Commentary

How you see statistics on breast cancer may depend on whether you've had it

By Leslie Martin

A government health task force released a report Monday stating that women in their 40s shouldn't bother getting mammograms. According to its research, only one life in 1,000 is saved. If so, that life is mine and, not to sound egotistical, I like to think it was worth saving.

My first bout with breast cancer came at age 42. The oncologist and surgeons all remarked how lucky I was to have had an earlier or "baseline" mammogram, which allowed them to see how significantly the picture, so to speak, had changed.

According to the report, screening prevents one cancer death for every 1,904 women age 40 to 49, compared with one death for every 1,339 women age 50 to 74, and one death for every 377 women age 60 to 69.

The independent task force of doctors and scientists is concerned that all this screening leads to many false alarms and unnecessary biopsies.

It was a biopsy that confirmed my first diagnosis and the one that followed 18 months later. Not to get all up in these experts' faces, but the first biopsy showed that my cancer cells were particularly nasty ones, growing rapidly.

"The mammogram almost certainly saved your life," my oncologist said.

And yet, the report would ignore the value of all that.

"The benefits are less and the harms are greater when screening starts in the 40s," said Dr. Diana Petitti, vice chair of the U.S. Preventive Services Task Force, as quoted by the Associated Press.

Regarding those "harms" -- do they include something worse than death?

Something tells me the harms take the shape of a dollar sign. In fact, one of those involved in the report said that if the new guidelines are followed, billions of dollars will be saved. "But the money was buying something of net negative value," he said. "This decision is a no-brainer. The economy benefits, but women are the major beneficiaries."

I don't see the logic. And, considering my own experience, I dislike the term "no-brainer."

What's really scary is that these folks carry a lot of weight in terms of influencing insurance coverage, policy and doctors' practices. The report mentions mammogram screening biannually for women in their 50s, up to age 75. Then what?

My mom had breast cancer at age 83. Was her life worth saving? My dad thinks so, as does the rest of the family. Who is to going to decide about women like Mom in the future?

If there's any good news in this, it's that the American Cancer Society and the American College of Radiology are standing by the previous policy of recommending annual mammograms for women in their 40s. How well this policy will stand up to government wonks is anyone's guess.

On the other hand, I feel betrayed by so-called advocacy groups such as the National Breast Cancer Coalition, Breast Cancer Action and the National Women's Health Network, which reportedly welcomed the new guidelines.

I've been a proponent of President Obama's plan for health care reform. Suddenly I'm worried about what I used to consider ridiculous scare tactics concerning government decisions on who lives and dies. Now I'm not so sure they're ridiculous.

When I was first diagnosed with cancer, my daughter was 4 years old. If these new guidelines had been in place in the late 1990s, would I have lived to see her senior year in high school?

Leslie Martin is an editor. She lives in Mendota Heights.