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Jacquielynn Floyd

Mammogram guidelines new, not confusing

12:00 AM CST on Friday, November 20, 2009

Could news-blurb writers, talking-head TV doctors and Cabinet-level government officials kindly stop telling me I'm "confused"?

I'm not a dolt, nor are most of the women I know. We're not hiding under the covers, too paralyzed with bewilderment and indecision over new recommendations for breast cancer screening to get out of bed.

Here's what has happened: An independent, government-appointed panel of 16 medical experts says most otherwise healthy women don't need as many mammograms, and they don't need to start getting them at as early an age as is currently being recommended.

You'd think this was good news, a sign that here's one area where we can worry a little less, where the burden of being a responsible guardian of your own health has just grown ever-so-slightly lighter.

My chief reaction was a mildly vexatious why-didn't-you-tell-me-10-years-ago. Plus, I felt a mild relief that my younger sister and nieces and sisters-in-law won't have to report quite so frequently for a test that, while not the agony of discomfort and embarrassment some people have made it out to be, isn't as much fun as shopping for a new handbag, either.

Breast cancer is, in fact, a public education success story, a centerpiece of an evolving focus on women's health.

Powerful lobbying and awareness campaigns – notably Dallas' own Susan G. Komen organization – have worked wonders in turning breast cancer from an unmentionable horror to be discussed in hushed tones to a public enemy we can rally to combat. One cornerstone of those campaigns has been early and frequent screenings.

The success has been so great that objective analysis of the statistics suggests we may have gone further than necessary.

"The public has followed the lead of public health officials and increasingly put their faith in screening and early detection, though we have never had good evidence that this would have a significant impact," says a public statement issued this week by the National Breast Cancer Coalition.

"The over-emphasis on the importance of screening, despite a lack of strong evidence, has been elevated to such a degree that some even equate screening with prevention of breast cancer."

Clear enough. Yet some experts think women are so dumb, so "confused," that they'll take a conflict between "frequent screenings" and "slightly less frequent screenings" as a signal to get no screenings at all.

According to the Wall Street Journal:

Len Lichtenfeld of the American Cancer Society says his group ... is worried that women will become so confused by the conflicting recommendations they will stop getting mammograms altogether.

"Frankly, from our point of view, that would be the worst possible outcome," Lichtenfeld said.

This is akin to saying that if your doctor adjusts your dosage for, say, blood pressure pills or cholesterol medicine, you might well be so baffled by the change that you just quit taking the stuff.

That would be a bad outcome, all right, but are you really that dense?

Most of us have the good sense to recognize that best medical practices evolve with study, research and the accumulation of information. If they didn't, doctors would still be bleeding people with leeches to cure pneumonia.

I'm assuming the panel's recommendations are an honest assessment of hard statistics and not, as the more conspiracy-minded among us believe, either the opening salvo in Obama-care socialism or the nefarious plotting of a secret insurance-company junta.

If it were really either one of these boogeymen, they'd surely have had enough sense to start with something less publicized and politicized than breast cancer.

The fact that experts, even those with common goals and commendable motives, can disagree isn't shocking news.

Be smart, read up, talk to your doctor. And just say no to "confusion."