My mammogram in September of 2013 found a tiny tumor near my left nipple. Oncologist said they’d remove it and I would not need chemo or radiation. In late October, the facility that does the screening in my area got a breast MRI machine. I had the scan and it found a very large tumor in the dense outer tissue closer to my underarm. When the two were removed, the much, by magnitudes, larger one was HER2 positive. If I had not had a breast MRI, I would have died from breast cancer years before it could be seen or felt.
I'm sorry but if I have a tumor I want to be treated like I'm in my 50s and not on Medicare. It should be MY choice if I want something removed I'm worth it all women are. I don't want Medicare making that choice for me just because they think I'm old.
Maybe profit motive and health/medicine aren't the best dancing partners. If you bring your car to a mechanic and say its making a noise, they'll find something they can bill you for. If you say you'll pay a reporter if he can find a story in something, he'll find the story. So forth and so on. Don't some of these scans make use of x-rays...which has its own relationship with cancer? The world is a racket.
This is helpful, thank you. I am one of those women whose physician recommends ultrasound or MRI due to dense breast tissue, but my insurance declines and I have very low risk by any assessment I’ve completed, so have never opted to pay for the additional testing. I also opt for every other year mammos, much to my physician’s chagrin.
I do have a question though. I’ve read on that screening mammograms do not improve survival, and that there is disagreement about when to start them. Is the issue that we should wait longer to start using mammography? Only use mammography based on risk factors and/or symptoms? Or is mammography just essentially useless and we like to irradiate breast tissue for no good reason?
The study referenced in this article is also interesting. The journalist says, "led to significantly improved survival rates", but the UofO media release doesn't quite say that.
..."Can journalism aspire to be curious?"...don't hold your breath. There is little proof that the health care system helps you be healthier or live longer in a healthier state. It's mostly a fantasy fueled by the fear of death.
Or these scans could help. We just don’t know without an RCT. I’m high risk, but my HMO won’t provide screening MRI or ultrasound. I make myself feel better by telling myself no one knows if these would help anyway.
On the other hand, I could die because of a missed cancer. No one knows - either way.
In 2011 OVERDIAGNOSEDby H Gilbert Welch( and coauthors) was published . It covered many of these issues.
Dr Prasad thinks it’s bad in the academic arena.Its much worse in the private sector. PCPs with a few PAs working for them, only care about moving patients through and getting good reviews on social media. I’m sure there are kickbacks from diagnostic labs and imaging centers. The rot is deep
We have a government that mandates t the coverage of “ trans care” for minors and adults( thank Obama for sneaking that into ACA) without any evidence .
There is no health care system in this country. What exists is very broken
Given that there is no test to tell which cancer will kill you, and which won't, screening is still important. It is what happens after a lump is found that needs to be worked on. Given existing law, an MD can't detect someone has a cancerous lump and tell them "let's see if it kills you". We need better determinants and tests on the back end. Screening i.e. finding the lump, is ok as long as the correct decision is made on the back end to either intervene...or not. Not screening isn't a solution as breast cancer kills women at very high rates and treatment of real, malignant tumors is effective.
Horrors! "Patients often end up paying the bill." Who ever dreamed that such a horrible thing could happen? Have we really reached the point where most people believe that because something is beneficial the government should pay for it? That is the clear implication when someone laments that Medicare is not paying for some medical cost.
As a Medical Director for a midsize PPO/TPA in the Pacific Northwest (now retired), I fought this ‘coverage battle’ for 11 years. The battles continue…
I don't think Medicare is somehow being rational... they just have not gotten the political pressure on this. Cue the NYT and soon enough, they will bed paying for it and asking forgivess forf their sexist sins
My mammogram in September of 2013 found a tiny tumor near my left nipple. Oncologist said they’d remove it and I would not need chemo or radiation. In late October, the facility that does the screening in my area got a breast MRI machine. I had the scan and it found a very large tumor in the dense outer tissue closer to my underarm. When the two were removed, the much, by magnitudes, larger one was HER2 positive. If I had not had a breast MRI, I would have died from breast cancer years before it could be seen or felt.
