Public Health in Oregon - Join The Conversation

I agree with Dr. Susan Love’s quote: What we really need is to figure out what’s causing breast cancer in these young women and figure out a way to stop it.” Education is key to empowerment; and when women feels that they have the knowledge and control over their body, the mammogram procedure will no longer be needed.
Along with promoting a healthy life style, an environment where women can connect also play a big role in making social changes. Human are social creatures, and when we feel like we are part of something positive we can achieve great things.

I think that having the option for a mammogram and being able to detect breast cancer that accurately is amazing. Stating that the negatives outweigh the positives is discomforting. I understand why cost vs. effectiveness come into play but for something as important as saving lives, especially because cancer has taken so many, i don’t think it’s something worth cutting.

I have heard of this before, and I was definitely skeptical! Every woman worries that breast cancer may plague them at some point in their lives. Self-exams are crucial, and with any annual “lady exam,” the doctor usually does a feel-test of their own. This may be a good substitute for annual mammograms. However, high risk groups, such as those with breast cancer or other cancers in their families, should definitely continue to be seen as often as they are comfortable with. Perhaps a mammogram every 3-5 years would be better for low-risk women. At what age would annual mammograms be required? And what other evidence or scientific research has been done showing that these mammograms truly have greater cons than pros? I think this article is lacking in its argument, but I can understand where the writer(s) are coming from.

I think this article brought up some both good and not so good points.  Yes it is imporant and a good idea to know how to do a self examination at home, and yes it is obviously cheaper to do self exams rather than going to the doctor.  But how is someone suppose to really know how accurate their self exams are? With that in mind, I think it is a good idea to do self tests, but keep the doctor in the picture. Doctors do, in the end, know best.

This article brought up information that I believe many women would be skeptical of, since it goes against what they have been told they need by health professionals. The harmful affects outweighing the benefits should be described further. This is a situation where the benefit of the population should continue to outweigh that of the individual, as appears to be the case. One idea however, could be that for women who know breast cancer runs in the family, pay extra attention to and possibly continue the annual mammograms.

I think that this article has both good and bad points. I think it is good that women are being encouraged to do their own self examination versus going to the doctors and spending money. However a self examination is not 100%, plus there are women who may not know how to do it correctly. So while this article raises a very good point i think that it needs to be taken with a grain of salt, for the simple fact that mammograms still have a benefits.

This article has good points on both sides of the argument. Yes annual mammogram screening is important and can catch cancer that may not have been noticed with a self exam, but on the other side if they are harmful to women to have every year why is that the recommendation. I know that if i had family history of breast cancer i would want to have a mammogram every year because its always better to catch it early. Yes women can to self examinations but women may not know the proper way to do one so education on that would be needed. Saving money isn’t the same as saving lives .

self examination is good and all but what if the women that think they might have cancer and don’t really and go to doctor for treatment, they would get stressed out and worry their families. i think they should get an exam when ever they want or think they need one, because a life is a life no one should loss thier life because of ristrictoins to mammograms.

I have a split opinion on the matter.  While I think it is good, and definitely a priority, to decrease the number of false positives, I also think it is important to find that one person with breast cancer before it spreads to other regions of their body.  It would be best if you could some how perfect our current mammogram, or find another form of testing that would be more effective in detecting breast cancer without the large amount of false positives.

There’s a lot of talk about “defensive medicine” and “unnecessary tests” that run up health care costs and causing unwarranted anxiety. If the evidence says most women under 50 don’t need a routine screening mammogram, that is good news for all of us. This is not to minimize the experience of women diagnosed with breast cancer before age 50, but it seems on average the world is a little less scary than we’d thought. A lot of women I’m sure feel more comfortable gaining less radiation from these guidelines, and mostly all women can do their own self-exams without help from a doctor. The most important thing is that women need to talk with their physicians and do what is best in their individual circumstances.

I can see both sides of this topic. From a Public Health perspective, I agree with Susan Love. If we stop requiring women to have annual mammograms then we need to be able to detect breast cancer in another way. We need to find out what is causing the cancer and how to prevent it. Also, for women, getting an annual mammogram is like a safety net. They feel comfortable that they are empowering themselves against this disease. Encouraging self-exams while the make the changes is smart but how long will it take for physicians to find the sources of breast cancer?

