Ladies: Stop Cutting Off Healthy Breasts

bra_breast_cancerReally scary story in The Wall Street Journal this week about a dramatic increase in double mastectomies in this country — and not for women who need them.

Most women diagnosed with breast cancer only need a lumpectomy in the affected breast or, more rarely, a mastectomy. There is no evidence that removing the healthy breast reduces the risk of recurrence or increases survival.

Yet rates of double mastectomy among women diagnosed with breast cancer have skyrocketed in the past 13 years, from 2 percent in 1998 to 12 percent in 2011. And no, it’s not because women have been diagnosed with more severe breast cancer or some major study showed that slicing off healthy breasts keeps cancer at bay.

As one plastic surgeon quoted in the Journal article tells his patients: “Why don’t we simply remove your foot? It will have the same effect on survival.”

Don’t take my word for it; check out this study of 190,000 women with breast cancer that compared survival rates in those who had a double mastectomy vs those who underwent lumpectomy followed by radiation. Bottom line: … Continue Reading

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Should You Listen to Your Doctor?

moneyWhen I speak about the US healthcare system, I always like to tell the story of my mother. A couple of years ago, she emailed my sisters and I. “Good news!” she wrote. “My nuclear stress test was normal!” (The test  involves injecting a radioactive dye into a vein after which a special camera scans the heart to determine if there are any blockages).

At the time, my mother was 70 and, with the exception of very-well-controlled high blood pressure (that she’d had all her life), extremely healthy. No sign of heart disease. No angina. No shortness of breath. In short, no indications for an expensive, invasive, potentially dangerous, test. So why, I asked her, did she have the test? “Because my doctor told me it was time,” she said.

At which point I began banging my head against the wall.

Even regular stress tests (where you run on a treadmill or ride a bike) are only recommended in people with heart disease or symptoms of heart disease, same with an EKG. Yet a survey of nearly 1200 people ages 40 to 60 with neither found that 39 percent had an EKG … Continue Reading

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healthcare costs healthcare reform healthcare system; patient-centered care patient-centered healthcare Unnecessary tests waste

Step Away From that Test

My best friend turned 57 in October (but you’d never know it by looking at her; she doesn’t look a day over 45). Like most of us of a certain age, she has a few medical issues. Years of working as an editor has left her with carpal tunnel syndrome. Years of living with cats has left her with asthma. Years of sun worshiping behavior has left her with basal cell skin cancer. Years of good eating have left her with a borderline high LDL level. And, as a result of being, well, 58, she has a pain in her left shoulder. Sound familiar?

My friend recently switched doctors and found a new primary care physician who, upon hearing her medical history and current concerns, performed and ordered several tests, including:

— A pelvic exam/Pap

— A routine physical

— A baseline EKG

— A complete fasting blood panel, including a special test that measures LDL-particles (LDL-P)

— A mammogram and an ultrasound on her right breast, because the doctor felt a suspicious tissue mass (my friend has a family history of breast cancer)

— A right carotid artery ultrasound based on a bruit,  the swooshing sound the doctor said could … Continue Reading

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healthcare costs healthcare system; high-deductible health plan ineffective procedure waste

Elective Deliveries: A Sign of a Healthcare System Out of Control

My husband is always getting on me about the number of tabs I have open in my browser at any one time. I think one time I had more than 100 open.

Within the past few days, at least 10 of those tabs dealt with the same topic: medical tests and procedures that we either don’t need or that don’t work. There are simply too many for a single blog, so I’m focusing on one here and will write more about others in the coming days.

The lucky winner? Births.

Seems like an obvious medical procedure, doesn’t it? Baby is delivered when mom goes into labor or, if problems develop or mom goes over her due date, labor is induced. So why, as  Kaiser Health News recently reported, are 10 to 15 percent of U.S. babies  delivered early without medical cause, up to 40 percent in some hospitals?

Early delivery increases the risk that the baby will have feeding and breathing problems, infections, and developmental problems, requiring a stay in costly neonatal intensive care units. It also increases the risk that mothers will need caesarian sections (indeed, many of these births are scheduled c-sections).

Why the early deliveries? Convenience for … Continue Reading

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fraud get better health healthcare costs healthcare reform healthcare system; ineffective procedure payment Uncategorized waste