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New Breast Cancer Recommendation May Cost Lives While Saving Money

Longtime OB/GYN warns against the new breast cancer recommendations released by the U.S. Preventative Services Task Force. These guidelines may be cost-effective, but they come at the price of human lives. When is it wrong to be safe than sorry?

The new U.S. Preventative Services Task Force recommendations, published in the current issue of the Annals of Internal Medicine, has set off a firestorm in the medical community. Major medical centers across the country and physicians who work in women’s healthcare have been firing back against the controversial recommendation that women between age 40 and 49 should not have routine mammograms.

“You cannot palpate or feel early breast cancer. With mammograms, we can see the calcifications that are indicative of early cancer before the patient develops any symptoms,” said Dr. James W. Brann, MD, a retired OB/GYN with 26 years of medical experience. “Breast cancer can take years to evolve into a metastatic disease. Therefore, by screening earlier, you’re able to catch and treat cancer in its beginning stages, rather than waiting the extra 10 years that are now recommended.”

Dr. Brann worries that if these new guidelines are put into practice, the breast cancer rate will increase along with the death rate.

“If you exclude human life, it is cost effective for insurance companies to pay for preventative mammograms at 50 because you will catch more disease at 50 than you would at 40. But you need to think about human life. You are going to be missing detecting early cancers, and possibly risk the loss of one life,” said Dr. Brann. “That one life is significant. It could be your sister, your mother, or a loved one.”

The National Center for Health Statistics estimates that in 2009, for women under age 45, there will be 6,460 cases of breast cancer in situ (cancer that is confined to the ducts and lobules) and 18,640 cases of invasive breast cancer (cancer that infiltrated to the fatty tissue of the breast). In this age group, 2,920 women will die from breast cancer.

In 2009, 6.2 percent of women between ages 35 and 44 will die from breast cancer and 15.1 percent of women between ages 45 and 54 will die.

“Common sense tells you that if you have a cancer in your early 40s and you are not screened until you are 50, your cancer is going to be more advanced and harder to treat than if you had been screened earlier. Your possibility of mortality is higher because you waited,” said Dr. Brann. “These new recommendations are going to cost lives, just because people are waiting. Would you rather be safe or sorry?”

According to the American Cancer Society, mammograms on average will detect 80 to 90 percent of breast cancers in women who have no symptoms.

The National Cancer Institute estimates that 1 in 8 women will be diagnosed with breast cancer during her lifetime.

“Look at the survival rates of breast cancer patients. You will see how vital it is that women are diagnosed early, before it is too late,” said Dr. Brann.

The American Cancer Society estimates that the 5-year survival rate for breast cancer is 100 percent in stage 1, between 80 to 90 percent in stage 2, between 50 to 70 percent in stage 3, and only 20 percent in stage 4.

“This is all about numbers. It comes at a critical time in the healthcare debate in Washington, D.C. The government is showing early signs of medical rationing but at the price of lives,” said Dr. Brann.

About Dr. James W. Brann, M.D. OB/GYN:

A board certified obstetrician and gynecologist, Dr. James W. Brann, M.D. has over 26 years of obstetric and gynecological experience. He is author of "Surviving the Joy of Pregnancy" (Xlibris, 2007) and is president and editorial director of Women’s Healthcare Topics (, a Web site devoted to educating women on healthcare issues.

Media Contact:
DoanPhuong Nguyen


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