Saturday, November 21, 2009

Mammograms Starting at 50? No Breast Self Exams? Sexist.

By now everyone has heard the new guidelines by an influential panel of "experts" -- the U.S. Preventive Services Task Force -- that mammograms should start at age 50, not age 40 as the American Cancer Society and American College of Radiology still recommend.

According to a recent New York Times article and every other source on this planet, this panel's reasoning goes something like this: 1) the radiology involved with the mammograms may be harmful so fewer mammograms should be encouraged by doctors 2) Mammograms find a lot of benign stuff, causing women needless biopsies and worries and 3) There's no need for breast self exams.

And now, women are left wondering what they should do. Women are scared and making that fear known.

First of all, the American Cancer Society stands by its recommendation, so hopefully that will quell a lot of fears. Best case (and hopefully most likely) scenario: nothing changes despite this panel's recommendations.

Worst case scenario: The ACS listens to these fools and changes its guidelines.

Let's discuss the worst case scenario.

I'm in no position to be affected by these new recommendations, as my double mastectomy with reconstruction exempts me from mammograms. However, I can tell you what I might hypothetically have done if I were in my 40s, a candidate for mammograms, and found out I could no longer get routine mammograms every year.

Hypothetically speaking, that is.

I might:

-- Tell my doctor that my mother and/or sister had breast cancer. (Yes, lie)
-- Tell my doctor that I found something in my breast and need it checked out. (Yes, lie)

Then again, I might not. I'm not advising you to lie, you see. I'm just throwing ideas out there -- brainstorming, if you will.

Finally, I will end this blog with a letter to the task force that recommended all this no-routine-mammograms-until-50-and-no-breast-self-exam nonsense in the first place.

Dear Task Force:

You don't want women to get routine mammograms in their 40s because they cost money and medical effort. The amount of radiation women receive during a mammogram is minimal. Truth is, you don't want women to get "needless" biopsies because, well, it's a whole lotta trouble (and $$) to do a biopsy.

By the way, isn't "needless biopsy" an oxymoron? Isn't a biopsy necessary to assess whether there's a malignancy? If a suspicious growth were benign, isn't it good that a biopsy was done to convey that information? If the growth in question were malignant, isn't it good that a biopsy was conducted?

You don't want women to do breast self exams because they may choose to get those needless biopsies and choose those needless mammograms, which cost money. And some medical experts even claim that some cancers will never be deadly, but they are benign malignancies.

If you or a loved one found a lump in the breast, would you take comfort in that whole "benign malignancy" hoopla and do nothing? Or would you want a biopsy? Would you want to know whether that lump was cancerous and, if proven to be malignant, would you just leave it in your breast and carry on with your life?

Finally, I don't see any guidelines changing for men any time soon. If your panel thinks women should forfeit their right to routine annual mammograms in their 40s, then the panel should level the playing field and tell men to wait until they are 80 to get a routine prostate exam.


Beth L. Gainer

Beth L. Gainer is a professional writer and has published numerous academic and magazine articles, as well as an essay on her breast cancer experience in the anthology Voices of Breast Cancer by LaChance Publishing. She writes about a potpourri of topics, including motherhood and her Chinese adoption experience at, and her cat Hemi blogs at Beth teaches writing and literature at Robert Morris University in the Chicago area. She has a guest posting on The World's Strongest Librarian at

She can be contacted at and


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