truth aren’t getting tested anyway. “With its new recommendations, the [task force] is essentially telling women that mammography at age 40 to 49 saves lives; just not enough of them,” Dr. Otis Brawley, chief medical officer for the American Cancer Society. The above narrative states “Remember the reduced mortality from mammography is 30% not 100%!” That sounds like pretty good results for any screening test – especially if you are one of the 30%! Other than routine screening and BSE, how do we achieve the goal stated above “to find the cancers that have the potential to kill you”? Mammograms aren’t perfect but they are one of the best tools we have available right now. Early detection makes a difference, not only for mortality, but also for the level of treatment required. Early detection allowed me to benefit from new and improved treatments with less impact on my life and health. The new guidelines only benefit the insurance companies who will immediately and gladly reduce coverage. Allowing more women to SUFFER with advanced cancers and DIE when it is too late. This is outrageous and shameful!
I’ll start by saying I do not have breast cancer, but just turned 40 and just had my first mammogram last week. And now I read all this and… feel truly sad for all the woman out there who will now believe they are safe.
I agree with all the other disagreements. I would like to add two things:
1) Please stop comparing what we do in the U.S. with all the other countries in the world, as if what we do here is automatically wrong. Is it possible, just possible, that we have it right and they don’t?
2) Dr. Love, please try to explain to all of us what good it does to tell woman to care about their health even LESS? Do you understand that, no matter the stats and ’science’ behind this, all these recommendations will do is give a whole lot of woman the excuse they need to pretend like it “won’t happen to me” and “i’m not old enough for it to matter”. How many pre-50 year old cancer survivors must post to your comment site for your mind to be changed? Or for you to see what this is REALLY saying to women?
Talk about a step back for young women with breast cancer. Is my life not worth as much as a women over 50? I was dx in 08, stage 3 triple negative at the age of 37. Young women are dyeing, if you do not think so you are foolish. Also someone stands to make a lot of $$$$$$ with a new type of screening for breast cancer. Some one owns the patent to Ductal Lavage. Dr. Love should be ashamed of herself!
My wife was 25 when she felt a lump during a self-examination. Her doctor told her she was too young and not to worry about it. So my wife, trusting her doctor, let her tumor grow for over a year until a different doctor insisted on testing it.
She’s now 30 and Stage IV. Thanks to people like you, Susan, more young women are going to find themselves in this situation.
And for those of you who say anecdotal family stories aren’t relevant – go jump in a lake. My wife is not irrelevant and neither are any of the other younger breast cancer survivors whether you want to believe they exist or not.
I wonder how much the Insurance Industry is paying Dr. Love for her endorsement.
I believe your support of the position of the US Preventive Services Task Force on mammograms for women under age 40 is reprehensible.
Three friends, all under age 40, were recently diagnosed with breast cancer. Thankfully, they did self breast exams and had mammograms and will hopefully win their battles against breast cancer.
This is a huge step backward in the treatment of breast cancer. I don’t want any task force making this decision for women. I believe the task force recommendation, and your support of the recommendation, will be disastrous for the fight against breast cancer.
Dr. Love…
Please enlighten your followers as to your conflict of interest in this debate.
http://www.imaginis.com/breasthealth/ductal_lavage.asp.
Your own “procedure” is what you are espousing, not a lack of testing. You have your own interests at heart, not those of the breast cancer community.
Dr. Love, you have now lost my support. I was diagnosed at 40, after having my very FIRST mammogram. I shutter to think if I had to have waited 10 more years.
Open your eyes people! We should not be putting back mammograms until 50, we should be supporting BSGI and other digital mammography for people under 50 to detect and treat cancer in young, dense breasts!
Where is the responsibility for providing accurate medical information to the millions who watched the GMA show this morning????? Dr. Susan Love, in describing the value of early detection in slow growing vs. fast growing cancers, stated that, “if it is slow growing then it doesn’t matter when you diagnose it.” If it does not matter, then why diagnose it at all? If it does not matter, then why bother to treat slow growing cancer? This is patently absurd. In fact, it is medical malpractice to provide false and misleading medical information to millions. Dr. Love, who is often identified as an expert in this specialty and whose word has carried more weight in the past, was so eager to support her position and “win” the argument that she forgot the first rule of medicine: first do no harm. In times of great confusion regarding changes in diagnostic standards, her misinformation is particularly damaging. My hope is that those supporting delayed diagnostic screening will not resort to falsehoods to justify financial gain, and that GMA will issue a clarification to educate any who heard, and believed, this medical misrepresentation.
I am shocked and saddened by Dr. Love’s endorsement of the new BC guidelines. Why are you selling us out? I, nor several of my friends would be here if we had waited until age 50 for a mammogram. I’m a 10 year survivor BECAUSE of a mammo. And be sure, I want my grown daughter to recieve at least the same care I recieved…and regular mammos starting at 35 for her, 10 years before mine.
How dare you! I guess I would have been one of your ‘low statistics’ and not worth it.
Dr. Love has lost all my respect. I ask everyone to boycott her, Avon and Army of Women. I would be dead if my cancer had not been caught by a mamogram at age 36. Even after the mamogram neither my doctor or surgeon could feel the lump. Thanks a lot Dr. Love, I suppose having me buried would suit you just fine, but it’s not ok with me and I don’t want my daughters to have to worry about it. Yes, we need a cure, but early detection saves lives!!!!!
When I saw the news this evening and saw that Susan Love is now recommending mammograms are not necessary before age 50 I almost threw up. My daughter died at age 39 (found her lump at age 36). She followed advice that she didn’t need a mammogram before age 40. This was a girl who was very conscientious about her health. No history of BC in our family. There are now two children without a mother. You can take my name off Army of Women. I just lost all respect for Dr. Love’s opinion. I pray that she never experiences losing someone close to her because they were under the age she recommends for mammograms and the disease was found too late. I mean it. I want my name taken off Army of Women. Judith B. Letsinger-Hopper (hopperjudy@hotmail.com)
This is outrageous! How can Dr. Love say early detection and self exams are not important. If you feel a lump of course you have to go get it checked! This is just crazy. I am a 4 year survivor diagnosed at 46… thanks to a mammo. Let’s not let millions of young women die!
Hi -
I’m a journalist at the public radio show Marketplace. We want to hear from people who either have had mammograms, or who have been thinking about having one, as well as people whose businesses or workplaces my be affected in some way by the new guidelines. We have a form running down some questions online, where you can share your insights. Please chime in if you’d like to inform our coverage on the new guidelines. Here’s the link: bit.ly/3kEqBo
Thanks for reading,
Joellen Easton
Dr. Love,
Are you listening yet?
How many more woman do you need to hear from to GET it?
I am absolutely appalled by this recommendation. We have come so far with women’s health, and now to have this? It’s an absolute fight to convince young women to have regular breast exams, and now this will set that back even more.
I have two friends in their 30s who were diagnosed this year and both found the lumps through a self exam and sought treatment. To suggest that self exams have no value makes me want to scream! How dare you!!!
And isn’t cancer in young women rather aggressive? So why would the panel suggest that it isn’t necessary for women under 50 to receive exams? I am really searching for some clarity here.
Shame on you, Dr. Love, for endorsing these guidelines!!!!
Wow, Dr. Love I can not say how shocked I was to hear your comments on ABC’s Good Morning America. I was diagnosed by mammogram at age 41. At the time, I was the mother of 3, ages, 2, 7, and 13. I am 57 and have been blessed to see them grown, with the youngest college. I kept your, The Breast Book with me and read it like the bible as I went through my treatment. You indicated that mammaograms created a false sense of protection. That is a complicated statement and one I would never repeat to my daughters. Wow. -Jan
Folks, carefully read the statistical data printed in this article. I don’t think the government task force, Dr. Love, nor anyone else standing behind the new guidelines are trying to kill women – again — look at the data that has been reported for women overall. And remember, these are only recommendations to women – no one is denying the right to have a mammogram before age 50. This is a complex issue. Mammograms have their place. all the task force is reporting the data and statistics and reiterating that for the majority of women, they will NOT be affected by breast cancer in their 40’s (there are always exceptions). One reader on this board even commented on women in their 20’s having breast cancer — so are we to then move routine mammograms back, starting women on them in their 20’s? That’s the point. There are women in their 20,s 30’s, and 40’s who get breast cancer — however, statistically, it is rarer than when one reached age 50. The women in their 20’s and 30’s got mammograms and found their cancers despite the recommendation that they need no mammograms till their 40’s. So, if you still want mammograms in your 40’s get one. But, again, simply stating the research and statistics, it is rare for a women of this age to get breast cancer (yes, it happens, but the odds are thankfully against it). Kudos to all of you who have fought and won in the battle against this hideous disease.
