Govt panel says to get mammograms at 50 and think self exams are useless!

Originally posted by drmgj... false positives will lead to many healthy people getting unnecessary surgery...

Maybe they need to do better testing.
But then again, more tests = more money.

yes, this has gotten my knickers in a wad, so one more thought about this and I will hush.

Just something to think about. Ask yourself WHY NOW?

The country is on the brink of having an alternative to health insurance that is not a private company. These massive conglomerates know they could be losing a huge amount of customers, both corporations and individuals.

Knowing this, they start looking for ways to reduce their expensives. They run research endeavors to see exactly how much money they are spending on preventive care. Hm. "here is something we can cut back on. We'll just spend money on those who are diagnosed with cancer, and not worry about finding it early". "That should save a whole mother lode of money". Can't you just hear them in a conference room?

What's next? PSA's for the prostate? Chest exrays during a routine physical? Will they even pay for an annual physical? Maybe you have to be actively sick to even have them contribute to a doctor's visit? Preventive medications? Pap smears?

Does anybody think it's interesting that it's the care of women they zeroed in on? Their wives, mother's, sisters and daughters?

As long as the company continues to show huge profits, what difference does it make? If anybody thinks this is a caring and concerned institution that is committed to your good health....then I'm happy for you. Ignorance is bliss.

Rant over. For the moment.

Excellent point in the OP, S&F for sure.

Lots of great comments throughout, but I did want to add a couple of points.

For some women, self exam is not fruitful because of fibrocystic breast disease, which a *lot* of women in their 40's have. The only way to do any decent exam is by mammogram. From there, if something of suspicion is found, an ultrasound is performed.

I also would like to make a point here about the statistics:

From age 30 to 39, absolute risk is 1 in 233, or 0.43%. This means that 1 in 233 women in this age group can expect to develop breast cancer. Put another way, your odds of developing breast cancer if you are in this age range are 1 in 233.
From age 40 to 49, absolute risk is 1 in 69, or 1.4%.
From age 50 to 59, absolute risk is 1 in 38, or 2.6%.
From age 60 to 69, absolute risk is 1 in 27, or 3.7%.

www.breastcancer.org...

Absolute risk is explained in the link above, but look at that number. 1 in 69? This is ok, *why*?! If anything, this makes the reasoning behind stricter screening starting at 40 quite sound.



If there is still a suspicion, a simple needle biopsy can be performed to rul out cancer.

If caught early enough, a lumpectomy can be performed, and the woman can retain her breast/s, and survival rates the first 10 years are better!

A randomised trial was conducted comparing modified radical mastectomy with lumpectomy and breast irradiation at 7 years follow-up. The trial included 206 patients with breast cancer stage I and II - 84 cases with mastectomy and 122 cases with lumpectomy followed by radiotherapy. Results: The risk of local recurrence and distant metastases was lower during the first 7 years after lumpectomy (24,5%) compared to mastectomy (35,7%) with no statistical significance in the number of total events between the two groups. Local recurrence rate was lower in the lumpectomy group 1,6 % compared to the mastectomy group 5,9%. The same trend was observed for distant metastases, which were the most frequent events- 23% in the lumpectomy group compared to 29,7% in the mastectomy group with no statistically significant differences. There was no significant difference in overall survival among the two treatment groups: 94,4% for patients assigned to mastectomy and 98,3% for patients assigned to lumpectomy. Conclusions: After 7 years of follow-up our findings indicate that lumpectomy followed by breast radiation is an appropriate therapy for women with stage I or II breast cancer; breast conserving surgery and mastectomy demonstrate similar survival rates at 7 years after surgery.

gineco.pulsmedia.ro...(Madden)_versus_lumpectomy_plus_radiotherapy_for_breast_carcinoma_-_outc omes_after_7_and_10_years_follow-up,_our_experience--5172.html


If faced with the choice of having a relatively minor surgery for a lumpectomy, or a radical mastectomy, which do you think will be financially more sound?

