McCarty: Women can handle scares of mammograms

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By Mary McCarty, Staff Reports 11:15 PM Saturday, November 28, 2009

Am I the only one feeling a tad insulted by the reasoning behind the new guidelines for breast cancer screening?

I know, I know, the study was supposed to be a dispassionate, serious analysis of risks versus benefits of mammograms for women under 50. Yet one of the advantages touted most frequently is reduced anxiety, fewer false alarms.

Seriously — we can handle it.

“If I had listened to the bean counters, I’d be one dead bean,” said my friend Laura Pulfer, who was diagnosed with breast cancer at the age of 42 following a routine mammogram. “The rationale is that women get these terrible scares with false positives. Well, if we can go through childbirth, we can go through a little bit of a scare.”

Twenty years later, the former Cincinnati Enquirer columnist is healthy and very much alive, enjoying her retirement and her two granddaughters.

I thought of the amazing women — many of them under 50 — I’ve come to know through my recent series on the Noble Circle Project, an innovative cancer support group. Would their lives, too, be regarded as statistically insignificant by the new study?

Pat Partida of Springfield believes her life was saved by a mammogram. “I think this is very condescending to women,” she said. “Cancer is not something to mess around with, and having just lost my daughter-in-law it makes me very angry to know that money comes before life.”

Nickie Sattler of Beavercreek believed so firmly in the importance of mammograms that she scheduled hers when she was 40 years and three days old. “Two days later, she received a phone call stating she needed a diagnostic mammogram which revealed cancer in very early stages. By the time of her surgery six months later, it had developed into Stage 1B invasive breast cancer. “There were no lumps to feel at any time,” she said. “If I had waited until the new guidelines of 50, I would most likely be dead or in advanced breast cancer.”

Her friend Rhonda Traylor of Huber Heights, another breast cancer survivor, said she was stunned by the recommendation: “Since breast cancer is much more life-threatening in women under 50, how can we not take every opportunity to encourage women to be screened as soon as possible?”

The new guidelines have been derided as an example of “Obamacare,” but in fact the task force, a 16-member panel appointed by the Department of Health and Human Services, began its research several years ago. Their research showed that regular mammograms resulted in a 15-percent decrease in the death rate for breast cancer for women in their 40s.

Wouldn’t that finding more than justify early testing?

The answer is more complicated than it seems, according to Dr. Mary Buchwalder, medical director for the Gosiger Health Center at the University of Dayton. She observed that “this is such an emotional issue for anyone who has been directly affected by cancer that it’s hard not to have a strong reaction.”

Yet she noted that it’s common for medical experts to weigh the benefits and risks of medical screening: “I’ve seen women who have had multiple biopsies for what ended up being benign lumps, and have scarring and even some disfiguration from the biopsies. I’ve also seen where women have developed horrible problems with infection after this ‘simple’ but invasive procedure. And anxiety can be huge for many.”

Buchwalder said that the American Cancer Society and the American College of Obstetricians and Gynecologists haven’t altered their recommendations for regular screenings beginning at 40.

Peter Osborn, public relations director for Southwest Ohio for the American Cancer Society, said, “We stand by our position that this is a useful tool for women in their 40s. We’re getting a lot of calls from women who are confused.”

Confused? Who wouldn’t be?

There may be legitimate medical disagreements over the proper age for breast cancer screening, but please don’t reduce them to an argument that amounts to “don’t worry your pretty little head.”

I’ll take a little scare over a missed diagnosis, any day.

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