There’s a saying that new truths go through 3 stages: dismay, redicule and finally acceptance (it’s something like that–). I think the same works for these new mammagram recommendations/guidelines. It is a big shift in thinking and most people aren’t comfortable with that. I think taking a deep breath, sitting back and looking at the situation objectively might help.
I am a 47 yr old diagnosed with triple negative BC. I don’t have any family history and my routine mammogram 1 yr ago was clean. It is appalling to think that I might have had my first mammogram at age 50 when my surgeon said she wished she would have seen me sooner when I had a 2cm tumor and clean lymph nodes. These new recommendations are going to lead to higher death rates in Dr love’s “populations of interest”.
Dr Love – happy to see once again your casual dismissal of DCIS and the women diagosed with it. Until the medical community can determine beyond a shadow of a doubt which woman will end up with invasive cancer and which woman will not, screening, testing, and treatment are not optional.
I was diagosed at age 46 via a mammogram. While my mother was dx with BC at age 62, because she was post-menopausal, I was told that the risk to me, her daughter, was minimal at worst. Lumpectomy, radiation, and tamoxifen and a year later diagnosed with LCIS after changes to a lesion found the year prior. Will I get invasive BC? Who knows? Will my daughters and nieces? Who knows? Will the insurance company deny payment for a 40 year old woman’s mammogram? Probably.
I will take anxious feelings and a false positive any day over the risk of not discovering invasive breast cancer until it is too late for treatment. Just ask anyone in your Army of Women.
Your Army just lost a recruit.
Hey, Nancy — are you actually reading any of this? Or just writing something that’s the equivalent of “everyone just calm down”? We are supposed to be fighting this disease with everything we have and instead a task force tells us to do LESS. Do you see the number of women here who would be dead if it weren’t for having caught their cancer earlier than age 50? Do you think this is just a small percentage of woman??? Let’s see how you feel about all this once YOU get cancer at age 41 and it’s not detected until age 50. We’ll talk then about who needs to take a deep breath.
Dr. Love,
I was shocked this morning when my husband showed me the newspaper article about the Task Force recommendations. I shook with anger.
Then I come to hear about your position on the matter. I could not believe what folks were telling me, so I came to your blog. I thought you would be the first to attack the recommendations. You are our advocate for breast health. You are a revered expert on the subject. So I took a deep breath and carefully read your comments and the responses, and sought out and watched the GMA segment.
I believe many of your arguments against early mammography and annual mammography for older women are statistically sound, but statistics don’t see the larger picture. Every single life saved by is precious, and a huge blow against the disease. I agree with you that this is a public policy matter. The respondents here are among those for whom policies are being established. Although these respondents, who are informed people with personal involvement with breast cancer, are as a group likely to be more opposed to the Task Force recommendations than the American public as a whole, I believe the American public will resoundingly oppose these recommendations. I, being a breast cancer survivor of 4 years, plan to be very proactive against these recommendations.
(I am reminded of the Verizon commercial where the Verizon guy and the cable guy are getting feedback from a customer focus group, and the cable guy says “I don’t understand why we are asking them their opinion.”)
I understand that mammography is an imperfect tool. At 53, my breasts were still so dense that neither mammography nor ultrasound could “see” my clearly palpable 4cm tumor. However I still encourage the women I know to get their annual mammograms. I encourage them to discuss other imaging techniques with their doctors.
I am sad to say I no longer have a dog in this fight. I won’t be affected by any change in insurance coverage for breast imaging. I haven’t had to have breast imaging since my breasts were removed almost four years ago.
I also am confused by your support for the recommendation that older women not receive annual mammograms. Older women are more likely to get breast cancer, and mammography is more effective on the less-dense breasts of older women. But, the only argument I see that you have for supporting that recommendation is that other places in the world perform mammography less frequently. That, for me, is not reason enough to reduce the frequency of mammography in older American women. That, for me, undercuts the validity of your other, more-sound arguments.
(I can hear my mother now. Would you jump off the roof just because your brother did?)
Yes mammography is imperfect, and yes false positives lead to anxiety and unneeded procedures, and yes we need a better screening tool and even more so a preventative for breast cancer. But we don’t have that replacement tool yet. Public policy maker should not throw the baby out with the bath water.
I won’t even get started on breast self exams. I found my tumor through self exam.
I work in a small rural Mammography Center. In the last 3 weeks alone we have had 4 women diagnosed with breast cancer. The first was 42 yr old this was her 2nd mammo her 08 studies were clean. The other 3 were 48, 52, and 54 who never had mammograms before. All read by a Radiologist with ACR codes of 5 These recommendations set the progress we have made for women’s healthcare back 25 years. Sorry Dr.Love I would rather have a radiologist be 100% sure I don’t have breast cancer and have a biopsy and have it be negative than not have a biopsy and miss a cancer and be in a losing fight for my life. I would rather put up with the annoyance of having a mammogram yearly and endure the compression for a few seconds then miss a cancer and not be able to see my boys get married or see my future grandchildren, and miss growing old with my husband. No thank you to OBAMACARE. IT comes down to the fact that insurance companies want to pay for less and less. Radiologist’s face the biggest ligation in reading of Mammograms so yes most are very conservative and would err on the side of doing a bx and having it be negative then miss a cancer. Maybe we should look at limiting the payouts in lawsuits against medical providers. It comes down to money fist women health issues, then children, then the old and the infirmed. What’s next death panels? Oops that’s what these recommendations are psuedo death panels for women.
I logged on to Dr. Love’s wesite to look for what I presumed would be her angered response to the new mamography recommendations. I am shocked. I was diagnosed at 42 with infiltrating ductal carcinoma by a digital mamogram, no family history or prior indicators. I referenced the Breast Book extensively, and have talked up Dr. Love’s prevention approach to those who will listen and stop buying pink external hard drives, et al, for the cure. When the new health care debates started, I argued ferociously with my mother that there will be no ‘death panels.’ Whoops ~ guess I would have been diagnosed much later when the cancer had spread, probably beyond much hope of a remission. I agree with so many here – do not abandon those women you will help to prevent ‘false positives.’ Like someone wrote earlier, no one died of a false positive, and until there are other resources, why stop what works the best to date? I am going to wait few days and try and read much more to see if I really want to quit the army of women and stop giving out the book to friends and family. I don’t think there are many reasons to stick around anymore.
One more thing – I think it is pretty telling that there was no e-mail blast from Dr. Love to her Army e-mail list after the mammoraphy recommendations were made. She just threw and article up on her website and let people happen upon it, perhaps to minimize the fire. When she is announcing a study and calling for participalnts – she doesn’t just post to her site. that would reach only a small portion of people – like she is hoping her article will.
Dr. Love:
I have worked on producing mammography equipment in the past 15 years, and spent all my careers on developing digital mammography systems that intend to detect cancer at the earliest possible stages. As part of my work, I worked closely with breast imaging centers all over the world and I know (and am sure you know better than I do) that many women found their cancers under age 50.
I want to let you know like you are, many people like myself are in our prefessions because we care about what we do. I have the opportunities to meet so many peole during breast cancer awareness events through the years, and the sprirts of those cancer surviors are what drive me hard at work. If you still rememeber the faces of those you treated, I can not imagine how can you ever say what you said last night.
You have been helping women through your great work. I am hoping that your supporters will continue to support your work, not your words from yesterday. As I believe what you do has a great cause.
I am so disappointed in Dr. Love’s opinion of these new guidelines. YOu have always been such an advocate for women and breast cancer. I was diagnosed with stage 2 breast cancer.( Estrogen positive tumor and 3 lymph nodes) I discovered it through self examination. How can you say it is not important. Even though I was over 40 when diagnosed I will insist that my daughters have mammograms at age 30 as my doctor recommended. I don’t care what this task force says. I think the insurance companies just don’t want to pay for any extra testing. Shame on them!!! and shame on you!!! How many women’s lives have been saved because they got mammograms and did self exams before the age of 50.
I will no longer support you or your organization until you change your opinion. And who are the other people on this task force ARe they being paid off by the government and insurance companies?
Also-wouldn’t you rather have a false positive then die???
