Blogfinger

Good Morning Dr. Paul Goldfinger. Here are today’s top stories. Tuesday, January 12, 2016

Source of this mammogram: Associated Press photo at the Washington Post.

The CBS Evening News (1/11, )  reported that the United States Preventative Services Task Force (USPSTF) “issued new guidelines for when women and how often women should be screened for breast cancer.” CBS’ Jon Lapook added that the USPSTF “says women of average risk should make an individual choice about whether to screen between the ages of 40 and 49 and be screened every other year between 50 and 74.” Lapook added, “Some doctors worry about the message these new guidelines may be sending to younger women.”

On NBC Nightly News (1/11, ), NBC’s Anne Thompson said, “The ever-shifting guidelines for starting mammograms leaves some women feeling like they are playing a game of chance.”

The Washington Post (1/12) points out that the USPSTF’s “final recommendation is likely to be controversial because some other groups say the screening should start earlier.”

The New York Times (1/12, ) reports, “The recommendations are not immediately expected to affect insurance coverage.”

Blogfinger Medical Commentary by Paul Goldfinger, MD, FACC, Blogfinger Off-Shore School of Medicine based in the seaside town of Ocean Grove.

As many of you know, we have taken an interest in the subject of mammography screening to prevent deaths from breast cancer.  It is not an easy topic; it is hotly debated and laced with emotion.  You may recall my controversial opinions about painting the town pink while failing to educate the public about breast cancer.  You can do a BF search above to follow our articles about this topic.

I am not a specialist in cancer, but I am fascinated by this debate partly because of my long-term interest in evidence-based medicine. In this case, we have a clash of opinions by world renowned experts in the field, so how do doctors resolve the differences in the interest of doing right by their patients?

I am floored by the latest solution which is to let  patients decide what to do when it comes to mammography screenings. I believe that every doctor who takes care of women, especially the gynecologists, oncologists, breast surgeons and even radiologists    (who sometimes actually talk to patients) should make a clear individualized recommendation while also discussing all options with their patients.  Of course, in the end, the patient should decide.

Here are two quotes which interest me:

Washington Post:  “The debate over when to start regular screening involves only women of “average risk” who don’t have specific risk factors for breast cancer such as the BRCA1 and BRCA2 genetic mutations or a family history of the disease. They’re also not aimed at diagnostic mammography, which takes place once a woman has a symptom such as a lump. The screening recommendations are not binding on doctors, hospitals or insurers.”

This quote mentions a major advance in breast cancer screening, ie the use of genetic testing to look for high risk patients who require special attention. It also admits that decisions about mammography cannot be generalized and reduced to pinkification of our town—these decisions must be individualized, and the public needs to  be respected and taught the hard facts——not the sugar coated, color coded substitutes for real education.

NY Times: The Susan G. Komen for the Cure foundation also expressed concerns about insurance payment, and issued a statement saying that a lack of coverage would hit “high risk and underserved” women hardest, particularly black women, who are more prone than whites to aggressive types of breast cancer.

This quote interests me because, when Ocean Grove was being plastered by pink ribbons and banners, the poor black neighborhoods of Neptune and Asbury Park had nothing pink in sight. How pathetic is that!!   Shame on Meridian Health.

You would all do well to click on the Times and Post links above.