January 8, 2010 Leave a comment
Via, Jon Cohn, comes the clearest explanation I've seen for the new mammography guidelines. It's a shame that it was never originally explained with this clarity.
Margaret Polaneczky, a New York physician who writes the "The Blog That Ate Manhattan," was among the few who paid attention. And she has written what is, I think, the clearest summary and interpretation of the issue I've read yet:
What the Task Force is saying is simply this – On
a population basis, the net gain from adding 10 years of mammography in
all women is small in relation to the risks of over-diagnosis, over
treatment, unnecessary biopsies and anxiety. But you, as a patient, in
consult with your physician and assessing your own personal risks of
breast cancer, may decide you want to get a mammogram anyway.
What they meant to do was to take mammography out
of the realm of the knee-jerk, automatic and into the realm of informed
decision making. They meant to inform women that mammography's 15% or
so reduction in mortality comes at a price–a price that is physical,
emotional and financial, in the form of false positive results,
unnecessary biopsies and the anxiety and dollar cost that accompanies
them. They also meant to dispel popular overblown notions about what
mammograms actually do by clarifying both their benefits and their
risks, so that women are making the most informed decision they can
about whether or not to have this potentially lifesaving test.
Unfortunately, they blew their 15 minutes. Which leaves it to the rest of us to clean up the mess.
This is an important issue. It's a real shame there's been so much misunderstanding and misinformation. I think it is an especially important point that we put to much faith in this particular technology (as we do with many technologies).