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David Mittleman
David Mittleman
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I Don’t Like What I’m Seeing in Healthcare

2 comments

As the husband of a 10+ year breast cancer survivor I know first hand the benefit of a baseline mammogram at age 40. I challenge anyone to argue that early detection doesn’t give you the best opportunity to cure breast cancer. The studies conducted are overwhelming.

Detecting breast cancer during Stage I gives women a 100% chance of 5-year survival from breast cancer after diagnosis. If the cancer is detected during Stage II, that chance of survival drops to 86%. Stage III means a further drop in survival rate down to 57%. If cancer is not detected until it reaches Stage IV, the chances of 5-year survival are 20%. Stages II and III are actually made up of IIA, IIB, IIIA and IIIB respectively, with the average survival rates of the two groups shown above. The point it this – early detection saves lives.

I am amazed how this government task force could actually release this study and say what they are saying. Is their motivation perhaps to reduce what would be covered by a national "health care plan"? I surely hope not. I am strongly in favor of health care for all, but I do not advocate playing with statistics just to get the result you want. In fact, women whose lives were saved by screening in their 40s are coming out in droves to support continued screening.

How could the United States Preventive Services Task Force come to the conclusion that "breast self-exams do no good", as that makes no sense and is contrary to the long-standing position of the American Cancer Society. In fact it is a MAJOR reversal from the ACS’s long-standing (as in decades worth of knowledge) position on screening and self-examination. In fact, the chief medical officer of the ACS, Otis W. Brawley, M.D., gave the following response:

  • But the limitations [of breast cancer screening] do not change the fact that breast cancer screening using mammography starting at age 40 saves lives. “As someone who has long been a critic of those overstating the benefits of screening, I use these words advisedly: this is one screening test I recommend unequivocally, and would recommend to any woman 40 and over, be she a patient, a stranger, or a family member.

Early last month I also addressed the questioning of long-time protocals in prostate cancer screening. The ACS wasn’t about to change their guidelines back then, and I don’t see any reason for women in their 40s to risk the chance of missing early detection of breast cancer.

2 Comments

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  1. Fred Moolten says:
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    David – the evidence is more complicated than you suggest, and indicates that mammography in the 40-49 age bracket probably does not save lives. For details on this issue, please see the analysis of the Scandinavian studies described in the Journal Of Family Practice, and entitled “Screening decreases breast cancer-specific deaths but not all-cause mortality – Patient-Oriented Evidence that Matters” –

    http://findarticles.com/p/articles/mi_m0689/is_6_51/ai_87914467/

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    Fred:

    Thank you for your comment, discussions like these are good and further debate on these issues. I will say that HHS Secretary Kathleen Sebelius, my wife and I, and the thousands of breast cancer survivors around the country disagree with you because they are not statistics, they are alive thanks to early mammogram studies catching deadly cancer before it was too late. I’ve provided some links below to comments from Secretary Sebelius and a story about my wife.

    http://www.lansingstatejournal.com/apps/pbcs.dll/article?AID=/20091106/ELANSING01/911080344&template=printart

    http://weblogs.baltimoresun.com/health/2009/11/more_mammogram_debate_administ.html