Outrage Over Mammogram Mix-Up

This is only tip of the iceberg. The cancer treatment industry has been driven by profits not science, and has not been subject to serious outcome studies. Where is evidence based medicine?

I think mammograms should be covered for women 40 and over, I have had a couple of items come up before 40. I have been lucky (no cancer), but had to go back for extra mammograms and wait. No lumps or bios done. A doctor and a woman know her family history. I had a girlfriend at work, around 40 had a rash come up on chest. Had mammogram, and bio said cancer., denied treatment.

Insurance wanted her to have other treatments first before removal of breast, had chemo, and radiation, retired under hospice, died. If she had had a mammogram every year it might have been caught earlier and she could still be here with her kids. Also my husband's aunt just had breast cancer. After her daughter had already had bio's, radiations treatments. And thought there were no family history problems. Now 2 of them. She is under 40 now.

I Wonder now many on that committee had breast problems in their families or how many doctors who were familiar with men and women breast cancers were contacted or allowed on that committee. Since the committee where deciding what the insurance co.s will allow now. SPEND MONEY ON MAMOGRAMS. LET DOC AND PATIENT DECIDE WHEN TO START? It will cost less to catch it early when it hasn't spread.

My niece was only 33 when she had to have BOTH her breasts removed I think mamms should be recommended for women as early as 20.

I think the important info here is that a woman and her doctor need to have the ability to make the decision whether or not a woman should have mammograms, not some person tied to an insurance agency who really doesn't know the woman's situation. Having had annual mammograms since 40 with no issues, I'm ready for every other year now.

20% of all breast cancers detected and treated at our local hospital occur to women under 50 years of age.

Mammograms do NOT catch everything -- you cannot rely on them totally. I have TWO friends in their 50s who had been having routine yearly mammograms find a 2cm lump 3 months after a clean mammogram.

My mother had breast cancer when she was 44 and again when she was 50. She found both lumps herself. She is now 93! The had two radical mastectomies. She never had a mammogram, she had no chemotherapy, she had no radiation. I don't believe I would have a radical mastectomy, but if I get breast cancer I will seriously consider NOT doing chemotherapy.

Because of my family history, they want me to go in every 6 months and alternate mammograms with an MRI. I'm not doing it -- I don't feel compelled to pay for the radiologist's expensive MRI equipment. I go once a year for a mammogram and to my gynecologist. And we wonder why American health care is so expensive!

Newer is not necessarily better, as witnessed by some of the recent findings that newer drugs are no more effective than older drugs, but they are way more expensive and often have more side effects. I agree with the comment that we need to be doing serious outcome studies. Unfortunately we live in a litigious society and too many doctors practice CYA medicine and too many patients demand the latest drug / technique, believing it is the greatest, when it may not be.

Great explanation by Dr. Hadler. Thanks, Joe and Terry, I always count on you for good info!

I am outraged that one in some thousands will die because of this new ruling. One already did- a dear friend who died at 43, lost a breast before 40. A cousin lost a breast in early 30's and now losing the other one at 67. I would not have her if they hadn't caught the first one. Get someone on that panel whose loved one caught cancer in her 30's, then see if it were a daughter, wife, or mother what their advice would be.

Just a point for your readers is that ANY ionizing radiation, while useful for detecting cancer, damages cells and has the potential of causing cancer. If testing was completely innocent, we could argue for doing it more often, but it's a far more complex scenario. The (small but not insignificant) increased risk of developing cancer rather blunts the reassurance of a negative mammogram.

The radiologist must compare the new mammo to the last one taken to look for changes. None of this sensationalist news is stressing 1] go to the same radiology department where they have your previous films for comparison; 2] take your films with you when you move too far away to use the same department. Once again journalists (another business) is running the show.
The postcard to you comes to remind you where your films are and YES mammograms are big business in the breast cancer scene.

insurance companies should have NO power over health care decisions; that should be up to us and our health care providers. i know many women who have gone through miserable treatments for false positives, but i'm sure many have been saved through early detection. mammograms are not effective for dense breast tissue either, and ultrasound screenings are rarely offered. if men could get breast cancer i'm sure the drug companies would have a dozen drugs on the market and a cure in the works...

