Comments on: Owning Our Boobs: An Integrative Medicine MD’s Thoughts on the New Mammography Recommendations

By: Lissa Rankin

Lissa Rankin — Wed, 02 Dec 2009 00:10:35 +0000

A great article about radiation exposure from mammograms in young women at high risk for breast cancer:
http://www.nytimes.com/2009/12/01/health/research/01cancer.html?_r=1&emc=eta1

By: Lissa Rankin

Lissa Rankin — Sun, 29 Nov 2009 05:05:26 +0000

Thank you dear Marsha for your insightful and well-thought out comment. I agree- we need better screening. I fear most for those who simply can’t afford to pay out of pocket for alternative screening. But yes, breast MRI is promising. Thanks for helping us keep this discussion so lively!
xoxo
Lissa

By: Marsha Nunley, MD

Marsha Nunley, MD — Sun, 29 Nov 2009 05:03:04 +0000

A comment on the recent controversy from another integrative physician (just to offer another viewpoint)…
I practiced primary care for years prior to concentrating on integrative health and these recommendations are not new. We have known for a long time that mammograms are a poor screening tool but it has been thought that they were the best we could do. As Dr Lissa says, the breasts in young women are more dense and the mammogram is even less sensitive and less specific in this group. Over the last few years, it has become increasingly clear that the incidence of breast cancer is not declining which one would expect if the screening was doing its job. Consider the decline in cervical cancer after the PAP smear became widespread which has not occurred in breast cancer. I think we are asking the
wrong questions and trying to hold on to a test that is not very good but is CHEAP and women seem to believe that it saves their lives. (Or they have been led to believe this) There is also the issue of repeated low dose radiation in a highly metabolically active tissue. We know that radiation causes cancer in the thyroid and other tissues, why do we think the breast is exempt?
I would suggest that the breast MRI though considerably more expensive is a much more sensitive and specific test and if we are going to screen for breast cancer, this is the test that we should be using. Even the thermogram though not widely available or covered by insurance is more sensitive and specific for breast cancer than the mammogram.
I am 59 years old and have had one mammogram but recently had a breast MRI (paid out of pocket $200-500) and this is how I will continue to screen
and protect myself from breast cancer. The MRI does not pose the radiation risks that occurs with standard mammography and does not require smashing of delicate breast tissue.
I have a friend whose 34 yo daughter was recently diagnosed with breast cancer found by chance because she had tenderness, confirmed by needle biopsy and then by MRI to see extent of disease. This woman has 2 aunts with breast cancer and it is my opinion that all her other aunts and siblings should be screened with MRI beginning in their 30’s. These women are not protected from breast cancer with mammograms.
So I think we are asking the wrong questions and accepting less than what medicine has to offer. I think every woman over forty and those at high risk less than forty should be screened for breast cancer with MRI. The savings in unneeded tests and treatment would easily pay for the added costs and
maybe we could truly decrease the devastation from this disease.
Just another perspective…Hugs to Dr. Lissa

MARSHA NUNLEY, MD

By: Lissa Rankin

Lissa Rankin — Fri, 20 Nov 2009 03:37:37 +0000

I think you’re spot on Darline. I think the government sat down to figure out how we’re going to afford health care reform, and when somebody said, “How can we cut costs,” someone said, “Hey, let’s ditch mammograms in young women. We’ll save billions and we’ll only lose a few 100,000 lives.”

But why women’s health? Why have we ALWAYS been the ones to get shafted? Why not cut off PSA testing? I mean, seriously, Pinkies.

How much IS one life worth? What if it’s your loved one? What if it’s YOU?

By: Darline Turner-Lee

Darline Turner-Lee — Fri, 20 Nov 2009 03:33:43 +0000

Thanks for such a well written explanation to the Government Task Force’s recommendations. I agree with you 100% and was going to write as much on my blog. No need to reinvent the wheel, however.

But I do want to highlight one point that you made. One of my greatest concerns is that in the wake of the health care reform debate, Opponents and insurance lobbyist will use this recommendation to deny coverage of mammograms to women in their 40’s. For women unable to pay out of pocket, this could have disastrous ramifications in that if they do have breast cancer, they won’t be diagnosed until they have a very palpable mass-and if they aren’t doing BSE’s, who knows how large the mass will be and how advanced the cancer before a diagnosis is made?

I can’t help wondering if all this “review of the data” isn’t a prelude to the fact that a government sponsored health care plan is imminent and this is “a way to cut costs.” Ladies, we have to stand and not let our health be dictated by those with nothing to lose and a whole lot to gain.

By: Lissa Rankin

Lissa Rankin — Thu, 19 Nov 2009 20:08:46 +0000

You go girl!

By: jane

jane — Thu, 19 Nov 2009 19:58:25 +0000

just had my annual thermography yesterday! drove 5 hours to do it and it was so worth it…

By: Eileen Smith

Eileen Smith — Thu, 19 Nov 2009 19:12:34 +0000

p.s. I have been getting them done since I was 35, due to my maternal grandmother having had breast cancer. My insurance didn’t cover it, and won’t cover it every year. So I pay for it myself. I don’t feel I have any other choice and feel a yearly examine is important. I would like to start getting the new digital ones offered now. I’m sure that won’t be covered either.

By: Lissa Rankin

Lissa Rankin — Thu, 19 Nov 2009 19:07:20 +0000

Clare,
There are some who choose to do breast thermography instead of mammography. Like I said, I recommend both- together. We just don’t have all the data yet to say whether thermography can replace the benefit of mammography.

Yes- we need better screening. Ultrasound as a screen has not been shown to be very effective, but it is useful at assessing lumps or following up abnormalities found on mammography. Pray for better tools, ladies!

By: Clare

Clare — Thu, 19 Nov 2009 18:57:50 +0000

Why don’t you go for a breast thermography instead of your mammography? All that squashing of a breast containing so much lymph can’t be good for the lymphatic system of the breast. Another thing I have often wondered is why not just do a breast ultrasound. If a problem is detected w/ a mammo then they do an ultrasound. Why not just start out with an ultrasound–no squishing, no radiation and it must be cheaper b/c it removes a test. Thanks for the forum