Afterall, that's the choice in losing one or both breasts, and having to face reconstruction afterwards, or a simple incision to remove a lump, and possibly radiation or chemotherapy, which may or may not follow a radical mastectomy.

Hm, let me think about that.

Ok, done! I will maintain my private insurance, and continue to get yearly screenings. The earlier it is caught, the less stress on the woman, and the less the financial burden.


What I do not understand is, by saying this is a low incidence group, that does not eradicate the threat, only minimalizes it. Why is it ok that some women may die if this is not caught in time? IMO, it isn't. It wouldn't be to the opposing side, either, if it was them or their wife or mother, or daughter.

Among women ages 40-50, African American women have a higher incidence of breast cancer than white women. African American women also have the highest death rate from breast cancer; Chinese American women have the lowest death rate.

www.webmd.com...

--------------------------------------------------------------------------
Oh, and to comment also, one of the posters in the thread made a comment about far more women dying from heart disease.

It has been found this is due in large part to sex discrimination in the emergency room, and women are not taken seriously when reporting to an emergency room with chest pain. Men are taken far more seriously, hence, less men die from heart disease than women.

www.faqs.org...

Supporting Research into Women's Health: Heart disease is the leading cause of death among women, accounting for nearly 39 percent of all female deaths. Studies show that after a first heart attack, women are less likely than men to receive diagnostic, therapeutic, and cardiac rehabilitation procedures, and are more likely to die or have a
second heart attack

www.michigan.gov...


A secondary factor is due to hormone replacement therapy, which carries a lot of risk, and this is not entirely explained to women.

From 2001 to 2004, breast cancer incidence rates in the U.S. decreased by 3.5% per year. One theory is that this decrease was due to the reduced use of hormone replacement therapy (HRT) by women after the results of a large study, called the Women’s Health Initiative, were published in 2002. These results suggested a connection between HRT and increased breast cancer risk.

About 40,480 women in the U.S. are expected to die in 2008 from breast cancer, though death rates have been decreasing since 1990. These decreases are thought to be the result of treatment advances, earlier detection through screening, and increased awareness.

About 90% of breast cancers are due not to heredity, but to genetic abnormalities that happen as a result of the aging process and life in general.

www.breastcancer.org...
____________________________________________

For any who wish to read more about the recent Healthcare decision, here is an excellent explanation as to what is happening and why the recommendations are being made.
covertrationingblog.com...



[edit on 18-11-2009 by Libertygal]

reply to post by Libertygal


Good for you Libertygal! I know a positive attitude means a great deal.

I'll keep my fingers crossed that you are not one of the tiny, insignificant percentage that gets undetected breast cancer!

ABC News is goin' rogue!

It seems there has been a sudden and loud backlash to the government panels suggestions.

abcnews.go.com...

Doctors, Medical Centers, Former Patients Reject New Guidelines
By JOSEPH BROWNSTEIN
ABC News Medical Unit
Nov. 18, 2009

New guidelines saying women between the ages of 40 and 50 should not receive mammograms to screen for breast cancer have met a groundswell of rejection from many medical centers, breast cancer survivors and numerous doctors -- some of whom have advised their patients to ignore the recommendation.
(snip)
Meanwhile, doctors' offices and hospitals have been fielding calls from women wanting to know what these new guidelines will mean for them.

One of these calls came not from a woman concerned about getting breast cancer but one who has already had it. Beth Thompson, 44, a mother of four who lives in the suburbs of Baltimore, Md., was first diagnosed with breast cancer following a mammogram at the age of 40.

"I had no risk factors and no family history," Thompson told ABCNews.com. "Under the new guidelines I wouldn't be screened. That's why I'm so upset about this. I firmly believe I would not be here today if I had not had a screening mammogram at 40."
(snip)
"[Some] women don't understand how screening can cause problems," said Dr. Bob Crittenden, an associate professor in family medicine at the University of Washington. "Personally, I think this is symptomatic of many in people in medicine promising good health if you get screened. As we know with PSAs and other screenings of asymptomatic people, we have only a few things we can do that actually help extend life and then usually only marginally."