I do not so much agree with eliminating annual mammograms because I do see what good that would do besides saving money. Even though women can do self examinations, sometimes they are unable to detect lumps for themselves. In my opinion, I think mammograms are helpful and also life saving. My aunt was diagnosed with breast cancer after she had a mammogram performed on her. She said she did many self examinations prior and never felt the lump for herself. I think that women should have both tests done, mammograms and self examinations because early detection will save lives. Also, if cancer runs in the family, you should have tests done yearly to make sure you can catch cancer early on, if that’s the case.

Breast cancer is so prevalent in the United States, with 192,370 new cases, and 40,170 deaths in 2009, that it doesn’t make sense to stop using this service of early detection. In this article it says that the health risks out weigh the benefits, but my question is what risks could out weigh the possibility of finding breast cancer and thus stopping another death? This goes in congruence with the statement “numbers don’t matter - only individuals do - and if just one life is saved, that’s good enough.” Yes, we should figure out what is causing breast cancer, but until then routine check ups should be preformed to stop the development of cancer, and for early detection!

There are many issues than can come out of false positive test, like unnecessary treatment which could obviously do way more harm than good. I think that people are making a much bigger deal of breast cancer than it needs to be, for instance why don’t we ever get tested for any other kinds of cancers? and getting exams done all the time, I mean each person has the responsibility to examine themselves and if at that point something is not right, i think a mammogram would be necessary. this method would save time and money, plus who knows if the actual testing brings any harm to the individual.

I think women should be doing self examinations on themselves anyway and this way it cuts down cost that can be used in other areas. I think yearly mammograms will be necessary for people who tend to be more at risk.

According to these facts it would appear that these changes in guidelines for mammograms are justified in the potential misdiagnosis or high cost that could be going to research instead. I feel that depending on individual risk factors, such as family history of cancer, that women should have a mammograms annually. Self-exams should still be taken as well as more research done.

I am shocked at the first statement in this article which suggest that women ages 40+ should stop having their routine mammograms.  Coming from a family with a history of breast cancer I feel that it is very important for all women to have annual check ups for cancers such as these that are very common. Whether you have a history of this cancer or not running through your family, self examinations are a must, as well as mammograms.  I see the problem when it comes to the financial burden that numerous mammograms can cost our country, but how is it fair to put a cost on life?

Women who do not have a family history of breast cancer probably don’t need to be getting annual mamograms in their 40’s. I still feel that they should routinely give themselves a self-test of course. I agree that the money could be better spent by using it to research the causes of breast cancer and ways to prevent the cancer.

If the facts in this article are true then I believe that women, who do not have a family history of breast cancer, do not need annual mammograms because that is a waste of money. Those women who do have a family history, I think annual mammograms are a great idea. I think that self-check examinations are a great way for early detection.

I am in disbelief that they would discourage women in their fourty’s from regularly having annual mammograms and to cut back to every other mammogram. Ehrenreich states that the numbers don’t matter, just the individuals. I strongly agree with her point. Personally, I believe that women of any age should routinely get checked for breast cancer. If just one life could be saved it would be worth it. Getting mammograms is a method of preventative care and could lead to a healthier lifestyle. If a woman is concerned about getting mammograms, it is likely that she would also get checked for other health issues. I would encourage all women in my family to get routinely checked and hope that other women take the initiative as well.

I am in disbelief that they would discourage women in their 40’s from regularly having annual mammograms and to cut back to every other mammogram. Ehrenreich states that the numbers don’t matter, just the individuals. I strongly agree with her point. Personally, I believe that women of any age should routinely get checked for breast cancer. If just one life could be saved it would be worth it. Getting mammograms is a method of preventative care and could lead to a healthier lifestyle. If a woman is concerned about getting mammograms, it is likely that she would also get checked for other health issues. I would encourage all women in my family to get routinely checked and hope that other women take the initiative as well.

First off, I’m extremly shocked by this article stating “women in their 40s should stop routinely having annual mammograms and older women should cut back to one scheduled exam every other year”(CHP.) Isn’t breast cancer the top cancer killer among women?  I understand slef examinations are just as important, however I feel that a self examination doesn’t do any justice as compared to a mammogram, specifically someone in their 40’s who happens to have breast cancer running in the family.
I could possibly be misinformed, regarding the New Mammogram Guidelines, but cutting back on mammograms for women, is like cutting back on women in the early 20’s from having a pap smear.  Both these routinely check ups are dire for a womans health today.  They are cancer preventing!
So I’m hoping Public Health officials rise to this opportunity and explain how mammograms are vital for a womans health.