Wonderful, thought provoking talk by Dr. Hadler. Much of what he had to say I agree with completely. My husband was diagnosed with prostate cancer almost 5 years ago. He has been on watchful waiting and the cancer has not spread. He is due for a biopsy in April 2010. I feel each person must find their stress level in order to decide if they want breast, prostate and colon tests on a regular basis.

I am a survivor, ten years 2010, because of caught early with mammograms on my breast. We must be responsible for our bodies and not the Government!! It is all about money, people, everything these days that is coming up and changing in this world. SAD!!!!! No one cares unless they get the MONEY!!!

That was and excellent presentation by Dr. Hadler.

Screenings save some lives, but false positives cause misery. But just driving to the grocery store may cost me my life. So does this (63 yo) punk feel lucky today, huh? I have had PSA's every year, just had my second colonoscopy. The first one found a "nodule" and the second found a 3mm (1/8 inch) polyp. I am supposed to have another colonoscopy in 5 years - not sure if I will or not. There is scant history of colon/rectal cancer in my family. One case in a great aunt and my great grandmother had cancer of some kind. I am more likely to die of heart problems based on family history.

My physical is coming up. I think I will "test" my doctor about having a c-reactive protein test instead of a PSA test. I asked about a CRP test a few years ago, and the doctor's reaction was to say I have heart problems so I most likely have high CRP. By that logic I have had very low PSA readings so it is most likely that I will not have a prostate cancer that kills me.

Anyway the doctor has given me valuable information on making a decision on whether to continue my current testing frequency or to forgo some of them. I must admit that another factor is that I tend to select health plans with higher deductibles and that may be a factor as well. But perhaps we would not have as high a health cost if we ignored the medical industrial complex and said no thanks to these tests.

I have some confusion on how the Breast Self Exam (BSE) study was done. Based on a person being interviewed on the Diane Rheem Show, I understood that the measure was based on the number of BSE education sessions and that outcome on breast cancer detection. I asked my wife and my daughter and they do not do regular BSEs. I would expect that of the women educated on BSE, that only 10 percent actually do their own BSE on even a quarterly basis.

I would like to know if the study attempted to actually survey outcomes on women that actually did their own BSE on a regular basis. It would be interesting to see outcomes on women that did BSE monthly, vs say quarterly.

If you could post what that study actually measured, it would be appreciated.

PEOPLE'S PHARMACY RESPONSE: THE NEW GUIDELINES DRAW ON SEVERAL STUDIES THAT SHOW BREAST SELF-EXAMS DO NOT HAVE ANY IMPACT ON MORTALITY. PART OF THIS IS BECAUSE ONCE A TUMOR IS LARGE ENOUGH TO BE DETECTED, IT HAS BEEN THERE FOR YEARS. THE OTHER PART IS THAT SOME BREAST CANCERS ARE QUITE AGGRESSIVE AND DIFFICULT TO TREAT, REGARDLESS OF WHEN THEY ARE DISCOVERED. OTHERS ARE SLOW-GROWING AND NOT A THREAT. NEITHER BSE NOR MAMMOGRAM CAN DISTINGUISH BETWEEN THESE TWO VERY DIFFERENT FORMS OF BREAST CANCER.

Women who were diagnosed and treated for breast cancer and survived on the basis of their mammogram results feel they owe their lives to the mammogram. In some cases they do. What they do not know is whether they would have survived without the diagnosis and treatment.

Over 20 years ago my mammogram showed a suspicious spot, resulting in much angst over what course should be followed. The radiologist wanted me to have mammograms every 3 months to watch it, which I declined. Luckily for me, the surgeon I went to was conservative and felt that the suspicious finding was not conclusive and did not warrant surgery at that time. Over the years, this spot always appeared on my mammograms. Several years later an expert told me that these sorts of spots were never cancerous. In retrospect, I regret having many mammograms given the useless results, the associated anxiety, and the amount of radiation.

I agree that mammograms do not catch everything. Five years ago, I was amazed that my breast cancer tumor
1) did not show up on the mammogram, and
2) was not found by my doctor.

I found it myself, and by that time it was about 2 1/2 cm. I had a mastectomy, no chemo or radiation, and am clear now.