I’m sorry to see all of the venom here and on the NY Times web site. Dr. Love, please know that your army has won a new recruit. Let’s focus on women who are sick and need all of your expertise and that of your fellow doctors and leave the healthy, asymptomatic women alone. I hope that no woman will have to lose a breast, or even part of one, to DCIS ever again.
Thanks, Dr. Love. You are taking a lot of flak for sticking up for science, not emotion. Many women and health-care workers are invested in the current system of regular mammograms and can’t look at the subject objectively.
To all those women who say they survived because they discovered breast cancer early through regular mammograms, I ask: how do you know the outcome would have been any different without the mammogram? In other words, you may have had a cancer that needed no treatment whatsoever. That is so hard for us to accept because it is drilled into us that early detection is the key to survival. If only that were true.
I wish we could accept that some aggressive cancers will kill us no matter how early we detect them and no matter how much chemotherapy or radiation we throw at them.
Mammography gives us a false sense of security. Thanks again, Dr. Love, for your willingness to speak out and take the heat.
this whole thing is absolutely unbelievable to me! I, too, am shocked to hear Dr. Susan Love, acting as though this is totally acceptable. While she indicates that the money from less than accurate mammography screening for women under the age of 50, could be better spent on other, more accurate ways of identifying breast cancer in younger women, there is no evidence that this study advocates this idea. nor does she put herself out there to demand such a course of action. For this study to suggest that women should no longer engage in breast self-exams (nor should their doctors routinely exam their patients’ breasts) is simply the MOST IRRESPONSIBLE thing I’ve heard in years! I, too, am a woman who found my own invasive lobular (very aggressive) breast cancer as a result of a breast self exam. I was Stage II (with a micrometastatic finding in one of my lymph nodes) when I found my cancer. True, the mammograms didn’t show it, but, ultrasounds did. Had I not been aware of my own breasts, and followed through on this, I would have been dead by the time I was a candidate for mammography according to this new study. I guess we are truly seeing the beginning of the new regime…welcome to universal healthcare!
Stand up, and fight healthcare rationing.
To those who support Dr. Love’s position because the science supports it — I am very scientifically minded. I don’t believe anything until it is proven to me. But on this issue, perhaps you (we) are missing the point that implying to woman that they can essentially ignore their health in this area until they are 50 years old is a large problem to create in itself. You are assuming that the majority of woman are going to be constantly up to date on the latest scientific evidence and follow accordingly. But that’s just not the case – you have to boil the issues down to the basics to make it “doable” and available to all, which is what 1) self-exams and 2) regular mammograms accomplish. You can’t tell people they can pretty much ignore this (because “self-exams don’t work” and “mammograms don’t find anything” and “early detection is a fraud”) and think that somehow they’ll be able to help their doctors with their health issues along the way. It seems to me this is putting ALL the pressure on the doctors to detect and none of the responsibility on the patients re: preventative care. And… just to be clear… are we somehow saying that self-exams and mammograms ordered in the past were all a big lie? Weren’t they based on something that still exists today? The American Cancer Society thinks so.
My breast cancer was found at age 47, via mammogram. Well, being treated for breast cancer was no walk in the park. I assume however, that there was a reason why I had surgery, chemo, radiation, more chemo, Tamoxifen, now AI. If that treatment was not a waste of time and money … then it follows that the mammogram itself was not a waste of money, no? I’m not quite sure what the dollar value of my life is – but I am grateful that my doctors, nurses and society was willing to take care of me and pay the cost of my treatment. I try to live my life in a way that makes the expense worthwhile.
Dear Dr. Love,
I have read these many comments and I know what a hot topic this is and I told my husband that you would not support these guidelines and then I saw your interview and I was shocked! I am nurse for the past 23 years and one year ago at age 45 was diagnosed with Stage II Ductal Breast cancer, which was 99.9% Estrogen positive! I had no family history, I was the 1 in 8 women who get breast cancer. Mine was detected through a breast self exam and I new as soon as I had felt it that it was breast cancer. I then had a mammogram which showed I had not one, but three tumors in my left breast. One year earlier my mammogram had been negative.I then had a biopsy and was dx with breast cancer. I had a left mastectomy and complete removal of all lymph nodes. I then had 5 months of chemo therapy.I now have developed lymphedema and i am dealing with these new challenges, however I am here to deal with these challenges because of self breast exams and mammograms. I believe that this is like the reaction when doctors said HRT was bad for you and put women in a place where they had to talk to their doctors to see what was best for them. I do feel that what you should have said was that we should look at all recommendations carefully and that we should not just have a blanket statement regarding such an important issue. I also have worked at research hospitals and know that there are certain ways information should be released and someone in your standing as an authority in your field should present a more balance stance on this issue.I believe in research, but I also believe in doing what works and screening through self breast exam and mammograms for women 40 and above works! I really hope you address your followers here and explain your feelings.I feel you owe it to all the women and men who look to you as an “expert” in the field.
Thank you,
Lisa Stewart
I am another woman considered expendable by the Task Force and Dr. Love. At age 48, I had no family history of breast cancer nor any other rusk fctors but thanks to a rountine mammography I was diagnosed with Breast Cancer. I had a large, aggressive tumor, stage II. I am now 60 and would be DEAD if I did not have that routine mammography.
When I was initially diagnosed I was given a copy of your book. I have since done the same for all of my friends who have been diagnosed. We trusted and relied upon you.I am shocked and disappointed at your reaction to the recommendations/guidelines and your obvious disregard for the value of my life. I feel betrayed by you.
Suzanne,
You ask women who have survived because of a mammogram how they know the outcome would not have been different without the mammogram.
Huh?
So: a 40 year old woman has a tumor growing in her breast but doesn’t know it because she hasn’t had a mammogram. But that’s ok because it might just maybe go away by itself.
A 50 year old woman has the same kind of tumor, a mammogram finds it, and now medical science says it’s ok for her to have a biopsy, lumpectomy,radiation,etc just because she fits into a statistical category that has been shown to benefit from mammograms?
Is this what you and Dr Love call sticking up for science?
Me, I’d rather stick up for my sisters.
This is just wrong. I was diagnosed with grade 3 DCIS on mammo at 47. Had I waited three more years for diagnosis, I would be terminally ill right now. What are you people thinking? I am not a statistic!
I am a breast cancer researcher, and also a volunteer with the Army. I was not surprised to hear about Dr. Love’s support of the recommendations– I had heard her opinions before at conferences–but was absolutely shocked to see her publicly endorse these recommendations.
From what I can tell, two main issues have been raised by the Task Force and echoed by Dr. Love with regards to screening mammography: 1. false positives i.e., benign lesions that are unnecessarily biopsied, and 2. overtreatment–maybe not all cancers detected by mammography will be life-threatening.
These are certainly valid concerns.
In the radiology community, lots of research is being performed today to try to improve screening tests to minimize the number of false positives i.e., benign lesions that are biopsied. Such research is critical, and scientists and clinicians should and do take it very seriously!
With regards to overtreatment concerns, can Dr. Love or the Task Force or anyone else right now tell me which DCIS lesions or which small IDC will NOT be life-threatening? As a scientist in this field, I can tell you the answer is NO. WE DO NOT KNOW RIGHT NOW. Prior posts on this blog lament getting mastectomies for DCIS–I *completely* understand their concern. But who is to say their DCIS was certainly one of the indolent ones? The problem is, scientists and clinicians CANNOT identify indolent lesions. So again, we come back to research– we need to better figure out which cancers are killing cancers and which are not!
So, just because there are some outstanding concerns about screening, should we change how we do things? No–we should do RESEARCH to IMPROVE the tests and our understanding. This is what research is for!!
And this is why I am so disappointed– the Army of Women is supposed to be about research. And Dr. Love’s endorsement is not only a blow to women under 40–who according to the recommendations should not do self-exams, should not get clinical exams and should not get mammography i.e., they should just wait around to get a big lethal cancer (as Dan Kopans said so well). Her endorsement also undermines her commitment to research. I will be withdrawing my membership in the Army of Women.
In response to Angela Bailey of Canada….you say we are behind the times and should not base our policy on “hysteria and anecdotal evidence” but on scientific fact? How about this for facts?!? The whole of Europe, the UK AND Canada have higher death rates due to breast cancer than the US!!!! These are facts! Changing our policy to match your so called better science would mean joining you all in seeing death rates due to breast AND other cancers increase not decrease as is presently the case in the US.
