NY Times article dated, May 7, 2014
A personal note. As one who had no family history and no symptoms, were it not for a mammogram, my breast cancer diagnosis would likely have come at a more advanced, more difficult to treat, and likely more deadly stage. This article and others like it gloss over important facts, such as our inability to discern which women are ‘at risk’ and should be covered (I wouldn’t have met the criteria,) and the personal ‘cost’ of diagnosing breast cancer at later stages (riskier treatments; more chemotherapy, more mastectomies.)
Hidden in the article is the statement that ‘Diagnostic methods these days catch most cases of breast cancer that can be effectively treated, and much of what is picked up by universal screening is over-diagnosis.‘ What are these ‘diagnostic methods?’ (Mammograms and then, if needed, sonograms and MRI’s.) Would all of these ‘effectively treated’ cases be caught if women had to pay for screening out of pocket? How much does a mammogram cost? Anywhere from $500-$2700 is typical. Where is the study showing what percentage of women would forego screening if they had to pay privately for it, and what the impact of this would be on number of diagnoses, and on staging, treatment and mortality? And as for over-diagnosis, another term that medical economists love to tout when talking about mammograms…let’s talk about how to address over-treating rather than over-diagnosis. As one who has been diagnosed with breast cancer as the result of a mammogram, I’d prefer to have been wrongly diagnosed even if it meant having to undergo an unnecessary procedure. I would bet that 100% of the 40,000 or so women who are diagnosed each year in the US and the 4,500 who are diagnosed each year in Israel, would agree with me on this one.
One could argue, but the worst part of these discussions is the unintentional fallout. It is confusing women and they are not getting screened.
Thie controversy over mammograms will be one of the topics to be discussed at the Lemonade Fund’s WOMEN’S HEALTH AWARENESS EVENT, Monday, May 12 in Raanana.