I think this is a very difficult and controversial issue and for some reason, it’s hard to think in terms of the population rather than the individual. At first I was shocked that the guidelines had been changed and had thought it was a big mistake. I was worried that too many women would go untreated because they weren’t being screened or monitored as often. However, upon reading the post above and really considering the issue from a population/community health standpoint, changing the guidelines makes sense. It saves women from unnecessary exams and also prevents the stress and anxiety that would accompany a false positive result. What struck me most was that the early screening of women under 50 didn’t reduce mortality. This has really got me thinking and it’s certainly challenging what I originally believed.

This message will be hard recieved because of the years of preaching early detection.  Women used to getting an anual mammogram may now feel entitled to continue getting one, especially if breast cancer runs in their family.  Although I don’t think excessive detection is the answer, I do think that insurance should continue to cover one mammogram per year.  Hopefully science will continue to move in the right direction and eventually isolate precursors and causes of breast cancers so we can shift funding to prevention rather than early detection.

Like Ehrenreich says, “numbers don’t matter — only individuals do — and if just one life is saved, that’s good enough.” I strongly agree with this. Public Health as we all know is preventative health care. This is a disease prevention technique, so I think regularly scheduled mammograms are a good idea and should continue to be encouraged.

I agree with what many people here are saying. False positives cause a lot of unnecessary stress and dollar spending. For people whose family it runs in, they should definitely be more wary and cautious and get examined but maybe not all women 40+ need to get yearly exams. Of course, look at the individuals risk factors. In my opinion, I do think more research should go towards actually finding out what factors cause/prevent cancer and taking more actions to stop it from happening in the first place. There needs to be more emphasis on primary and preventative care here.

I think it is wise to cut back on annual mammograms for women. However, I do think that women, who have breast cancer that runs in the family, should still get checked yearly because they are at a greater predisposition than others. For everyone else, self-examinations and examinations done by their local physician can be done instead of having a mammogram annually. If something suspicious is found through self-examination or by your doctor through a routine examination, then maybe yes, yearly mammograms should be done for that person.

This article brings up a good point, are annual mamograms really necessary for breast cancer screenning/ prevention?  Are the risks of radiation exposure worth the prevention?  If women are seeing their doctors on a regular basis, living a healthy lifestyle, proper nutrition and exercise,Do they really need these scans on a yearly basis?  Of course there are those who have a predisposition or who might be at more risk but, if they are having regular physicals these would most likely be discussed in an office visit.  Risk vs. quality of life and fear of…...?

I believe that self-screening would be the best option for these women. Receiving false positives would be horrifying and a waste of time and money. Looking more into how women can prevent breast cancer and spreading that information seems like it would be the most cost effective route.

I think that doing the self breat examinations is the way to go because if mamograms are not accurate sometimes then its just a waste of money. By doing the self examination it is more benificaial because i believe it is way easier to notice if something was wrong. The other side would be if history of breast cancer existed in the family then it would most likely be best if people visited the doctor for an exman.

If statistics prove that getting mammograms as often as has been recommended in the past is harmful and does not reduce the mortality rate of breast cancer in women then it is reasonable to reduce the amount of exams. If more women could learn to give self breast exams maybe that can do just as good of a job without exposing them to harmful radiation and spending tons of money.

Ehrenreich argues that “the numbers are increasingly insistent: Routine mammographic screening of women under 50 does not reduce breast cancer mortality in that group.”

This statement from the article is enough for me to make a change in my thinking in regards to women and routine mammograms. I agree that it has been a long standing “traditional” health screening, but traditions have a way of changing with time, and in some cases money. I would like to see how long it takes insurance companies to jump on board with less mammograms since it is one of those routine checkups like dental cleanings and physicals.

If a woman knows that breast cancer runs in the family, then she ought to look into having a mammogram on a regular basis, but for those of us who are educated on how to give a proper self-examination, it doesn’t seem like such a needed screening. The women who have dealt with the emotional devastation of having a false-positive can probably behind this new information.

