The great and powerful Oz warned Dorothy not to pay attention to that man behind the curtain, but Dorothy chose to open it. News from the U.S. Preventative Task Force (USPTF) recommending women not perform breast self-exams and that they start their mammograms at 50 rather than 40, has become quite controversial — particularly in the younger-than-50 age groups. But while Dorothy had just one wizard telling her what to do, we have too many, which can confuse matters more.
Sixteen well-educated wizards sit on the USPTF “Oz” panel — eight men and eight women. Hailed as doctors holding impressive credentials, most of them are university professors, a few deans … one a dean-professor. One has a relationship with Kaiser and another with Blue Cross Blue Shield. And another one researches disease prevention and behavioral risk factor modification with a primary focus on tobacco use.
What is concerning is that there are no oncology wizards. No radiology wizards and no breast reconstructive surgeon wizards.
Many national/global breast cancer nonprofits and government-funded agencies are providing politically correct responses regarding the Oz panel’s news release. Could their large donors be the reason for this? Do they have pharmaceutical companies, universities, medical schools or political affiliates? Perhaps the next step will be insurance companies dropping coverage for mammograms until one reaches 50. And if this happens, what will the women, particularly the ones younger than 50, choose to do for breast cancer prevention?
But the real problem is not the dictates from the USP Task Force. The problem is also not what the other health organization wizards surmise from the data. The problem is life and the way each individual perceives and lives it, with or without insurance. The choice whether to become educated and proactive toward breast health care in one’s life depends upon so many complex circumstances.
Breast cancer has become a big business for countless global corporations and drug companies. For so many others, breast cancer (and other cancers) has become an individually painful reality as they become instant caregivers to their loved ones who are diagnosed. With regard to breast self-exams, some women (and men) choose to do nothing after they discover a lump, inverted nipple or other breast cancer symptom. Others follow the strict advice of their doctors, which includes when a woman should start having mammograms. And some actively participate in asking questions, considering the answers and making their own decisions about their breast health care. By focusing on the voluminous quality and perceptions of one person’s life, that quality of life can be affected by fear, social rank, income status, culture, addiction and sundry complexities.
It is the combination of diversity that makes breast cancer not just a global medical-life problem, but a global societal-life problem. Overall, breast cancer is a hot and complex topic — and, I’m sorry to say, one that will not magically disappear anytime soon. Our ever-changing medicine and insurance may dictate women’s breast health challenges, but each woman can make a conscious choice to look behind that curtain and focus on the solutions regarding her own breast self-care and ways to detect it early. Personally, I was diagnosed with breast cancer at age 44 after having a routine mammogram. I encourage each woman concerned with this topic to use her brain and her heart to gain the courage to become a proactive breast health care advocate.
A proactive discussion, rather than a two-sided debate, can also help us better understand the numerous complexities regarding the costs of breast cancer prevention and early detection and the direct connection they may have to the quality and longevity of life.
Lisa Barreto is on the board of director for Ribbons of Life in Ventura and a breast cancer survivor.