The Antidote

Counterspin for Health Care and Health News

Thursday, November 26, 2009

Breast cancer screening - more politics

Contrast the conciliatory tone of this editorial co-authored by Eric Winer, MD, Medical Director of the Susan G. Komen Breast Cancer Foundation with the gloom and doom expressed by Komen's president Nancy Brinker, as quoted in this op ed piece by Washington Post writer Dana Milbank.

Per Winer:
Fourth, we must be careful not to send a message that screening and early detection are of no value: there is no doubt that early detection of breast cancer can save lives. We are particularly concerned about the perceptions of women who are members of disadvantaged minority groups and those who lack education and health insurance. It would be lamentable if progress made in breast-cancer awareness were reversed as a result of this debate. Efforts to educate the public about breast cancer must be maintained and, in some areas, increased.

and Brinker:
The recommendations "have taken a tremendous toll, and I believe they set us back," Brinker told reporters at the National Press Club on Monday afternoon. "The women I have heard from, thousands and thousands and thousands, are justifiably outraged and worried and angry."

Oh, and here's a quote from a statement by Winer on Komen's website:
Susan G. Komen for the Cure wants to eliminate any impediments to regular mammography screening for women age 40 and older. While there is no question that mammograms save lives for women over 50 and women 40–49, there is enough uncertainty about the age at which mammography should begin and the frequency of screening that we would not want to see a change in policy for screening mammography at this time.

What do you think? Are the substance of what Winer and Brinker said similar enough that Winer will keep his job? (Note that Milbank himself is probably just as angry as Brinker, yet he claims he has no problem with the science, just in the way the recommendations were rolled out.) Does Winer's official Komen statement waffly enough to accommodate both his view of the uncertainty of the science and Komen's aggressive pro-screening stance? And will women reading the recommendations - or more importantly the docs who are recommending screening - really take home the message that mammography screening is useless?

I'd love to hear the behind-the-scenes discussions at Komen as they proceed.


At 2:23 PM, Blogger Michael Kirsch, M.D. said...

What have we learned from the USPSTF debacle? That comparative effectiveness research (CER) and implemention is a figment. It will be a pinata to be struck down by various stakeholders and interested parties. This was a major setback for those of us who believe in evidenced-based medicine. See


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