At the heels of Breast Cancer Awareness Month, the United States Preventive Service Task Force made an unlikely announcement on Monday.
The USPSTF discouraged the recommendation of annual mammograms for women between the ages of 40 and 49, supported mammograms every two years rather than annually for women over 50 and discouraged the teaching of breast self-exams for all women.
The implications of the report have led many women to wonder whether or not their insurance plans will cover the cost of their mammograms by the time they turn 40 or 50 and their doctor recommends routine testing.
However, according to the health insurance lobbyist group America’s Health Insurance Plans, a change in coverage in the near future is unlikely, as most of the current guidelines are enforced by law.
The new recommendations contradict those laid out by the American Cancer Society, and the debate involves complex economic and health factors that ought to be explored in depth.
However, it is the recommendation against the teaching of breast self-exams that is irresponsible.
The USPSTF based its recommendation on the findings of two large studies, one in Russia and the other in China, that both concluded there was no difference in mortality rates between women who performed breast self-examinations and those who didn’t.
Additionally, the women assigned to perform regular self-examinations were nearly twice as likely to undergo breast biopsies than women in the control group, while the number of cancer diagnoses was not significantly different.
I find two major issues in the USPSTF’s reliance on these findings.
First, in the Russian study, women who performed breast self-exams were more likely to find both benign and malignant tumors.
Second, the women’s behavior was likely affected by the design of the study.
“Women in the self-exam group knew they were part of a study that was testing or grading their ability to find possible breast cancers early … these women may have reported findings or concerns that they would not have otherwise mentioned to a physician had they not been enrolled in a study,” said Dr. Marie Savard in her article “Why women must still examine their breasts.”
Women who think they have found an abnormality in their breasts ought to report it to their physician. As Savard said, “Rarely do doctors perform breast biopsies solely because of a woman’s complaint without a clinician evaluation and recommendation.”
This renders the fear of unnecessary medical procedures and trauma incurred from a self-examination quite unlikely.
Moreover, in the face of declining support for vigorous testing, now more than ever women should strive to be advocates of their own health.
According to The Canadian Medical Association Journal, visually examining the breast and using the finger pads and three middle fingers to examine the breast are the most effective tools in breast self-examination.
In the end, it’s a simple solution: Breast self-examinations have little to no risk, are easy to do and are free of charge.
What could be better?
Kristen is busy encouraging women everywhere to be their own advocates. Reach her at kckelle2@asu.edu.
