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The other side of breast cancer

I understand the outrage over new federal guidelines suggesting a much more limited (and less expensive) approach to screening women for breast cancer. I just watched Rep. Deborah Wasserman Schultz, D-Fla., explain to one of the cable news networks that she caught her own breast cancer at 41 and if she had followed the new guidelines she probably would not have caught her cancer and could have died from it by now.

Lots of doctors are not going to follow the guidelines, which raise the age at which women should start receiving annual mammograms, as described in The New York Times:

"The recommendations, issued Monday by a federal advisory panel, reversed widely promoted guidelines and were intended to reduce over treatment. The panel said the benefits of screening women in their 40s -- saving one life for every 1,904 women screened for 10 years -- were outweighed by the potential for unnecessary tests and treatment, and the accompanying anxiety. Women considered at high risk should continue to have early screening, the panel said."

Wasserman Schultz, by the way, noted that the head of the House Health Subcommittee intends to schedule hearings on these new guidelines, so watch for the controversy to continue. It's far from over now.

I don't take a position on the guidelines, but I do want to explain some anecdotal information that pushes me, in my own personal situation, to agree with this change in policy. I am polycystic, which means my breasts are naturally lumpy. But that does not predispose one to cancer. Nonetheless because of that, I have been screened and screened and over-screened for breast cancer for the past 20 years.

When I was much younger and less sure of myself, I let a cancer-crazed oncologist talk me into having a stereotactic biopsy. She described it as a needle biopsy, but the "needle" she stuck into my breast about a half-dozen times during the procedure was the size of a pencil and looked nothing like any needle I've ever seen. She quite literally maimed me during the procedure, going back and back and back for more tissue. My breast was green and purple and aching for six weeks afterward and her work left a huge scar and disfigurement.

When she read the negative results I asked her why she had put me through what she did. She said, "I diagnosed my own breast cancer." She added something to the effect that she would make extra, doubly sure no patient of hers ever left her care with a false negative.

In addition, a former M.D. friend had undergone 12 biopsies under general anesthesia in an operating room, all of which came up negative. Each of these procedures left large scars and were painful. I asked her why she hadn't told her doctor, "no" after the first one or two biopsies and she could not give me an answer.

My point is, I believe the medical system has gone a bit over the top when it comes to screening for breast cancer, although I'm sure most survivors of the disease will call me crazy. If you ask most women today what is the leading cause of death for women, they will tell you breast cancer. Actually, it's the seventh leading cause of death, according to the Centers for Disease Control and Prevention, beaten out by heart disease, cerebrovascular disease, lung cancer, chronic lower respiratory disease, Alzheimer's and accidents.

The Susan G. Komen's Foundation's "Race for the Cure" has been hugely successful at raising awareness about breast cancer and supporting survivors. But I also believe the groups' incredible PR savvy has blown the disease's prevalence out of proportion in the average person's mind and caused women a lot of unnecessary anxiety, including yours truly.

I don't agree with the federal panel's recommendation to push back routine screenings for women with no family history of breast cancer to age 50. Breast cancer is a different and much more aggressive disease in younger women, so routine but perhaps more sporadic screening should start in the 30s. I do believe there's a happy medium out there somewhere between the rational approach and the semi-hysteria that exists now. We just have to find it.

-- Erbe is a TV host and writes this column for Scripps Howard News Service. E-mail her at bonnieerbe@CompuServe.com.

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