Mammography and the Right to Choose
(Editor's note: This is a guest blog written by Valerie M. Chapman, RN, MSN, a
pediatric nurse for 25 years. She is a 3-year breast cancer survivor
and lives in Medford, NJ, with her husband and two children.)
I am a wife, a mother of two awesome kids, a daughter, a sister, and a nurse. I am also a survivor.
At the age of 43 a routine screening mammogram picked up an
abnormality in my left breast that turned out to be invasive lobular
carcinoma. I had no family history or major risk factors, but there it
was: breast cancer. I had breast sparing surgery to remove the tumor
and then six weeks of radiation therapy. I started oral treatment with
tamoxifen to reduce the incidence of a recurrence. My life was saved.
The system worked.
Thus, on Nov. 16, 2009, I was horrified, stunned, angry, and scared
for myself and all American women when I read that the U.S. Preventive
Services Task Force (USPSTF) was recommending against routine screening
mammography in women between the ages of 40 and 49. Their assessment in
recommending this mind-blowing change is "moderate certainty that the
net benefit is small."
What is the USPSTF, anyway? A few clicks on Google told me: The
USPSTF is an independent group of "experts" appointed by the federal
Department of Health and established by congressional mandate. It is
charged with reviewing the scientific evidence related to the
effectiveness, appropriateness, and cost-effectiveness of clinical
preventive services for the purpose of developing recommendations for
the healthcare community.
And net benefit to whom? Certainly not women. We should all be asking ourselves these questions.
How will this translate to the lives of American women if this
policy becomes the standard of care? That, it seems, is really the
heart of the matter. My American sisters, it means that our right to
choose the preventive healthcare that is right for us is on the line.
The false positive mammograms in our age group (ages 39-49) cost the
insurance companies money. Those false positives often result in
retesting, which costs more money.
The ugly and painful truth is that the USPSTF does not think the
cost is worth it to save one woman. As one woman whose life was spared
by a screening mammogram, I can tell you: American women are not
statistics. Each and every woman is of immense worth and value, and we
will not have our lives marginalized by a "decision analysis." If the
USPSTF guidelines were to become the standard of care, I am frightened
for the lives of all American women, thousands of whom would likely die
due to lack of access to preventive mammography services.
Did the USPSTF consider the "net" cost to society of the deaths of
the women aged 40-49 years who will not be alive to raise their
children? To be wives to their spouses? To care for their aging
parents? To contribute to the work force, to PTA's, to carpools, to
community service projects, to houses of worship?
The answer is a glaring no, they did not. Make no mistake: The
controversy over screening mammography is about women's rights -- our
right to choose the preventive healthcare that is right for us. The
decision to have a screening mammogram should be between a woman and
her healthcare provider. It is essential that insurance companies and
third party payers fund annual mammography if a woman and her healthcare provider opt for this approach. Health Care reform legislation is
currently being considered in the Senate. If the USPSTF
recommendations are widely adopted, insurers could deny payment for
screening mammograms. I am standing for myself, and for women
everywhere in supporting screening mammography every year for women
aged 40 and over.
Let your voice be heard.