I had to stop and read this paragraph several times, because I simply could not believe what my eyes were seeing.

Read that again, and see if you see it too?

"As we know with PSAs and other screenings of asymptomatic people..."

Isn't this what preventative medicine is all about? I thought one of the main factors to reducing health care costs was to have more preventative medicine, to catch problems early and head them off at the pass before they became bigger problems?

Wasn't one of the points of the reform issue that people that did not have affordable healthcare often delayed or often put off going to doctor because they could not afford it, until problems manifested themselves at a later and more costly stage?

If you did not go to the doctor for breast cancer until you became "symptomatic", chances are, you would be told you waited to long, and in essence, had signed your own death certificate!

"...we have only a few things we can do that actually help extend life and then usually only marginally."

I put forth this is a blatant spin on the facts in an attempt to marginalize the success in research and cancer treatment, *especially* in the field of breast cancer.

I am of the strong opinion that breast cancer is NOT equal to prostate cancer, as most men that will develop prostate cancer will die from other things such as old age, heart disease, etc before the prostate cancer kills them.

Such cannot be said for breast cancer. Attempting to compare the two is like comparing apples and oranges.

Dr. Gary Lyman, a breast cancer oncologist at Duke University who researches comparative effectiveness, says guidelines like those issued by the USPSTF may cause a great deal of harm.

"This is a reversal of the position they took in their previous recommendations, and this flies in the face of previous guidelines from other groups in the U.S.," he said. "[While] the risk of breast cancer is less in the younger age group, 40 to 50, mammograms save lives in those age groups."
(snip)
"I'm puzzled why, when the evidence hasn't really changed, when the estimate in benefit and risk hasn't really changed, why they reversed their position," he said.

Indeed something else is at work. One of the leading factors in healthcare reform is to cut expenses on "older" people in an attempt to have more funding to "save the lives" of younger people that need treatment.

Such a blatant about face on the recommendations should urge an in depth review of who is exactly behind the scenes, and how far the long reaching arm of this administration may have reached into this decision.

While many have said the new recommendations are part of a bid to lower medical costs, Lyman said he does not believe there was an economic motive.

Instead, he said, the issue could be that the panel does not include a breast cancer specialist.

"There's no breast cancer expertise on that panel, and I think it's hard to develop guidelines with the data as it is without understanding breast cancer," he said. "It's certainly not a change in the evidence. Something else is at work."

And when healtcare reform is passed, and we have these panels telling doctors what they may and may not order, this is the kind of precarious position we want our families and loved ones put in? Panels making healthcare decisions that don't have representation that is adequate to make those decisions?

While false positives may create problems for some patients, many seem to feel that those are outweighed by the deaths that can result if the screening is not done, something that will present a challenge to any desire to change screening guidelines.

"At the Methodist Breast Center, we diagnose and/or treat about 500 patients with breast cancer every year," said Dr. Luz Venta, medical director of the Methodist Breast Center in Houston and fellow of the Society of Breast Imaging, in a statement. "And about 21 percent of these are women under age 50. Should these women be sent away and told the cost of screening for breast cancer is not justified in the number of lives that can be saved?"

So lets take a look at those numbers. That is 105 people that may die or be faced with drastically radical treatment due to delay at higher cost, in one year.

That is just ONE medical center.

That is very devaluating to women with respect to their value as human beings, and now we have the governmment placing a rather low price on our heads in retrospect.

There was never a better argument against this "reform" debacle.

No one is denying there is rampant discrimination against women in the medical field.

But the very first line if defense is knowledge. And the symptoms for women are different then the symptoms of a heart attack for men. Women are not informed and many don't recognize the signs. Plus you hear so much about breast cancer that is the forefront on women's minds, not heart attacks.

