Goodman on mammography: Policyspeak v. pink ribbons

Globe-based national columnist Ellen Goodman writes today about how badly the USPSTF delivered the message on the limits of mammography in women under 50. She agrees with their recommendations. She just thinks the panel was blindsided by extremely angry women who are not willing to reconsider the notion that early detection is key to cancer survival.  Then there was the anti-health reform “guidelines = rationing/death panel”  crowd.

This was never going to be an easy message. The breast cancer research is more complex and controversial than the cervical cancer research that was released just days later with recommendations to delay and reduce pap smears. But nevertheless, this perfect storm created a perfect case on how not to deliver a public health message.

It’s important because – and I say this as someone whose mother, aunt, and sister have all had breast cancer – the task force had a strong story to tell. The benefits of mammography for younger women have been oversold. As Laura Nikolaides of the National Breast Cancer Coalition and a cancer survivor says, “People have been doing mammography as a security blanket: If you have a mammogram, you won’t die of breast cancer. We wish that were true.’’ The biology of the tumor – how aggressively it grows – is now judged more important than the size at which it was discovered. And the terrible reality is that we haven’t done much to change the survival rate of younger women who get this disease.

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