When it comes right down to it, we have an individual responsibility to have the exam or not, and as long as women are educated in that decision, then we can make up our own minds about having a mammogram or not.

Thanks,
CC

I believe that changing something that has been grilled into our mind for so long is going to take awhile for people to accept. Women have been told for years that they need to get yearly breast examinations once over the age of 40. Women who are currently following all those rules are going to have a tough time being told not to get yearly exams. Every year they are reassured that they are breast cancer free. What if they don’t get checked every year, and the get the cancer? They could have had it for over a year. I personally find that upsetting. I understand that they are trying to lower costs, but to do that by taking away a big health care issue won’t solve everything…

I feel that yearly testing may be hectic, and also costly but in the end I believe it could save that one important life.  One life may not seem like a big deal on paper, or a statistic, but when that one life is someone who is close to you I truly believe it is worth taking an annual exam.  Promoting self testing is a great idea and should be an option to anyone who agrees to take them, but if there is a history of breast cancer in the family, it would be a good idea to continue with the mammograms.

It states that, “the potential harm to women having annual exams beginning at age 40 outweighs the benefit.” so annual exams for women over forty probably isn’t necessary. However if someone does have a history of breast cancer in there family they should probably continue frequent checkups. A good way to make it so less women are coming in annually for checkups is to inform more women on how to do self exams, it would not only save money but also decrease the amount of false positive tests.

On one hand the money saved on false treatment could be put towards other Public Health initiatives, however it seems that the prevalence of breast cancer amongst women is rising, so why remove methods of prevention? Perhaps research should be done to find more cost effective and accurate early detection methods to reduce fatality due to breast cancer.

Is this going to raise the cost of mammograms since a lot less will be taking place? Also, is there special circumstances for people who have breast cancer in their family history?  I can’t help but to wonder if the cases of breast cancer being diagnosed in later stages are going to go up after a couple years of these new rules.

The new recommendations will have positives and negatives: fewer mammograms might lower costs and risk of false positives, but it will also add to the confusion that many Americans already face in terms of health guidelines. It looks like the best option is routine, but not overly frequent, mammograms paired with regular self-checks. It will be interesting to see how this plays out with professionals.

In my opinion i think that changing the ways women get their mammograms is an extremly awful idea because a women could go for a year and a half with breast cancer and not even know she had it. The whole purpose for mammograms is to stop the cancer from the start and if we take that away what will we have for these women? Knowing how much of a growing issue breast cancer is in our country, why would we want to jepordize more women dying each year from it? I agree with Barbara Ehrenreich when she says; “numbers don’t matter — only individuals do — and if just one life is saved, that’s good enough.” It makes sense that even though money is spent, what is more important, money or a life?

It’s hard enough to do the right things to keep healthy even when the recommendations are clear. Confusion may cause more attention to be brought to the subject, but it might just confuse women. I agree with the importance of self-exams, but I don’t know how much security we should place on them, since it is it not done by a professional. It will be interesting to see if primary care providers and women’s health care professionals choose to use these new guidelines.

I agree with the person who posted below me. Women have been told for years to get mammograms for the early detection of breast cancer. A simple, never mind and different recommendation from health authorities will not reverse years of pushing mammograms. A dialogue, educational campaign or other public health initiative is needed to effect any change. Also, like the article mentioned briefly, if saving one life means 1,000 “unnecessary” mammograms, isn’t it worth it?

Instead of simply announcing that the number of mammograms should be decreased, there needs to be LOTS of reassurance that women will still be ok if they get mammograms less often. It is VERY difficult to have been told for so long by doctors (who we trust) that it is necessary to be screened so often, and then all of a sudden to have another group of people telling you that your doctors have actually been doing more harm than good. It makes for a very uneasy general population. Instead of scaring women, there needs to be a good, complete explanation of what’s going on. Women get screened because of the “what if’s”, because we are nervous about what will happen if we don’t. These conflicting messages are confusing, and causing women to ask themselves what will happen IF they get screened as often as they have been for years. Seems a bit unfair to me to drop this information on everybody without having an intellectual, understanding conversation with the women about it.