I am so grateful for Dr. Susan Love and her team of experts. I had my mammogram at 50 and was told something might be there, come back in 6 months, and then again, and again. Am I one of the lucky ones or am I not. To live with a maybe you have cancer is living in constant anxiety. My Dr was of no help. Only Dr. Love and her team have been able to give me the correct information to keep my anxiety in check. We have a generation of women who have been taught that mammography saves lives, it will take time to educate us all and understand. Thank you again Dr. Love and your team, you have my support and greatest respect.
Shame shame shame. Are you more interested in getting your “procedure” to be the standard test rather than mammography?? The fact that you believe those diagnosed in their 30’s and 40’s are expendable and lives aren’t worth the false positives is just disgusting. And how condesending could you be by stating “no one is taking away your right to be radiated”. Don’t patronize us. We get enough of that from the medical community and sure as hell don’t need it from you.
After the evening news on which Dr. Love appeared Monday night, a doctor from the Siteman Cancer Center in St. Louis appeared on the local news. She said that the data the task force looked at was not complete and if they had used ALL the data, their findings would have been different. Anyone can manipulate data to support their findings. I’d like to see findings of the true, complete data.
To those of you who say, “calm down”, “take a breath”, I say talk to us when you or a loved one has heard the words “You have cancer”, when you have the rug ripped out from under your feet, when you try to figure out how you’re going to keep working full time while going through treatment, when you have to explain to your children why you’re going to lose your hair.
To the survivors here who think they were over-treated, I say at every step in my treatment I had the option of researching my options for myself, of seeking a second opinion, and even of not having the mammogram in the first place (at age 44).
What I am saying is don’t take away or jeopardize our right to have our insurance pay for a routine mammogram at age 40.
And Dr. Love, I have no idea if you have any monetary interest in promoting this task force’s guidelines, but as a physician who has taken an oath to save lives, why are you advocating anything that could endanger even one life?
Dr Love,
I hope that no 29 year old mother of two in your family goes undiagnosed because of the new guidelines. SBE saved my life and I will collect cans if I have to to make sure that my girls get early screening. They may fall into the smaller percentile, but their lives matter to me and mine matters to them. You can take your Army and shove it up your ass. It’s clear that you don’t care about us and I don’t want to march with you.
As a 34-year old breast cancer survivor (diagnosed at 33) with no family history or obvious risk factors to speak of, I have serious problems with the USPSTF’s recent recommendation for new screening guidelines.
A breast self-exam saved my life and had I not preformed this test, and had I waited until even 40 to get screened, I probably wouldn’t have lived to receive my first mammogram.
When I had that mammogram, it lit up with suspicious calcifications. I was sent immediately for a biopsy. The mammogram seemed to work just fine on my “young and dense” breast.
There’s no telling how many other young women share this same story. It’s been proven that early detection saves lives, and all reports seem to show that breast cancer in young women in on the rise. Why, then, would the USPSTF want to push the screening age further back? Of all things, discourage self-breast exams?
After looking in the many faces of other young women like me, you can’t help but wonder why the screening age isn’t, in fact, lowered. That the USPSTF thinks women should wait until age 50 strikes me as simply outrageous.
This is absolutely insane. I was diagnosed with BC when I was 48. Never had cancer in my family and I was lazy at least on the self exams. Had I been smarter and gotten my mammo’s yearly, I could have been diagnosed sooner and probably not had to go thru chemo. As it stands I had surgery,chemo and radiation and am on a 5 year drug to try to prevent BC from coming back.
The fact that this is a government task force finding, in the midst of a health reform change, which to me seems to be leading to socialized medicine, scares me even more.
Women know that we are most vulnerable in our 40’s ,especially with estrogen based cancers, but I have met more women thru my experience going thru treatments in their 30’s than ever before. And they would die if not diagnosed. Furthermore belonging to group the Army of Women,I am furious that Dr Love herself has agreed with these new “findings”. We survivors must start getting involved to help our mothers,sisters,daughters,families, friends be able to fight this type of health reform. In ten years I would almost guarantee the breast cancer survivor findings will be much different, and not on the good side either.
Dear Dr. Love,
I am sad that you find it necessary to punctuate your belief that we need to change our standard for mammography by demeaning women (many of whom lives were saved by mammography) with your condescending comment “right to radiate yourself”. While I am in full agreement that mammography is not the best way to find many cancers (and in my case it totally missed it), the way that you express your opinion is dismissive and disrespectful. We may not all be doctors, but we still deserve your respect when addressing an issue that could impact our life or death.
Marianne Miro
Barbara, I had a mammogram 4 years ago, at age 54, and was told there might be something in my left breast and to come back in 6 months. Had the second mammogram, nothing had changed and was told to come back in one year. I was not anxious the six months waiting for the 2nd mammogram. I trusted my doctors and went about my life. This past Aug, I had my yearly mammogram and again the mammogram found something but in my right breast. Again I had total trust in my doctors and was gaining so much knowledge as to what the possible diagnosis could be. I remained calm, did some research online and waited for my doctors to give me the results. After another mammogram, ultrasound, biopsy, and a MRI, the results were stage 2 Invasive Lobular Carcinoma. The MRI detected cancer in my lymph nodes. The MRI also showed that my right breast was cancer free. The new guide lines of mammograms every two years would have worked for me 4 years ago, but not this time.
Young women, under 50, statistically have more aggressive growing tumors. How can anyone consciously recommend these guidelines without a better alternative????
I am appalled by these new guidelines. I was diagnosed with breast cancer this past July at the age of 43. There was no history of breast cancer in my family. I thought I had done all the right things to prevent breast cancer including having my first child before the age of 30, breastfeeding, eating in a healthy manner, and exercising diligently throughout my life. Because my invasive cancer was caught by an annual mammogram in an early stage, I did not require chemotherapy and have an excellent prognosis. I shudder to think what my prognosis would be if my first mammogram was at the age of 50.
I understand the difficulty in identifying breast cancer tumors in young women with dense or fibrous breast tissue. However, my personal breast cancer journey began with a diagnosis at age 38, when my gynecologist discovered a lump during my annual physical. The lump did not show up on mammography even after knowing it’s location, and ultimately turned out to be a 0.8 CM DCIS. I didn’t regularly do BSE because I really had no idea what I was feeling or not feeling. What if I had not been consistent on my gynecological care? The lump would like have gone unidentified until later.
Many, many of my friends were diagnosed before the age of 50, some with mammography, although no all. 1/1900 women age 40-49 have breast cancer per USPSTF determination. July 2008 US population estimate of women age 40-49 = 22,327,592. The new guidelines could
result in 11,751 US women/year going undiagnosed with breast cancer until later stages.
I believe the new guidelines are short sighted and will likely increase the number of late breast cancer diagnoses and deaths.
My mother had Stage 2B detected by mammogram 18 months after her last clear mammogram. If she had waited two years, her cancer would have had 6 months to spread.
My cancer was detected at age 42 on mammogram. In clinics, support groups, and online boards, I cannot tell you how many under 50, no family history women I met battling Stage 2 or 3 cancer. I am certain deaths, or later stage detection will rise if these guidelines are followed.
Really?! All in an effort to save money. I find this appalling. I found my cancer (5-6 cm tumor)after a self breast exam. Just 3 weeks before finding that I had a clinical breast exam which detected nothing. I was Stage 3 within 3 weeks of not feeling anything. I was not in the high risk category. Had I not done a SBE I shutter to think what stage I would have been. I was 32! I was sent for a mamogram but with the new recomendations would that have been harder to do? What will these new recommendations do for the next person (people) with a case like mine or the many people I know who had their cancer detected by mamography (in their 30’s or 40’s). I have been a member of the Army of Women but will not be apart of it anymore.
Here is a link to the USPSTF website for the details of their new recommendations, and their summary:
http://www.ahrq.gov/clinic/uspstf/uspsbrca.htm
Summary of Recommendations
The USPSTF recommends against routine screening mammography in women aged 40 to 49 years. The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account, including the patient’s values regarding specific benefits and harms.
Grade: C recommendation.
The USPSTF recommends biennial screening mammography for women aged 50 to 74 years.
Grade: B recommendation.
The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of screening mammography in women 75 years or older.
Grade: I Statement.
The USPSTF recommends against teaching breast self-examination (BSE).
Grade: D recommendation.
The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of clinical breast examination (CBE) beyond screening mammography in women 40 years or older.
Grade: I Statement.
The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of either digital mammography or magnetic resonance imaging (MRI) instead of film mammography as screening modalities for breast cancer.