I'm sorry but if I have a tumor I want to be treated like I'm in my 50s and not on Medicare. It should be MY choice if I want something removed I'm worth it all women are. I don't want Medicare making that choice for me just because they think I'm old.
Maybe profit motive and health/medicine aren't the best dancing partners. If you bring your car to a mechanic and say its making a noise, they'll find something they can bill you for. If you say you'll pay a reporter if he can find a story in something, he'll find the story. So forth and so on. Don't some of these scans make use of x-rays...which has its own relationship with cancer? The world is a racket.
This is helpful, thank you. I am one of those women whose physician recommends ultrasound or MRI due to dense breast tissue, but my insurance declines and I have very low risk by any assessment I’ve completed, so have never opted to pay for the additional testing. I also opt for every other year mammos, much to my physician’s chagrin.
I do have a question though. I’ve read on that screening mammograms do not improve survival, and that there is disagreement about when to start them. Is the issue that we should wait longer to start using mammography? Only use mammography based on risk factors and/or symptoms? Or is mammography just essentially useless and we like to irradiate breast tissue for no good reason?
Indeed, I have so many issues with the way the health care system works. Above and beyond what happened in 2020-22.
This is odd. Is there some sort of coordinated push?
https://www.cbc.ca/news/politics/cancer-screening-canada-guidelines-1.7180878
The study referenced in this article is also interesting. The journalist says, "led to significantly improved survival rates", but the UofO media release doesn't quite say that.
Thx
.
Most Doctors
Enjoy Being Proven Wrong
Far Less
Than They Tolerate Killing You.
.
..."Can journalism aspire to be curious?"...don't hold your breath. There is little proof that the health care system helps you be healthier or live longer in a healthier state. It's mostly a fantasy fueled by the fear of death.
Or these scans could help. We just don’t know without an RCT. I’m high risk, but my HMO won’t provide screening MRI or ultrasound. I make myself feel better by telling myself no one knows if these would help anyway.
On the other hand, I could die because of a missed cancer. No one knows - either way.
In 2011 OVERDIAGNOSEDby H Gilbert Welch( and coauthors) was published . It covered many of these issues.
Dr Prasad thinks it’s bad in the academic arena.Its much worse in the private sector. PCPs with a few PAs working for them, only care about moving patients through and getting good reviews on social media. I’m sure there are kickbacks from diagnostic labs and imaging centers. The rot is deep
We have a government that mandates t the coverage of “ trans care” for minors and adults( thank Obama for sneaking that into ACA) without any evidence .
There is no health care system in this country. What exists is very broken
Given that there is no test to tell which cancer will kill you, and which won't, screening is still important. It is what happens after a lump is found that needs to be worked on. Given existing law, an MD can't detect someone has a cancerous lump and tell them "let's see if it kills you". We need better determinants and tests on the back end. Screening i.e. finding the lump, is ok as long as the correct decision is made on the back end to either intervene...or not. Not screening isn't a solution as breast cancer kills women at very high rates and treatment of real, malignant tumors is effective.
Horrors! "Patients often end up paying the bill." Who ever dreamed that such a horrible thing could happen? Have we really reached the point where most people believe that because something is beneficial the government should pay for it? That is the clear implication when someone laments that Medicare is not paying for some medical cost.
100% of breast cancers were fatal before the surgical era.
https://pubmed.ncbi.nlm.nih.gov/5220111/
As a Medical Director for a midsize PPO/TPA in the Pacific Northwest (now retired), I fought this ‘coverage battle’ for 11 years. The battles continue…
I don't think Medicare is somehow being rational... they just have not gotten the political pressure on this. Cue the NYT and soon enough, they will bed paying for it and asking forgivess forf their sexist sins