Wednesday, November 18, 2009

To Screen, or Not to Screen... why is it even a question?

This week, the internet and water-coolers near and far are abuzz regarding the latest positions taken by the U.S. Preventive Services Task Force (found at http://www.ahrq.gov/CLINIC/uspstf/uspsbrca.htm). Mammograms will no longer be recommended for women 40 and up, but rather 50 and up.

Here is the Lance Armstrong Foundation's official statement: http://www.livestrong.org/site/apps/nlnet/content2.aspx?c=khLXK1PxHmF&b=2661079&ct=7675937

Now, here's my take. I will freely admit that I am terrible at remembering to perform self-exams. I've been told I've got "lumpy breasts" anyway - as some of us do - so, when I've done self-exams, and mentioned this to doctors in the past, they just tell me the same thing, "you've just got lumpy breasts." I'm under 40, and well under 50. So by any standard, I wouldn't require a mammogram. And, when I've said to my doctors, "Look, I know I have lumpy breasts, but, really? Are you sure there's nothing to worry about?" I'm told, "Nope, nothing, these are normal for lumpy breasts."

Which leads me to wonder: 1) Are lumpy breasts normal in the first place? 2) What if just ONE of those lumps isn't just a "normal" lumpiness lump, but a bad, malignant lump. And it's getting lumped in with all the rest of the "normal" lumps? 3) How many women out there are also dismissed as "just having lumpy breasts", only to discover, at a later date, that they didn't "just" have lumpy breasts, but breast cancer?

So, even when I was diligent about my self-breast exams, and I found a lump, it was dismissed.

When I asked this year about having a mammogram, just to "be on the safe side", I was told that not only was it not necessary, but that my insurance wouldn't cover it because there wasn't enough cause.

Now, this is NOT a dig at my doctor - I LOVE her to death. I happen to trust her when she says I have nothing to worry about - to date, she hasn't been wrong about anything. BUT... what about women who don't know without question that they can trust their doctors? Or that don't know to continue to question or push?

Forgetting, temporarily, about women without insurance, what about women who have insurance, and, even with the old standards, cannot have a mammograms covered without "due cause"? What qualifies as "due cause"?

Here I am, a woman in my, well, under 40-years (and no longer 21... ), who has found lumps in her breast, asking for a mammogram, with a family history of cancer (including an Aunt who survived breast cancer), being told I can't have one?

Can you imagine what is going to happen with the new standards?

To me, it just seems like insurance companies and like-minded physicians are trying to set themselves up for protection as the current health care system is being reviewed and possibly becoming a federal mandate. After all, the best defense is a good offense, right? Are they really taking the stance of, "Ok, you want us to take care of everyone? Fine, Mr. Do-Gooders, we're gonna make you pay. Now this isn't necessary, and this isn't necessary, and neither is this, so get out the checkbooks, because someone is going to pay us the premiums we want... "

Am I being extremist? Perhaps.

But I happen to like my breasts. Lumps and all. They have a small fan club, in fact. So, I'd rather not lose them in the near future because I'm told I'm too young for a mammogram.

Sorry.

1 comment:

  1. Great blog post, Rica. This just makes me so angry. I have been told too, that I have 'lumpy breasts' so apparently i am supposed to be so familiar with said lumps that i can detect a unusual one. One doc told me it would feel like a frozen pea.
    I am 42 so i have gotten a mammogram. But i am also on disability so if this goes into effect then i highly doubt medicare will pay for it! So, i'm thankful I just got one in. I was just about to schedule another. I just think this is ridiculous and that you're probably right about why they are doing it now of all times.
    Jody

    ReplyDelete

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