This is one of those topics that is interesting to look at because it includes a few different obstacles. First of all, I think that behavior change regarding mammograms will be hard because so many women have made it a public health routine which I’m sure gives them a sense of security regarding their health. By telling people they don’t need to take the precautions that they used to, they will obviously worry about what the absence of this behavior means and what problems may be going undetected. Also, I would say that many people would be more concerned with detecting cancer than being exposed to radiation. Not that one issue is more severe than the other, but cancer is everywhere in the media and has become something that we are determined to fight against. So this is why I think women will be reluctant to stop getting mammograms so frequently/at a younger age.

I think that a lot of people find this hard to swallow because for so long they have been told that mammograms are only beneficial, and now that they are hearing different it is difficult to comprehend. Overall I feel as though it is a waste of valuable funds. Like the article said mammograms produce many false studies and unneeded treatment, which are very stressful for women and their families, not to mention very costly. With a return rate of 1 every 1900 test you have to ask yourself is it really worth the money in an already financially stretched to the limit world.

I am a firm believer in prevention vs treatment mentality for medicine. This wasted money needs to be put toward finding out why young women are getting breast cancer, what is causing it, and ways to prevent it, instead of merely hoping to catch it early and pray for minimal damage.

I agree with several things this article is stating. As i scanned some of the the responses, I noticed a few with the basic premise of “I can’t imagine a mammogram causing more harm than good”. I think this lends into a lot of health conscience Americans believe that “an ounce of prevention is worth a pound of cure”. And while that is a good and accurate statement, it can also lead to the mentality of if one is good, then two must be great, and hence over use is very possible.

We often times get conditioned that certain things are good for us, and we should never hesitate to use them. All the campaigns and cancer awareness leads us to believe that it is the appropriate course of action, and a large part of me agrees as a family friend has recently had a double mastectomy because of breast cancer.

But I also realize the rate of cancer and I can see the numbers and any persons likelyhood, and how MAYBE some of the motivation behind yearly testing wasn’t pure altruism. I am sure mammogram machines are not cheap, and I am sure that many clinics make money on screening. pushing a level excessive exams is a way clinics and hospitals make money, it has happened many many times with other machinery.

I also have first hand knowledge of the emotional damage of false negatives as well. that is the harm that people refer too, not to mention the wasted dollars on tests, exams and more tests.

If good sciences tells us that the numbers do not add up, and the incidence of breast cancer does not justify the frequency of screening, then lets follow suit. It is one more step to lesson the strain on health care we face and excess costs that possibly do not need to be there.

It ,however, also goes without saying that you as a person should be responsible for your own health. and if you have a family history, or think you have found something in a self exam, then one should never hesitate to be checked out.

It is really difficult for me to comprehend that getting an annual mammogram does more harm than good. That, if these mammogram detect some cancerous or pre-cancerous material, that it will not reduce the rate of deaths due to breast cancer. I suppose I can entertain the fact that it may cause false positives, which I do agree is a cause for concern, but for that one woman who detected cancerous formations, it seems more than worth it. And there must be hundreds and thousands of women annually whose lives may have been saved because of a mammogram. It seems like postponing the age of recommendations for a yearly mammogram is just a way for companies to save money. They aren’t concerned with these individuals that could potentially have their lives saves, they are concerned with their wallets.

I think preventative methods should be taken more seriously. More education to be able to perform self-breast examinations, are beneficial because numbers of cases will begin to decrease. Preventative methods are also cheaper and better because if there is something abnormal it can be caught in earlier stages and treatment can be more effective.  If more people are aware of things and how to prevent them, many will take more precautions knowing a simple task can prevent a serious disease like breast cancer.  I still believe mammograms are necessary, especially if breast cancer runs in family, but maybe not needed as much if people perform self exams.

I think that the sheer number of false-positive screens that occur can be cut down on by reducing the number of mamograms that are done.  I also agree that people should know how to give self mammograms.  I feel like recomending fewer mammograms is a perfectly reasonable thing to do.

Being a women myself it is important for me to keep up on my health. Learning how to do a self breast exam is something i believe every women needs to know how to do. Lots of women dont have health insurance and cant afford to go to the doctor so a self exam is a simple free way to know whats normal for your body and know when its time you get help.

I think you can make a argument for both sides. I understand that people want to do everything they can when it comes to cancer. But from reading this article there’s a argument to be made that mammograms are expensive and can be inaccurate at times, therefore adding unnecessary costs to the health care industry. But until we find out what causes breast cancer, I think women will still rely on mammograms because as of now, it seems like the best scenario against breast cancer.