Sanchez: See past the controversy of mammogram guidelines

By Mary Sanchez

Backlash to the shifting guidelines on breast cancer screenings highlighted one rather disheartening truth:

When it comes to our health, we women may not be as empowered as we think. How else to explain the torrent unleashed when it was put before us that mammograms are not as effective for some women? This shouldn't have been new information. Screenings for younger women always have been controversial when weighed against their benefits.

Word has gotten out so well that even relatively young women can die of breast cancer that it has twisted our ability to accept new research. Even logical research, such as the task force report that brought more scrutiny to giving mammograms to women under 50.

How in control of our health can we claim to be without a more careful analysis of current testing - and its rate of success?

I still believe mammography is the best test readily available.

But now that the initial frenzy has subsided, it's time to apply a bit more intellect and a bit less emotion.

The U.S. Preventive Services Task Force raised the point that for women under 50, mammograms may not reduce mortality enough in asymptomatic women under 50 to counter other issues that arise with the screenings.

That's largely a judgment call. Obviously, it is one that many women and doctors rejected. U.S. Health and Human Services Secretary Kathleen Sebelius practically had to issue an apology for even allowing the task force to report facts that fly in the face of public perception.

Mammograms in women under 50 give many false positives and increase the likelihood of more testing - including possibly unnecessary biopsies and treatment of cancers that wouldn't have caused health problems if left alone. Another problem is the incredible anxiety for women and their families when the screenings detect even the faintest possibility of an abnormality.

Yet the mere suggestion that mammography is not the literal savior women want it to be that seemed to cause the greatest reaction.

Breast cancer deaths have been reduced

30 percent since 1990. In addition to increased screenings, the decline is credited to improved treatment, women living healthier lifestyles and a decrease in the use of postmenopausal hormones.

I suspect many young women would be equally surprised to know the risk that a 40-year-old woman will die of breast cancer in the next 10 years is 0.19 percent, according to the National Cancer Institute.

Breast cancer, contrary to common belief, is not the leading cause of death for women. Heart disease is, by far. But breast cancer is often the scariest way for women to contemplate death.

On its Web site, Susan G. Komen for the Cure, an organization supporting breast cancer research, asked women to react calmly. Komen echoed the task force's advice, stressing women should become better educated, know their risks, consult with doctors and make their own decisions.

That's the same advice I always heard from a friend. She discovered her breast cancer when something didn't seem right as she breastfed her son. She lived a remarkable five years with end-stage cancer, dying last year at 42.

“Regardless of what any scientific study says or any scholar, what matters is you listen to yourself and your needs,” she once said.

Sound, calm advice from one who knew much about the cancer we fear from afar.

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msanchez@kcstar.com