Many physicians don't even know women die of cvd then men do.

Women are less likely to report chest pain. There are major differences in how the medications work among the genders.

Half of women don't even realize that heart disease is the lead killer of women.







[edit on 18-11-2009 by nixie_nox]

reply to post by Libertygal


Star. Thanks for posting this information. It certainly gives one pause, and the attitudes are absolutely chilling. CNN's Sanjay Gupta does not appear to be supporting this much, I noticed.

This whole idea seems surreal to me. It is certainly not being put into place to serve women. It's to better serve insurance providers, and increase net gains. Clear and simple.

reply to post by ladyinwaiting


You are quite welcome.

I started doing some research in this group, and found some interesting facts. Not only is this an HHS group, they were slated to receive over 8 billion inTARP funds at the first part of the year.

Follow the Money!

So the tree is thus:

U.S. Department of Health and Human Services
|
AHRQ - Agency for Healthcare Research and Quality
|
The U.S. Preventive Services Task Force (USPSTF)

www.ahrq.gov...



Stimulus Bill Gives NIH A $10 Billion Boost
Over Two Years, And $1.1 Billion For AHRQ

By Paul Goldberg
House and Senate conferees last week reconciled the differences in the
economic stimulus bill that will give NIH $10 billion over two years and
put $1.1 billion into comparative effectiveness research at the Agency of
Healthcare Research and Quality.

The $789-billion measure has been sent back for action by the House
and Senate, and insiders expect that it will be passed and signed by President Obama.

The bill would give NIH $8.2 billion to fund research over two years.
Another $1 billion would pay for construction on campuses of grantee
institutions, $500 million would pay for on-campus construction and $300
(snip)
The compromise bill gives $1.1 billion to AHRQ for assessment of comparative effectiveness research. Of this money, $400 million would be transferred to NIH to start such studies. NCI-sponsored clinical trials
cooperative groups are well positioned to conduct such work.

Several groups have been applying the A-word— accountability—to NCI, not a gratuitous dig, considering that one of its recent directors, Richard Klausner, ended up under Congressional investigation.

The Congressional investigation suggested that Klausner had steered grants to associates, questioned his acceptance of awards and lecture fees, and alledged that he engaged in negotiations with potential future
employers without proper recusal.

www.bcm.edu...

In its continuing investigation into how the National Institutes of Health (NIH) awards research grants and contracts, the House Energy and Commerce Committee is seeking to determine whether Richard D. Klausner steered a $40 million contract to Harvard University while director of the National Cancer Institute (NCI) and during the time he was a candidate to become the school's president.

www.the-scientist.com...

Ex-NCI Director Quits Leadership Role in Gates Foundation

Dr. Richard Klausner, global health director for the Bill & Melinda Gates Foundation, resigned yesterday, saying he is launching a new venture in Seattle. He would not reveal details.

Both Klausner and Joe Cerrell, director of Global Health Advocacy for the Gates Foundation, said Klausner's resignation had nothing to do with a Friday Seattle Times story that the Government Accountability Office has begun looking into conflict-of-interest guidelines and Klausner's role in a lucrative contract awarded to Harvard University when he was National Cancer Institute (NCI) director.

seattletimes.nwsource.com...

