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Mammograms for 40-Year-Olds or BUST!

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Judy, Debbie, Kathy, Barb and Sarah. All these women are close friends of mine. All these women were diagnosed with breast cancer under age 50.

I know clinically of hundreds more and I am sure that you can name countless others who were also diagnosed with breast cancer before 50. The USPSTF is now recommending these women (under age 50) should not have received the mammogram or done the self-breast exam (in all women) that found the cancer and saved their life.


Not because cancer is the leading cause of death in women in their 40s with breast cancer being at the top.

Not because mammograms reduce the risk of dying from breast cancer by 15%, the same rate as in women in their 50s.

Not because younger women have more aggressive cancers.

Not because there are other more effective screening tests for breast cancer.

Not because 17 percent of breast cancer deaths occurred in women who were diagnosed in their 40s.

Then why did they recommend stopping mammograms for women in their 40s?

They interpreted data stating the mammograms had a small net benefit in women in their 40s. (Grade C) What does this mean? There were many false positives or a finding that required additional testing that showed it was not cancer.

Younger women have lumpy, bumpy breast so it is harder to find cancer. The current testing will have many women get additional views with a mammogram. Very few of those will require a biopsy. There will be several biopsied that are not cancer. This translates into about 5 extra biopsies to diagnose 1 case of invasive cancer. The USPSTF says that cost is too high. The American Cancer Society and the America College of OB/GYNs (ACOG) say that it is not.

SO who decides? Unfortunately with the USPSTF, it may be your insurance company that may make the decision for you. Many will only cover preventative recommendations that have a grade A or B.

So what do I do?

Write your Congress person and well as your insurance company demanding that they continue to cover preventative mammograms for women in their 40s as recommended by ACOG and the American Cancer Society.

Continue to do self-breast exams.

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HERWriter Guide

Hi Dr Deb - Thanks for the straight-forward look at what's often been a confusing and misleading dialogue. As a breast cancer survivor who was diagnosed in my 30's I find the recent guidelines to be appalling.
One point I wanted to add to yours is that we may have to start thinking differently and make more decisions on the basis of what's best for our health, not what an insurance company will or will not pay for. We may also need to become more informed about our options in fighting an insurance company decision we believe is wrong. It's also becoming more important than ever for patients and physicians to partner together to determine the appropriate course of action and then follow through. Early detection not only saves lives, it also enables women to avoid a wide range of costs, problems and treatments. If you have breast cancer, the value of an early diagnosis is priceless, and worth far more than the dollars that may be charged for any procedure.

Thanks for writing,

November 24, 2009 - 5:37pm
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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