Grade: I Statement.
Please pay attention to the recommendation grade. For example, the recommendation grade is C for the 40 to 49 group. If you read the definition of Grade C, it basically means that the recommendation was made WITHOUT strong scientific evidence.
So for those people who make claims that the decision was made by a group of independent of scientists based on science, they need to understand how the conclusions were reached by the committee. It is NOT based on science. But rather the recommendation was made based on the AGREEMENTS by the “experts” served on this task force. What’s more disturbing is that there is nobody on the panel who has experience in mammography, and in breast cancer treatment.
Just facts.
Dr.Love had been my “hero” when I was diagnosed with Stage 1, IDC in 08/08. Her book helped me in my decision making process, much more so than my doctors. To hear her on NBC Nightly News, supporting these Task Force guidelines, was disappointing to say the least! I am 55 yrs. and my tumor was found at 1.3 cm, on my yearly mammogram. How big would it have been if I had waited two years as recommended by the Task Force! I am a trained medical professional, in laboratory medicine. Let ME decide if a biopsy is stressful. I was able to have a lumpectomy & radiation. If you want to talk about stressing a patient, tell her she now has to have chemo because we didn’t find it soon enough!
I just emailed to have my name and membership deleted from An Army of Women. Your stance on this issue makes no sense! I am 59 years old and have had a mammogram every year like clockwork. In June 2008 they found a mass which turned out to be invasive breast cancer, I had surgery, radiation and now return to the doctor every three months for follow up. I was told that if I had waited and not had the mammogram when i did the outcome probably would have been much worse. I’m sorry these new recommendations smell like insurance companies are dictating the decisions.
I think your army just deserted!
Dear Dr. Love,
I am speechless at your condoning these recommendations re. mammograms!
How in God’s name will you sleep at night knowing that there may be thousands and thousands of MOTHERLESS children because of these new guidelines!! I am married to a gynecologist, and as he said, they are not interested in saving lives, they are interested in saving money!! Better get yourself a sleeping aid to deal with the guilt, as well as a HUGE fall in your patient load!!!!!
I am also appalled at Dr. Love’s stance on this issue. I was diagnosed with triple-negative, agressive BC at age 49 in a routine mammogram. It was deep and not even the doctors could feel it. If I had waited just one more year, it would have been much larger. My 2nd cousin had the same diagnosis with a larger tumor at age 39. Had she been getting mammograms since 35 (which is when I think they should start), it would have been much smaller, perhaps saving her breast. I was planning a year-end donation to the Love Foundation, but definitely will not be sending it now.
The general’s mind has gone AWOL! I was promoting army of women to many. Brilliant idea I think (army of women) but the leader of the pink army has lost a HUGE amount of respect. We need a new general.
All you have to do is visit some breast cancer forums to see how many people were saved by early detection. If you are so desperate to save money I can understand the mammogram recommendation (though it will kill many). But supporting no self exams is extreme reckless behavior. Why, why would they recommend that. All the 50 and under cases are to die? What about all the motherless young children? I also can not believe the ignorance of thinking it must be ok b/c Europe does it. They have horrible health care people. Talk to people who live there. The wealthiest of people fly to the USA for care. Educate yourselves people.
I agree that we need improvements in the system BUT they are jumping ahead of themselves. I agree that getting rid of radiation is the way to go. We are not ready though! Yes, we need better tools, but are we to raise the death rate to get there?
I was not high risk and 44 when diagnosed. My eight year old daughter would be without her mother had it not been for the care I received.
The PINK army needs to take this to the streets! Our lives DO have meaning!
Dr. Love: Will you respond? It is difficult to advocate for Army of Women when so many are outraged with the new recommendations.
Good for Dr. Love!! I hope she stands firm against all the rage that is being directed at her. I was diagnosed with non-invasive DCIS 3 years ago and had a lumpectomy. (I found it myself during a self examination) Unfortunately, they did not want to stop there. I was sent to a radiologist who took it for granted that I would also have radiation and tamoxifen. Because I had done research on my own, of course I refused. When I told him of my decision and why, his reaction was offensive, insulting, and he tried to frighten me into changing my mind. The fact is that many physicians will over diagnose and subject women to possibly harmful radiation and dangerous drugs even for stage 0 “cancer”. Hopefully it is out of ignorance and not because it is an industry and it is their livelihood. Having said that, The anecdotes about the lives that were saved can not be easily dismissed and ignored. However, my hope is that the 180 degree turn that these new recommendations represent will cause women not to take doctors recommendations at face value, do their own research, and make educated decisions based on facts and science, not emotions or fear.
I am a 15 year survivor of BrCa with which I was diagnosed at age 44. I am not unique.
I am disgusted by Dr. Love’s stance, particularly since the panel of experts does not include an oncologist. The study was completed on older mammography equipment.
Statistics are merely numbers, and the insurance companies look for excuses at the expense of lives to cut costs.
I absolutely do not agree with the new recommendations for breast cancer screening.
At age 40 I had a base line mammogram. I was happy to learn I had healthy, albeit, dense fibrous breasts.
At 42 I found a pea size lump in my right breast when performing my monthly self breast exam (now not recommended to do). My doctor sent me for a mammogram and also did a needle biopsy. The biopsy was clear, however, the mammogram indicated micro calcification’s. Another biopsy was performed which removed the lump and surrounding tissue. The lump was indeed just a cyst but I was diagnosed with intra-ductal carcinoma. I had a modified radical mastectomy. My cancer was Stage 1 and had not reached the lymph nodes. It was detected early enough that I did not have undergo chemo or radiation.
I wonder if the current recommendations were in place then, would I be alive now, writing to you at age 60?
I whole heartedly believe that the mammogram and doctor who read it saved my life! I also believe that the only thing the new recommendations will accomplish is to allow health insurance companies to deny younger women a form early detection in order to boost their bottom line. Or, is this recommendation released now in advance of a National Health Insurance to “shave off” costs being told to the American people? Conspiracy theory?? Hmmmm…
Dr. Love, I am shocked that you are aligning yourself with the new recommendations. Over the years I have heard you speak to all women that early detection can and does save lives. Why now, are you reversing your stance for women in the 40-49 age bracket?
As you can see from above I fell into that category 18 years ago. To whose benefit would it have been if I even reached the age of 50 for my first mammogram? Oh yes, of course, the insurance company that paid most of the fee’s to allow me to survive!
I understand that we must find a cure for this horrible disease, but until we do, resources for early detection must be kept available to ALL.
What about Thermography???
My Thermogram found my breast cancer when my Digital Mammogram did not!!!!!
Obviously the posters who are expressing shock and anger at Dr. Love’s support of the new recommendations have never actually read any of the research on her website. Apparently, she has been putting the facts out there regarding the efficacy of mammograms and SBEs before age 50 for years and years.
Amazing that such an expert on breast cancer would agree with these ridiculous findings. I was diagnosed at age 30 but not with a mammogram.I have a family history but tested negative to BRCA1 and 2. I know so many more women now in their YOUNG 40s who were diagnozed via mammogram on their 1st screening. You are gonna tell me that that cancer wasn’t growing long before that mammogram screen picked it up? Shame on you Dr. Love. I wonder how many 40 – 50 year old breast cancer survivors are going to want to be soldiers in an Army whose leader thinks they don’t matter. What do you say to all the survivors alive today whose cancer was picked up on a mammo between ages 40 and 50?
As a woman with boobs and at risk for breast cancer, I sure hope Michelle Obama has enough sense to kick her husband and his stupid health care reform right where it hurts.
When I first heard about the task force’s recommendations, I was in disbelief. When I saw Dr. Love on Good Morning America supporting the recommendations, I wanted to scream. I was diagnosed with DCIS with a microfocus of invasive cancer thanks to a screening mammogram at age 42. No family history of breast cancer. I wasn’t very good at self-exams because my breasts were “lumpy.” I had a lumpectomy and sentinel lymph nodes removed. Cancer was ER/PR positive, and biopsy showed a second cancer within the tissue removed. I had 7 weeks of radiation and have been cancer free for four years. Can you imagine my daughters’ lives right now at age 8 if my cancer hadn’t been detected early? Shame on you, Dr. Love. Every life saved through screening mammograms starting at age 40 is worth lifetimes more than the inconvenience of some women having false positive results, which are determined to be true negative results on further examination. All those women with false positives should be getting on their knees and thanking God when they learn they don’t have cancer.