Richard Klausner
Political Campaign Contributions
2008 Election Cycle
2008 Transaction Count/Amount 14/$6,550
2006 Transaction Count/Amount 6/$5,250
2004 Transaction Count/Amount 0/$0
2002 Transaction Count/Amount 0/$0
2000 Transaction Count/Amount 0/$0
Name & Location Employer/Occupation Dollar
Amount Date Primary/
General Contibuted To
Klausner, Richard
SEATTLE, WA
98177 The Column Group/Physiscain/Venture $-4,500 10/20/2008 P OBAMA VICTORY FUND - Democrat
Klausner, Richard
SEATTLE, WA
98177 The Column Group/Physician $500 10/06/2008 P ACTBLUE
Klausner, Richard D.
SEATTLE, WA
98177 The Column Group/Physician $500 10/06/2008 G JUDY FEDER FOR CONGRESS - Democrat
Klausner, Richard
SEATTLE, WA
98177 The Column Group/Physiscain/Venture $5,000 09/29/2008 P OBAMA VICTORY FUND - Democrat
Klausner, Richard
SEATTLE, WA
98177 The Column Group/Physiscain/Venture $500 08/29/2008 G OBAMA FOR AMERICA - Democrat
Klausner, Richard D.
SEATTLE, WA
98177 The Column Group/Physician $1,000 07/23/2008 G JUDY FEDER FOR CONGRESS - Democrat
Klausner, Richard
SEATTLE, WA
98177 The Column Group/Physiscain/Venture $1,000 07/15/2008 P OBAMA FOR AMERICA - Democrat
Klausner, Richard
SEATTLE, WA
98177 The Column Group/Physiscain/Venture $-1,000 07/15/2008 P OBAMA FOR AMERICA - Democrat
Klausner, Richard
SEATTLE, WA
98177 The Column Group/Physiscain/Venture $1,000 07/15/2008 G OBAMA FOR AMERICA - Democrat
Klausner, Richard
SEATTLE, WA
98177 The Column Group/Physician, Venture $300 04/17/2008 P OBAMA FOR AMERICA - Democrat
Klausner, Richard
SEATTLE, WA
98177 The Column Group/Physician, Venture $500 04/05/2008 P OBAMA FOR AMERICA - Democrat
Klausner, Richard
SEATTLE, WA
98177 The Column Group/Venture Capital $500 02/22/2008 P OBAMA FOR AMERICA - Democrat
Klausner, Richard
SEATTLE, WA
98177 The Column Group/Venture Capital $1,000 01/27/2008 P OBAMA FOR AMERICA - Democrat
Klausner, Richard d
SEATTLE, WA
98177 The Column Group/Physician $250 09/27/2007 P JUDY FEDER FOR CONGRESS - Democrat

www.campaignmoney.com...

continued...

OBAMA CANCER PLAN MUST PRIORITIZE PREVENTION, SAYS CANCER PREVENTION COALITION

CHICAGO, IL, January 23, 2009 --/WORLD-WIRE/-- President Barack Obama is the first President to develop a comprehensive cancer plan. While the plan reflects strong emphasis on oncology, the diagnosis and treatment of cancer, no reference is made to prevention. Yet, the more cancer that can be prevented, the less there is to treat.
(snip)
In March 1998, in a series of questions to then NCI Director Dr. Richard Klausner, Congressman David Obey requested information on NCI’s policies and priorities. He asked, “Should the NCI develop a registry of avoidable carcinogens and make this information widely available to the public?” The answer was, and remains, no.

Klausner’s responses made it clear that NCI persisted in indifference to cancer prevention, coupled with imbalanced emphasis on damage control - screening, diagnosis, treatment, and clinical trials.
(snip)
It should be further emphasized that the costs of new biotech cancer drugs have increased more than 100-fold over the last decade. Furthermore, the U.S. spends five times more than the U.K. on chemotherapy per patient, although their survival rates are similar.

The Obama Cancer Plan is subject to Congressional authorization, and funding approval by the House and Senate Appropriations Committees. These committees will be in a position to require that major priority should be directed to cancer prevention rather than to oncology. Clearly, the more cancer is prevented, the less there is to treat. This will also be of major help in achieving Obama’s goal “to lower health care costs.”

Does this very staement not fly in the face of the panel recommendation?

