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Public Health

Monday, September 12, 2011

Opinion: Cost Issues Delaying Breast Cancer Screening Bill

Contra Costa Times columnist Tammerlin Drummond writes that cost is the "underlying issue" delaying passage of a bill (SB 791) that would require health care providers to inform women about the presence of high-density breast tissue, which can obscure the presence of cancerous tumors. Drummond writes that health care providers and insurers "have fought tooth and nail" against the bill, saying it would cause unnecessary panic and "could cost $20 million to private health care plans and insurers." Drummond adds, "It is dishonest to the point of criminal to have countless women believing that mammograms will detect their breast cancer when, in fact, health providers know the opposite may be true."

Reader Comments:
  • 3
  • 09/22/2011
  • Kim whittemore

Now lets talk about anxiety caused by diametrically opposed info shared between radiologist and referring dr and patient:
My last “normal” mammogram results were communicated to me on 3/9/10 in a lay letter from Palo Alto Medical Foundation (PAMF) Radiology as follows
Dear Ms.___:
We are pleased to inform you that the results of your screening mammogram performed on March 4, 2010, are normal, and did not show any significant change since your prior study. It is recommended that you have your next routine screening mammogram in 1 year.

Corresponding medical report for “normal” mammogram, sent by my radiologist to my Dr read:

INTERPRETATION: Breasts are very dense (76% -100% composed of dense fibroglandular tissue). This decreases the sensitivity of mammography. Lesions could easily be obscured by overlying breast tissue.

Less than TWO (2) MONTHS later, the MRI I demanded because of the persistent, painful lump I felt, found two large advanced stage tumors in my “normal” left

  • 2
  • 09/22/2011
  • Kim whittemore

and to the "anxiety" argument I offer the following:
A national survey found that women overwhelmingly want the option for additional screening tests to find cancer early, even when testing resulted in a false positive - a suspicious area found by biopsy to be non-cancerous. Nine out of 10 women who required a biopsy to determine a false positive indicated that they would still opt for the additional screening the following year.

  • 1
  • 09/22/2011
  • Kim whittemore

anecdotal costs avoided - none of which were considered
Between July 2007 and July 2010, Dr Grady and his North Valley Breast Center in Redding CA detected 11 small breast cancers with ultrasound & 4 with MRI in women who had recent mammograms read as negative & had no symptoms or other indications that they had a cancer. All of them had dense breast tissue. The average age at diagnosis was 46. All of these diagnosed cancers were at an early stage and none of these women required chemotherapy or extensive surgery. All are still alive and have an excellent prognosis.



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