Dr. Love, I first came across your name when my mother was diagnosed with Breast Cancer and was given a copy The Breast Book to help me uderstand what we were dealing with. May my mother rest in peace. I have given your book to many women and have been a true supporter. I have always agreed with your strategy to find the cause so we can help with a cure. So much so, that I helped to organize a charity event benefiting the Dr. Susan Love Research Foundation and sent you a check for $30,000. What I can’t understand is how you expect us to carry on until you find the answers to the cause through your research. That is the future – hopefully a future filled with the answers to this disease that you’ve been searching for. How can we fight today? How can we prevent another from dying today? The answer – early detection. How do you detect early – mammogram screening and self breast exams. I will continue to fight for my life by demanding to be examined. I deserve it, my life is worth it. My mother is not resting in peace at this very moment….I know she is appalled at the decision of this government to make such a statement and at those that support the guidelines. I will no longer be and advocate of your foundation and will withdraw my financial support. I wish you the best of luck in your endeavors in research. But we need to live TODAY. Ironic, I had my mammogram today!
A mammogram at age 40 saved my life. At the time of my diagnosis I was living in a foreign country where routine mammograms are not performed until age 50. I insisted on having my first mammo at 40 simply because I knew that the US guidelines recommended it. The mammogram spotted my early stage invasive cancer straight away and I am here to tell the tale. Mammograms do save lives even in women under 50 – just because there are fewer of us, does that mean our lives don’t count??
Dr. Love, please do your best to educate the world about DCIS. The New York Times hasn’t touched it. Strangely, the best discussion I have seen of it is on a Newsweek blog.
I was diagnosed with DCIS a few months ago at the age of 46. It was low-grade, so, as you describe in your book, it was spread out and hard to pinpoint. Like a good girl, I had a lumpectomy, but not surprisingly, the margins weren’t clear. Now my choice is a re-excision, which will be cosmetically unappealing, or a mastectomy, which is a major surgery that I would rather not endure.
Do I feel like a survivor? No. I can’t help but think that I wouldn’t be sitting here with a big scar if I lived in Vancouver. Or if these recommendations had come out a year ago (and you can bet, I would not have gone for my mammogram, given my lack of risk factors). I consider myself the poster girl for unnecessary treatment.
I saw your appearance on the MSNBC web site and was very impressed. Please don’t give up.
Well, here we are back when women’s lives mattered little. I think 1 in 1,900 cases is a large number of women to tell they don’t matter because that is what this study is telling them. I, for one, think 1 life is too many to lose to breast cancer.
Those with DCIS – don’t get complacent – my sister’s breast cancer started with DCIS and was local disease by the time she had surgery to remove the breast and was well on it’s way to metastisizing. My other sister was diagnosed at 45 with a very agressive breast cancer – the same my mother was diagnosed with 2 years before. The kicker is that my sister with the DCIS was the first member in my family to be diagnosed with breast cancer – ever.
Dr. Love you should ask Susan Komen if the recommendations are a good idea – oh but you can’t because she died of breast cancer with the ‘wait and see attitude’ and she was 36. I won’t resign from the Army of Women because I think we need to do all we can to fight the disease. I will just bear in mind that some of us are expendable because of our age.
SHAME, SHAME, SHAME ON YOU!!!
I had my first mammo at age 35 in 1987, thanks to a pro-active gyno. It showed calcifications. I had an annual mammo until 1997, when a different gyno, following the “guidelines” at the time, told me I only needed them every 2 years. Unfortunately, I trusted him. Several months later, I found a lump, had a mammo, which was inconclusive (found something, not sure what it was). My PCP, radiologist, gyno – none of them would recommend a biopsy over waiting 6 more months for a followup mammo.
I demanded that my PCP give me a referral to a surgeon, told the surgeon I wanted the lump removed, not just a biopsy. Turned out to be a small cancerous tumor – WITH POSITIVE LYMPH NODES. I was then required to have chemotherapy & 7 weeks of radiation.
If I had not skipped the 1997 mammo, it could have been found sooner, before it had spread to the lymph nodes.
How much does it cost to find cancer early, as opposed to treating a more serious case? My radition alone was $40,000 in 1998. My chemo was almost that much. My surgery was also substantial amount.
A mammogram costs around $200.
I’d rather go through 10 false positives than go through chemo again.
The new digital mammograms are safer, and there are also ultrasounds & MRI’s if there are questionable results. So there’s no excuse for telling a woman not to get an annual mammogram. It not only saves lives – it saves money.
I turned to your book when I was first diagnosed, but I’ve lost all respect for you. I’m leaving the Army of Women. You have let us down very badly.
At least HHS Secretary Kathleen Sebelius is using her brain. She stated today that the US government is NOT CHANGING there recommendations for mammograms.
A comment on the post from Canada. My friend’s sister-in-law was living in Canada when she was diagnosed with breast cancer. She was told she would have to wait 6 months just to get an MRI. She and her husband moved to the US temporarily while she underwent treatment here. They decided they would rather pay for treatments here than wait until it became available in Canada.
Dear Susan,
I was surprised when I realized your stance on the new recommendations, but was certainly willing to hear what you had to say because I do consider you to be an expert. The problem for me was that during the interview I watched with you and a man from the American Cancer Society, you kept butting in and speaking to/over him in a condescending manner. I wanted to hear HIS views as well since a change in screening could potentially affect my health and that of others I know. I had a right to hear what HE had to say as well. You were disrespectful to him and a bully. Your stance is not why I’ve withdrawn my support for your “Army,” but it was your obnoxious know-it-all attitude.
This makes so sense to me. False positives are a reason not to test? I’ll take anxiety over actually having cancer any day. Also, even if the mortality is “only” reduced by 30%, isn’t that better than nothing? You also cite that 50 is an average menopausal age. Average! My mother went throught it at 42. I am almost 40 and experiencing early signs. I personally know SEVERAL instances where a mammogram saved a life of someone in their 40’s–high risk or not. Also, you yourself up until 2 days ago recommended women start screening in their “early 40’s” despite the “controversial” recommendations that were in place. If insurance companies take this recommendation as gospel on which to base benefits (and they will) this could be disastrous. Even those who have risk factors will be fighting to get a mammogram covered. This is not good medicine…In fact it smells a lot like politics to me.
The plot has thickened. The liberals who got the Obama administration elected are trying to get their “dues.” The SPIN on the govt-appointed task force’s (which included NO oncologist or radiologist, and was not PEER reviewed)findings is worse than any political election.
Dr. Love has a steering committee for her foundation. Fran Vesco, who founded Breast Cancer Action, is on it. Breast Cancer Action is really the only group I could find which seems to completely agree with this nonsense.
This “preventative” (don’t you just LOVE that name) task force is only looking for ways to “save on wasteful spending” that the administration has promised that will pay for the proposed new health care plan.
People are starting to ask WHERE all the waste is going to be cut. And women’s breast health is first on the chopping block. Let’s hope and pray these “recommendations” do not become “policy” in a 20,000 page congressional bill that no one reads and the vote is taken at 3 am.
I,like so many other women feel as if medicine as taken a giant step backward. My sister died with breast cancer at the age of 28 because this was before screening was done. I also have a sister 45 that is alive today because of screening. If these guidelines are followed and screening is reduced what will the outcome be? How many women will die before, in another ten years, a new study is done that states yes screening should be done to help prevent cancer. My prayers are with all women at this time.Without screening prayer may be all we have left.
Dr. Love, Please – respond to these replies! I was diagnosed at 44 – my INVASIVE tumor found by a mammogram, and not a digital mammogram. It was non palpable – and 10 doctors at 2 cancer centers could not find it manually knowing where it was. I have no family history and if these guidelines were in place would not have had mammograms.
My life matters. 1 in 1900 does matter – just ask my kids and husband.
How absurd to compare the stress of a negative biopsy from a false positive mammogram to saving lives.
Most of the women I know are diagnosed in there 30’s and 40’s without risk factors.
Please respond.
I am one of those who found a lump through diligent self-examination. Who is better to recognize early changes than someone familiar with her own breasts? My cancer was fast-growing and was not detected by mammogram. With these guidelines, I am pretty sure my diagnosis would have been beyond Grade 2 by the time the lump was large enough to be noticed. This is the scariest thing I have ever heard. Please rethink this one. All women need the opportunity for early diagnosis and treatment. I believe that these guidelines will be used by insurance companies to limit coverage for tests that we have fought so hard to obtain! The statistics show that we are doing better in the battle but we have far to go. Why set us back??????