Because Klausner had the unfortunate circumstance of announcing his resignation on the same day as the terrorist attacks, Sept. 11, few people paid much heed to those who praised his leadership as he left the cancer institute.
(snip)
He moved on to serve briefly as president of the Case Institute of Health, Science and Technology, part of the Case Foundation started by AOL Time Warner Chairman Steve Case and his wife, Jean. But because of Sept. 11, Klausner was asked to head a National Academy of Sciences task force to make recommendations on how to use science and technology to fight terrorism, and the new institute never got off the ground.
(snip)
Developing a vaccine against HIV, the AIDS virus, is also one of the top-funded priorities of the foundation. Klausner has a lot of experience in that arena, noting that the study of AIDS-related cancers at NCI made his institute the second-largest AIDS research program (in terms of funding) worldwide. He also helped launch a center at the National Institutes of Health devoted to the search for an HIV vaccine.

He thinks his work as chairman of the National Academy's task force on terrorism will dovetail nicely with his new position.

www.seattlepi.com...

Huh. Interesting.

Revamping the Grant Process

Dr. Richard Klausner, former director of the National Cancer Institute, now managing partner of The Column Group, a venture capital company:

www.nytimes.com...

And now, for the juicy part you have been waiting for!

The plan has been developed with funding from the Gates Foundation of Seattle. The foundation's director for global health, physician Richard Klausner, says the proposal follows the example of the Global Alliance on Vaccines and Immunization, a grouping of governments, drug companies, and private institutions that buys existing vaccines for global distribution. Dr. Klausner says the Alliance's efforts have expanded hepatitis B vaccine suppliers from one to about 10 companies and the price has dropped 20 percent. He says the Center for Global Development idea could provide the same incentive for new vaccines. "This specific report presents a convincing argument that we may now have one more specific tactic, a new tool, for pulling vaccine development," he said.

www.voanews.com...

A new biotechnology venture-capital firm launched by Richard Klausner, the former director of global health at the Bill and Melinda Gates Foundation, has raised at least $132 million in funds and begun investing in startup companies, according to one of the firm's managing partners.
(snip)

Svennilson declined to discuss The Column Group's investments in any detail but did confirm two investments: NGM Biopharmaceuticals and 3-V Biosciences. Neither company has a website but both appear to be based in California.

seattle.bizjournals.com...

Novavax and Bharat Biotech announce a pandemic influenza vaccine development alliance

Novavax and Bharat Biotech announce a pandemic influenza vaccine development alliance
10 Mar 2006 - Novavax, Inc. and Bharat Biotech International announced a strategic alliance to pursue the rapid development of pandemic influenza vaccine for India and other ASEAN markets. Under the terms of the Agreement, Bharat Biotech will fund all preclinical and clinical development, work with Novavax on optimal manufacturing processes, and be responsible for the commercialization of the vaccine. In return Novavax will receive unrestricted access to all preclinical and clinical data, and a royalty on all sales.

Novavax's Virus Like Particle Technology uses recombinant protein technology to imitate the structure of a virus to provide protection without the risk of infection or disease. Virion proteins can self-assemble into virus-like particles (VLPs) when over-expressed in certain cells. Novavax's proprietary VLP technology produces safe and effective vaccine products through an aseptic process that reduces contamination risk and produces high, cost-effective yields. A key advantage of the technology is the ability to rapidly respond to emerging threats or new strains.

The alliance will be overseen by a steering committee chaired by Dr. Richard Klausner, eminent scientist and Former Executive Director of the Bill and Melinda Gates Foundation and Former Director of the US National Cancer Institute. Dr. Klausner is a special advisor to the Government of India and to Novavax, Inc.

www.bionity.com...

Originally posted by ~Lucidity

Originally posted by drmgj... false positives will lead to many healthy people getting unnecessary surgery...

hardly. additional mammograms, ultrasounds, and needle biopsies maybe, but that is standard BEFORE ANY SURGERY. this is a flat out crock.

Agreed! Anyone who has done BSE & discovered a lump will know that surgery is ALWAYS a last resort.


Interestingly enough, I am friends with a lady who is an Oncologist & she tells me that most breast lumps are discovered by the partner of the woman, & not by self examination!! This is exactly how my breast lump was discovered too, not by me!