You’ve come a long way, Baby

Some of you reading this blog may not know that this phrase was once the advertising mantra for a cigarette marketed to the “liberated” female. Most of you probably do not know that in that “enlightened” decade, the incidence of breast cancer was only 1 in 20. Today, “enlightened” women do not smoke and the incidence of breast cancer has increased to 1 in 8. So what are we suppose to think when the recommendations of the US Preventive Services Task Force (USPSTF) are to cut screening entirely for women aged 40-49 and decrease it to every other year for women 50 and older? After all, haven’t we come along way, Baby?

Yes, we have in many ways come a long way- like assuming responsibility for our special female needs such as breast health. When the experts get together, as they did in the USPSTF, we usually listen and trust their recommendations. Unfortunately - or fortunately - that is not happening with these recommendations. Nationally, about 18 percent of all breast cancers occur in women who are aged 40-49. We all know of or know personally some of these cancer survivors. It’s their personal stories that convince most of us to ignore or disregard the more liberal recommendations.

The issue is actually quite complicated- factors such as what type of mammogram a woman gets, such as digital, full-field, as well as radiologist expertise, technician expertise, false negatives, breast density, additional diagnostics, cost, survival, etc can be considered “evidence” in support of or against the Task Force recommendations. In their defense, members have since announced that the communication of the findings may have been misleading; and that a woman’s individual factors should determine at what age and what frequency her mammograms should occur.

Since the USPSTF recommendations were reported, numerous prestigious medical institutions, professional organizations and individuals across the country have restated their support of the present recommendations that have guided millions of women in assuming responsibility for their breast health. Some of these include MD Anderson Cancer Care Center, Duke University, Mayo Clinic, the Seattle Cancer Care Alliance and many others.

What do I think? Emotionally, I KNOW that you better start mammography at 40. Statistically, cancer will not be found in the overwhelming majority of the women who do have mammograms yearly starting at age 40. Economically, it will not be cost effective. Therefore I do agree with the USPSTF on one point and that is that women should look at their own individual factors and decide what is right for them. So all in all, we really have come a long way, Baby!

Jenny Ellis, RN, MS, AOCN
Oncology Nurse Specialist
Texas Health Harris Methodist Hospital
Hurst Euless Bedford