Thank you for your feedback everyone. Please read this special message from Dr. Love http://blog.dslrf.org/?p=116
I am saddened and sicken by Dr. Susan Love’s recommendation’s regarding not having mammograms until age 50. I would be dead had I not gotten my mammogram. After many years of normal ones a mammogram detected stage three cancer . So now…the supposedly queen of breast cancer has gone against women of all ages. How could you do this? This is only going to confuse women, discourage them from getting mammograms that could save their lives and insurance companies now won’t have to pay for the much needed screenings. Dr. Susan Love, how can you sleep at night?
Just another woman still kicking thanks to a routine mammogram. My tumor went from 0 to over an inch in less than the two years recommended, and I was 44! I didn’t know I had family history, so I would have waited 6 years had I followed Dr. Love’s endorsement, with the tumor doubling in size every 60 days. So what are we going to do about it? If you have ideas about protest, specifically a march of women who would have died, or an art project or something, let me know at MotherEarthBooks@live.com
Don’t do BSE because we can’t prove it can find tumors at a curable stage? What???? If there is a chance in a million, I would want it. Even if not, I would want to know I had incurable cancer at the earliest possible moment, to give myself the most choice about how to spend my days. How can we so disrespect a woman’s right to know just to save a few bucks on false positives? Or are we still mired in the condescending ethic that women are better off not knowing because they’ll just worry? We don’t tell me not to do testicular exams despite that possibilty. We don’t tell them not to get a PSA even though there are false positives. We must organize a response, or we will be written off as “anecdotes” as the next generation of young women die.
I’m completely appalled by this giant step backwards.
1) For those who posted about agreeing w/ Dr Love because they were “over-treated”, this isn’t about treatment, this is about EARLY detection and testing. Treatment is a totally separate issue. The point here is about FINDING the cancer. First you need to FIND it and then manage and deal w/ treatment. How can you possibly agree w/ supporting NO early detection theory because YOU were over-treated? Many will die (and are dying) from not detecting soon enough. Look at the whole picture and think about others LIVES please. Not everyone had your same experience or cancer type.
Once people know they have cancer they can then figure out what treatment is best. If some people are over-treated as a result of early detection that’s unfortunate, but don’t blame the “knowledge” of the cancer’s presence for an Oncologist over-treating you.
2) For those who posted about the other countries waiting until 50 -saying US should jump on the band-wagon….just because other countries do it doesn’t make it right and many woman die as a result. Apparently YOU haven’t had a loved affected by this, have you? Maybe you’d change your mind if you did.
3) For the woman who agrees w/ Dr Love because she never had a mammo and found her own cancer: did you know the guidelines also advise against self-exam? Before you agree w/ Dr Love, read all the guidelines….where would you be if you listened to them back then?
In general I am sickened. Here, we’ve been trying to teach women to be in touch with their bodies, self exam and report changes. We advise women to get mammograms on time. If my best friend (in her 40’s)had been doing self exams and was on time w/ her mammogram, they would have found the cancer much sooner. She would not have stage IV today. She will die young as a result. And here you are taking woman completely backwards. Why is saving lives being minimized? Mind boggling and angering!! We have to fight this. Going backwards should not be an option.
I found a small lump 14 years ago at age 39. Had lumpectomy/radiation following the diagnosis of grade I/II invasive cancer .5cm with no lymph node involvement. No matter how many mammograms I had it never showed up. Now 14 years later age 53 with still dense breast tissue I had a breast MRI. We found another tumor, same breast and quadrant (new cancer)1.5cm invasive grade I/II (no lymph nodes left to biopsy) but Oncotype DX score of 16: low grade slow growing, 10% chance over 10 years to possibly lead to anything more. This time I had skin saving mastectomy/reconstruction because second round of radiation is out of the question. I have had over 20 mammograms since age 39 and this tumor was never seen. Even after MRI, knowing where the mass was, the tumor was not seen. I believe that this tumor was there, in my breast 14 years ago, most likely smaller, but there none the less. I also believe that my first tumor, perhaps needed to be removed for my own peace of mind, but that radiation to the whole breast was overkill. But even if I did not find that tumor, I am not so sure having it sit for these 14 years would have been a worse scenario for me, since my second one was sitting there doing no harm. My oncologist commented about the fact that 14 years ago if my first tumor was the size of this one I would have had chemo no mater what. “We over treated women back then” was her exact words. Lets look forward 10 years and we will be saying “We over treated women back then”. We just need better tests and screenings to give us chances for better decisions. I know we will get there.
With all respect I am very disappointed that you support the new mammogram guidelines. The lump I found, at 36, was not cancer. The mammogram taken, because of the lump, found the malignant micro-calcifications.
Don’t you really believe healthcare for breast cancer shouldn’t move backwards?
This proposal is an absolute outrage!!! Are you really a proponent for saving women’s lives?
My dear friend Patty had her baseline at 35. At 41 had her second mammogram which showed 2 tumors on one side and she was already at stage 3. After aggresive treatment, she lost her battle with this ugle disease 18 months later. She left behind a devastated husband and 4 beautiful, young children.
Please reconsider your stance!! Many lives of mothers, daughters, wives, sisters and friends are now at risk!
Dr. Love–I’m a 2x bc survivor who was not in a high risk category and whose bc was found, both times, by mammography. I found it curious that we should not do self exams because we might find a lump that just might kill us; I find it curious that ultrasound was not suggested for younger women; I find it curious that the cut-off date is 74 y/o (why not 73 or 75.2); and I find it offensive that anyone determines what my appropriate level of anxiety should be–that’s just plain rude and patronizing. As someone who has admired you for a very long time, I think you need to offer a better explanation than you did on your blog.
wow, it’s very evident by all these comments that a lot of women get diagnosed in their 30’s and 40’s. These are the ones in 1,900 that mammograms actually helped???? Are these lives worth saving to you Dr. Love? I was diagnosed at 44, just finished chemo and am headed to radiation. I thank God every day that I was familiar with my breasts and felt my lump, followed with a mammogram rated a bi-rad 5. I am so thankful that I have good doctors who care about my life taking care of me. I have lost all respect for you. To those of you leaving comments supporting Dr. Love, I notice that none of you have actually been diagnosed with invasive breast cancer, hmmm, interesting. Good luck to you, hope you don’t have cancer now and wait till 50 to get checked out.
MediaCurves.com conducted a study among 600 about the new guidelines released by the Preventive Services Task Force of the Department of Health and Human Services recommending against regular mammography tests for women under 50 years old. Results found that the majority of physicians (78%) reported that they do not agree with the new guidelines. Furthermore, the majority of physicians (78%) also reported that the advice they give to patients will not change based on the new Preventive Services Task Force of the Department of Health and Human Services guidelines.
More in depth results can be seen at:
https://www.mediacurves.com/HealthCare/J7646-MammogramGuidelines/Index.cfm
Thanks,
Ben
One of the posters made a very good point related to the technology of mammograms. Obviously if they are yielding too many false positives while
ramping up radiation exposures ove years, and if they are not even finding the very lumps they are supposed to,m too many times, then someone should be on the air waves suggesting an investigation of the technology and how it is hindering or hurting women in their quest to be properly screened for breast cancer. As I recall some time ago the same was brought up about other health screening technologies. Might I dare to think that the INDUSTRY making megabucks off women might shrink from a Congressional investigation of mammography and the state of the art.. as well as some of the ill trained techs who perform these.. or the erratic procedures and machines from city to city, state to state. Let’s dig deeper and find out.
With all due respect to survivors’ posts here, but don’t you understand the concept of overdiagnosis? Just because your cancer was diagnosed doesn’t mean it saved your life. It may well be the case that your specific cancer would’ve never spread if remained undetected. If every single cancer detected by mammograms corresponded to lives saved than the statistics would’ve looked very different than it does. Studies show that as much as a third of mammogram-detected cancers represent overdiagnosis and you still claim that in your specific case it was not? The number of DCIS is not high enough to account for so much overdiagnosis. Some early invasive tumors may well be among overdiagnosed cases as well.
Cancers spread at different speeds. Some are so aggressive that would kill you anyway and because they spread so quickly they are the ones mammograms are more likely to miss or find after they’ve already spread. Some spread so slowly that even if they are found later e.g. when you can feel the tumor they are still treatable. Some are indolent, regress or spread so slowly that they will never cause problems in your lifetime yet if found with mammograms you’ll be treated and suffer side effects of the treatment, potentially life long side effects. Mammograms only make a difference to a specific subset of cancers – those which are destined to spread between the time they are diagnosed with mammograms and the time you notice them. Unless you have a crystal ball, you don’t know which is which.
