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How Much Is A Woman's Life Worth?-The Great Mammogram Debate

How Much Is A Woman's Life Worth?-The Great Mammogram Debate

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A discussion of the mammogram debate, breast cancer screening and the financial incentives to put women's lives at higher risk for dying from breast cancer.
A discussion of the mammogram debate, breast cancer screening and the financial incentives to put women's lives at higher risk for dying from breast cancer.

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Published by: Dr. Cheryl Bryantbruce, M.D. on Nov 26, 2009
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11/25/2009

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How Much Is A Woman’s Life Worth?-The Great Mammogram DebateBy Dr. Cheryl Bryantbruce, M.D.First the American Cancer Society (ACS) suggested that there was no evidence forphysicians to recommend self-breast examination. Then, just last week, the U.S.Preventive Health Tax Force made the recommendation for women to delay gettingroutine mammograms until the age of 50 with follow-up mammograms every twoyears. One would like to think the theory behind it all would be to save women’slives by reducing their exposure to potentially cancer causing radiation and toprevent them from undergoing unnecessary testing, but the reality is that thesedecisions really boil down to a matter of finances. It’s cheaper to let a few morewomen die of cancer by reducing screening and starting at a later age than it is toscreen earlier and work up the positive findings. The American Cancer Society estimates there will be more than 190,000 new casesof breast cancer this year with approximately 40,000 resulting deaths. The newgovernment task force recommendation means later diagnosis, inspite of the factthat we know that the earlier breast cancer is detected, the greater the chance of survival. The U.K. screens breast cancer with mammograms once every three yearsuntil the age of 50. The death rate from breast cancer is from 11-14% higher in theU.K. according to the Concord Study as reported in Lancet Oncology 2008. This isconfirmed by the 1996 Study on Health Care Productivity at the Mckinsey Institutein Los Angeles, California. Although this seems to support the call for laterscreening, the McKinsey study concludes that, “findings from the high-resolutionstudies indicated that the poor results from the U.K. were attributable mainly topatients having more advanced disease at diagnosis than patients in otherEuropean Countries. Also, the U.K. spends less on breast cancer diagnosis andtreatment than the U.S. every year.If it were not about money, it would make no sense for the ACS not to recommendself-examination.Self breast examination costs nothing. Self-examinationincreases the risk of nothing except perhaps finding a lump. The ACS says thatresearch does not support findings for or against the benefit of self-breastexamination. Yet they admit that 80% of breast cancers are found not bymammogram, but rather by women “Touching Her Breast.” Self-examination,whichequates with touching her breasts in my book , increases a woman’s chances of finding a lump. Finding a lump means a work-up. A work-up costs money forinsurance companies and government run programs alike.It is money spent with a relatively low cancer yield until the age of 50, at which agethe incidence of cancer increases dramatically. If the recommendation is to not

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