Hey USPSTF: Seeing is Believing

This post was submitted by Ally Parnes, M.D., Breast Imager and Breast Cancer Survivor.

After reading the latest U.S. Preventive Services Task Force (USPSTF) draft breast cancer screening recommendations, I would really like to meet with the USPSTF members. You see, not only did I decide after 10 years of medical training that there was plenty of reason (solid, scientific evidence) to dedicate my entire medical career to breast imaging, but also because I’m a 42 year old breast cancer survivor, diagnosed just 2 years ago (by wild coincidence given my chosen career path) from a mammogram.

There is no doubt in my mind that I’d now be dead or close to it had it not been for that exam. My tumor was less than the size of a pea, far back in my left breast. It was the type of tumor that, once seeded outside the breast, likes to come back years later to rear its ugly little head, cropping up in bones, belly, or even brain. But, I was lucky. The day after I sat for my radiology board exam in Louisville, Kentucky I went to the O.R. to have my tiny, early-stage cancer removed, before it could grab a hold of me anywhere else.

A few months later, during my women’s imaging subspecialty training, and while I was also undergoing chemotherapy, I read a less fortunate young patient’s abdominal ultrasound. She was pregnant. She felt a lump. She was diagnosed with breast cancer, an aggressive type, and I was examining images of her liver, and there they were—ugly tumors that had spread to the rest of her body.

If the committee members don’t think young women can benefit from early detection, or that any woman needs a mammogram more often than once every couple of years, they should come to work with me. I’ll show them how easy it is to find a later stage tumor sitting in the breast of a woman who didn’t think it was important to keep up with annual screening. I’ll ask them to tell her how big it is, that they’re not sure where it has spread, or how aggressively it will need to be treated.

I can also introduce them to the 39-year-old young woman that I saw last month with a large, aggressive tumor deep inside her breast that had already spread to her chest wall and lymph nodes… and who is now waiting to learn if any other sites have been infiltrated. Sadly, there are many more women just as young – and just as sick.

Cancer is a war against humankind. You don’t win that war by sitting back and letting it run amuck, then acting at the ninth hour.

To the USPSTF: If life and quality of life are precious to you, meet me and the women for whom I’m privileged to care. Stare cancer in the face not just on my computer monitor, but inside my patients and tell us all how unimportant screening mammograms are. Just try.