New Mammography Guidelines: Celebrities Speak Out

Many people have had strong reactions to the new guidelines on routine mammography screening for breast cancer. Unfortunately, the pros and cons of the new guidelines have become co-mingled with the current political debates about health care reform. People also seem to be confusing population health issues with their personal experiences. And the mainstream media have dumbed down and sensationalized the debate.

Influential celebrities have spoken out about these issues, an example of which is this Access Hollywood video featuring statements by Jaclyn Smith and Olivia Newton-John:

  • Smith: “I’m shocked. They want to abandon proven therapies. It’s wrong.”
  • Newton-John: “We are being put back in the dark ages again…We are not data, we are human beings”

Ms. Smith is apparently confusing diagnosis with treatment. The guidelines have nothing to do with “abandoning proven therapies” but rather involve diagnostic screening technology and its effectiveness. With regard to Ms. Newton-John’s statement, no one is saying that we should ignore decades of cancer research and increased breast cancer awareness. Just the opposite is the case: what’s being done for any disease in terms of screening, diagnosis and treatment needs to be continuously evaluated in light of new research information and technologies. The general guidelines for patients and physicians need to be updated when appropriate. (For an interesting story about the true “dark ages” of breast cancer, see our story about Frances Burney d’Arblay who was diagnosed with and treated for breast cancer in 1811.)

We’d like to suggest that the new guidelines could actually be a blessing in disguise on the road to a new era of personalized medicine and customized care. In our view, Melissa Etheridge gets it right when she says: “We, women, have to start looking at ourselves and taking control of our health back…It’s understanding your health…When someone tells you that you don’t need a mammogram until you’re 50, you know what, you take charge of that [decision].” Similarly, Sheryl Crow has said: “I encourage all women everywhere to advocate for themselves and for their future. See your doctor and be proactive about your health.”

We completely agree with Ms. Etheridge and Ms. Crow that the key is to be a well-informed consumer who actively pursues a dialog with their healthcare providers about what is best for them, given their family medical history and all of the environmental factors that affect their personal health and well being. Our companion site, Resounding Health, is an important tool with which women can do online research about whatever health issues concern them and save the results for sharing with their families, healthcare providers and each other.

Let’s look at some celebrity cases and consider how the guidelines might have affected them. In the case of Christina Applegate, no one would have denied her a mammogram given her family history and breast and ovarian cancer. Quite the contrary, much earlier and more frequent screening for breast cancer, and perhaps even genetic testing, would have been the most personalized and customized care for her. Similarly for Ms. Etheridge whose grandmother had breast cancer and Cynthia Nixon whose mother had the disease and whose mammograms began age 35 because of her family history. Jaclyn Smith‘s mother also had breast cancer, making her an exception to the new “general guidelines” that were recently issued. We don’t know anything about Sheryl Crow‘s family medical history. If there was no family history of breast or ovarian cancer among the Crows, she is the only celebrity whose preventive medical care might have been affected by the new guidelines since she falls below the new cutoff age for routine screening.

Age at diagnosis How detected? Family history of cancer
Christina Applegate 36 Mother (breast & ovarian at age 54)
Sheryl Crow 43 Unknown
Melissa Etheridge 43 Self-exam Grandmother (breast)
Olivia Newton-John 44 Self-exam Unknown
Cynthia Nixon 40 Mammogram Mother (breast)
Jaclyn Smith 56 Mammogram Mother (breast)

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Mark Boguski, M.D., Ph.D. is on the faculty of Harvard Medical School and is a member of the Society for Participatory Medicine, "a movement in which networked patients shift from being mere passengers to responsible drivers of their health" and in which professional health care providers encourage "empowered patients" and value them as full partners in managing their health and wellness.

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