The Breast Business

It is a little known fact that I dabbled in medical sociology for a while. It wasn’t my fault. Baqar Husaini at TSU twisted my arm and got me involved in several of his projects. If the grant money hadn’t dried up in under the Bush Regime (which had no interest in the study of racial disparities in health), I may still have some research in this arena.

I’m happy to see Barbara Ehrenreich weigh in on the issue of the shift in guidelines for mammography. The wacko left, far right, and the generally clueless hypochondriac crowd is all aflutter about the supposed radical shift in testing guidelines for mammography. For the political types (right and left) the contention is that this is a way to save money for the insurance companies (left) or federal socialist medicine (right). For the loonie hypochondriacs, its just meant to kill women. In reality, research has been suggesting that our protocols were off kilter for more than a decade. The dominant opinion in 1999–when I was writing grants about health education programs for breast cancer mitigation for minority populations–was that the guideline should be 50 years old. Many also suggested testing only every two years until age 60. That was TEN years ago. This is not a sudden shift.

Have you ever seen a mammogram? Unless there is some honkin’ tumor, they don’t show shit. And, the younger the patient, the worse the mammogram looks (lots of fibrous tissue, as they say). If there is a small aggressive cancerous lesion, you are not going to find it on a mammogram. Worse yet, as Ehrenreich notes, MANY breast cancers are not prone to metastasize, and yet they are often treated with extreme medical aggression (including radical chemo, radiation, and proactive mastectomies!). Yet, in reality, many of those cancerous tumors could easily be removed and treated with minimal invasion or procedure.

The same is true in spades for prostate cancer. The more than decade old consensus is now that you should get checked, some (finger up the ass variety). But that PSA’s and that stuff is about as good as going to a witch doctor. And, Bob Dole could probably still have his nads had he not been treated under the old radical regime. If you look hard enough, most old farts are “living with prostate cancer”. And, it won’t make them die anytime sooner to leave it be than if you’d chop off their nuts and dick and give them chemo.


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