Yes you may be this 1 in 1900. But you also be one of the women to have received unnecessary treatment…
I guess I am also one of 1900 diagnosed before age 50 because of my mammogram. Regardless of what you might think I know that mammo saved my life. My lump was very deep and could not be felt, but was aggressive. Instead of loosing my breast, or worse my life I was saved by a lumpectomy, chemo, rads and now an AI….I am thankful for that mammo and the fact I am still here with my family.
I am concerned that my daughter will not be able to get her mammo covered early even though she is at risk because of my cancer. My Onc encouraged her to have a baseline this year (25 years) and go from there as indicated, but her insurance has already refused to cover it as she is not “at risk enough”…this study only gives insurance more reason to say NO (a word they already love and use often)
Prevention Task Force…..16 members. 12 are educators and 4 are medical directors/officers. No practicing oncologist is involved with these recommendations.
The findings of this task force is insane at best, and it seems that we have a whole new Army of Women at hand here. An army that we, who have or had breast cancer, should be on the task force, instead of a government appointed panel of people who obviously have no idea what they are talking about. The whole study reeks of pushing this country towards socialized medicine, where you will not even have the choice of whether or when to get a mammo let alone treatment should you be diagnosed.
I was diagnosed with BC when I was 48. Had I been smarter and gotten my mammo’s yearly, I could have been diagnosed sooner and probably not had to go thru chemo. The only part of that task force I would even remotely agree with are the self exams. My cancer was too deep at the time of discovery to be felt and it was already 2.5 cm. By the time I would have felt it, well I am just so thankful for a primary care physician that ordered a chest x-ray as part of a physical,and a radiologist that picked up a “shadow” and suggested a chest cat scan and mammo.
As it stands I had surgery,chemo and radiation and am on a 5 year drug to try to prevent BC from coming back. Women know that we are most vulnerable in our 40’s ,especially with estrogen based cancers, but I have sat with, during my chemo and radiation, more women who are much younger, too many in their 30’s and one who was 27. And they would have died if not diagnosed early.
Furthermore belonging to this group, the Army of Women, I am furious that Dr. Love has agreed with these new “findings”. I urge her to please reconsider, and listen to us, the survivors. We as survivors must start being involved to help our sisters,daughters, families be able to fight this disease, as early as possible. I want to belong to a group like Army of Women, to support and be supported by women going through this… but not if it follows these ridiculous “findings” and can contribute to any woman delaying early diagnosis of BC. There are too many women terrified to get a mammo tobegin with. This just gives them a very dangerous excuse not to get one.
Please remove my name and e-mail address from all further correspondence from the Army of Women… After watching Dr. Love on national tv state that she agrees with the guidlines for not starting mammograms until age 50,I have lost all respect for her and her beliefs in regard to when to begin annual mammograms.
My 44 year old daughter lost both breasts to cancer last fall,we do have strong family history, but there are 5 women in her age group in her daughters freshman class at school that also were diagonosed in their 40’s about the same time she was, with no family history of the disease. all have gone thru chemo and or radiation treatment. I shudder to think where these 6 women would be if they had not had their yearly mammograms, which revealed in all of the womens cases their cancers if they had waited until age 50 to have their mammograms. I am deeply disappointed in Dr. Loves support of the latest recommendations.
Wow. A lot of negative responses to Dr. Love’s support of new mammogram guidelines. I had a mammogram and it did not find anything. Yet I was diagnosed with DCIS. I think the negative reaction is due to lack of understanding of the medical details involved. Every case is different. Just because a mammogram finds cancer in one person here or there out of the millions of women taking the test does not mean that everyone should take the exam. And the guidelines don’t FORCE you to NOT take the test. If you are at high risk, common sense would dictate that you should probably take the test before age 50. Even before these guidelines, my doctor was insistent that I take a mammogram after 40, but I didn’t because I don’t have any risk factors. And my diagnosis for DCIS was low grade and considered precancer. I don’t think there is a need to lash out at Dr. Love or anyone else who supports the new guidelines. You can make your own decision based on your history, risk factors and doctor’s opinion.
Are we really reading the recommendations here?
The following is quoted directly from Dr. Susan Love’s blog.
The new recommendations are:
• Screening mammography should not be done routinely (routinely being the operative word, here) for all women age 40 to 49 years.
• Women and their doctors should base the decision to start mammography before age 50 on a woman’s individual breast cancer risk and her understanding of the benefits and harms.
• Women age 50 to 74 years should have mammography every 2 years.
• More evidence is needed for the USPSTF to recommend for or against screening mammography after age 74 years.
The choice for mammograms before 50 is left to the woman and her doctor.
Women over 74 are not automatically ruled out of screenings. More evidence is needed for that to be recommended.
I, too, am a cancer/treatment survivor. The 2.4 cm lump never did show up on mammogram because it hid within dense tissue. I found it poking around. Oh, and you don’t have to be pre menopausal to have dense tissue or a Her2 positive tumor. I absolutely agree that better screening methods need to be found, because the “gold standard” fails so many. We definitely need a more global screening approach, so all women, regardsess of breast type. are adequately screened whether it be every year or every two years.
Mammography failed me big time. If the cancer had been caught sooner I would still have a breast!
1. Could be that they have discoverd all this xray mess is actually causing cancer.
2. Could be the insurance companies are putting pressure on them to cut the cost, thus cut the testing; mamos and paps… coincidence…. give me a break.
3. Question: Did they cut the prostrate exams?
Its about women and money ladies… nothing more, no one can tell me differently.
Too bad.
Once again I find myself in agreement with Dr. Love. I was diagnosed with a “lump” by a CNM during my annual gyne. exam. A follow-up mamo did nothing to clarify the situation and given that I was 34 at the time – a mammo would never have found the lump given the density of my breasts at the time and the location (high up in the external reaches of the quadrant). I was referred to a surgeon who thought we should remove the lump just to be safe and given that the location made removal easy. I was never worried about anything up until the final pathology came in and it turned out that this pea shaped lump bearing no resemblance to a typical cancer turned out to be a malignant and invasive form of breast cancer. I was lucky and had lupectomy, 4 rounds of high dose chemo (I was also offered a tamoxifen clinical trial- but opted for the chemo) and 6 weeks of radiation. So here I am almost 15 years later and can tell you that I believe in Dr. Love – because at my age mammography would not have helped me – I do get mammo’s evey year now – but I’m now in a different risk category. However I still feel my best line of defense is the hand’s on exam done by a medical professional – preferably a surgeon at a breast center. I have been told that surgeons hands are better at giving the breast exams because of their experience with removing tumors and also because they tend to examine more women with questionable lumps and have learned to better distinguish between those that are cancer vs. those that are “nothing to worry about”. Whether or not their is evidence to support this I don’t know but it sure seems to make sense to me – and so far that approach has worked for me. Even though I have the mammo’s – a negative mammo result does not make me feel lie I have a clean bill of health – I know full well they are not a perfect diagnostic tool.
Although I understand you are a Dr., you need to get your facts straight. The mammography guidelines were NOT controversial. The US Task Force under Pres. Clinton passed the guidelines in 1997 for women ageg 40 – 49 to get mammograms every year or two. I am a 40 yr old very healthy woman and have ER+, PR+, HER2+ and Sent node involvement with NO palpatable tumor. (Stage llA, Grade 3) If I wasn’t allowed to get a mammogram, by 50 I would be DEAD. Extra money for our country raising my two small children!! Being a breast cancer advocate (or so you say), you should be aware that breast cancer among younger women is much more aggressive than cancer in the over 50 population. Do your homework…..
Maybe instead of cutting guidelines because of the 10% failure rate, we should push MRI’s for the younger, more “dense breasted” community.
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The new recommendations are WRONG. I was diagnosed with stage II breast cancer. It was found through my annual mammogram. I have no family history of breast cancer. I did not feel a lump. This important diagnostic tool saved my life.
I’m glad I have doctors that care, and not doctors like Susan Love, who advocate changing the age of routine mammograms for women in their 40s. Ladies, get your mammograms. I am proof that they are a lifesaving tool. Fight this change with all of your power – write to your newspapers, congressional representatives, the surgeo general, while you’re still alive to do so.
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