This really floors me. It always comes down to statistics, but the problem here is this--statistics are fine and dandy UNTIL IT AFFECTS ME. Or YOU. My husband, at age 48, has been recently diagnosed w/ prostate cancer. Sure if he had been diagnosed at 60, he might have died WITH the cancer and not FROM it, as Dr. Hadler says. But at age 48?! I'm glad we found the cancer early, so we can research and choose the correct treatment for his case.

What if we had waited until he was 60 before checking a PSA? Would the PC be in his bones at that point? Very possibly. Same w/ breast cancer. The statistics say that screening does nothing. But what about all the women who've talked about their experiences just here, who have been saved by finding cancer early on a mammogram.

All the statistics don't mean squat when it's YOU whose life is at risk.

Has no one ever heard of Thermography??? This is a far safer and far easier test to determine the condition of the breasts. It is a thermal image camera operated by a thermographer trained in this procedure.

Why no one talks about this other method is really mystifying..It is the first line of defense against breast cancer. Duke Medical Centre trains the thermographers. In Canada we have to pay for this procedure because our government plans do not recognize it. However, it is a viable first alternative to mammograms.

If a small tumour or any unusual thermal reading should show up on the computer screen, you would be notified quickly to get an ultrasound thereby skipping the mammogram.

Radiation is avoided by having thermographic images instead of mammograms.

Look this up on the internet...

I am 61 years old and have not had a mamogram since 2005..I no longer believe they are the best screening tool.

A doctor from Sloan-Kettering, on the View this morning, said to continue the way mammograms and checking the breast have been done. This was just a team that used older data, before many of the new stats were known and this report should be disregarded.

I found the little 'pea size' in my breast after having a mammagram showing a 'shadow' and advised to have another in 6 month....thank heavens I did not wait 6 months and did the breast exam myself and found it, had a lumpectomy and radiation and lived to rejoice for 15 years now. I will continue to have the mammograms as much as I hate them.

Wow, this brings up a lot of issues. To begin with, everyone has equal rights and freewill. Every medical choice has risks and benefits. Other choices have risks and benefits too. There are limited resources and unlimited desires for resources. People who say that, "You can NOT set a price on life" are obviously not aware that we already do. Your choice to get a mammogram effectively might lead to someone else not getting the care they need to live.

Your desire to be calmed by a mammogram or colonoscopy or ultra-safe automobile is YOUR choice. If you happen to have a stronger desire for "safety" you would be willing to pay for it (the insurance companies no longer will).

This is all a good thing. In the USA our rights are protected and we have the freedom to choose. My desire for a mammogram does NOT trump the insurance company's desire to pay just as my desire for a new insurance company does not trump the companies desire to keep me as a customer. They can choose not to pay and I can choose to find a new insurance company.

Four friends had breast cancers. In three of them, nothing had been seen in mammograms performed 3-6 weeks before lump development. One did not survive, it went very fast and she passed away in less than 5 months. Her mother and grandmother had both died of breast cancer. A fourth acquaintance felt a lump, then had the mammogram. She is doing well, it's been 20 years.

So here, in 3 cases mammography detected nothing and in one case it confirmed a diagnosis. I don't have much confidence in this examination (and it leaves my breast painful and swollen for about 3 weeks), however mammography should be covered by insurance whatever age the patient, if doctor and patient require them.

I don't think the new regulation is about not covering the examination if the doctor requires it, but about the patient age for making it part of a routine recommended examination.

My mother (80 now) and grandmother and all older women in my family never had a mammogram, and none developed breast cancer.
I work with chemicals and radiation and certainly don't want more. Thermography sounds better.

It seems that many are missing the point, it is such a hard pill to swallow--you did not need to go through the aggressive treatment, you were not going to die from the cancer. Paradigm shifts are so hard to swallow.

I totally agree!

I am happy you had that result...but it is not always that way. I had a spot which they also said looked benign. Also radiologist recommended more frequent mammograms, 3 then 6 months. My last mammogram had the same result - "probably benign" with recommendation to recheck in 6 months.

Nevertheless, my doctor decided to biopsy. I was concerned that this stayed there so long, and he thought he saw a change in the spot. Result-I have invasive ductal carcinoma. If not for the mammogram, we would not know this. We cannot feel the tumor. I only wish they had biopsied earlier...now we are two years into it. I understand that 80% of the time lumps are NOT cancer. But when you are among the 20% of people not so lucky....well, no way I can agree that mammograms should be reduced...or biopsies.