|
Poor Women Often
Face Ill-Advised Breast Removal
Opinion by Nicholas
Regush, ABCNews.com
It's time for some hard answers from breast cancer
specialists and surgeons. They've been sitting on a powder keg issue concerning
the health of women for far too long.
While we hear news almost daily of the need for women
to have mammograms and to inspect their breasts for changes that could
suggest breast cancer, the actual treatment for breast cancer that many
women receive, especially poor ones, is often outrageously out-of-date,
if not bordering on the criminal.
An article published this month in the Journal of
the American Medical Women's Association provides a summary and analysis
of key studies on breast cancer treatment and raises serious questions
about medical conduct.
Poor Get Poor
Medical Advice
According to the medical review by Diana Zuckerman,
the author of the journal article and head of the Washington, D.C.-based
National Center for Policy Research for Women and Families, many women
are getting their breasts removed for no good reason - meaning that such
decisions are often not based on sound medical judgment but more on the
basis of other factors, such as a woman's income, the training of her
doctor and where she lives.
For instance, if a woman is poor, chances are good
that she'll have a mastectomy rather than a lumpectomy (removal of the
cancer but not the breast.). It's cheaper to remove a breast. Lumpectomies
also require follow-up radiation.
In Texas, for example, a study of breast cancer treatment
at one large urban hospital revealed that 84 percent of the women with
early stage breast cancer had mastectomies and only 16 percent had lumpectomies.
The women who lost their breasts were mostly poor.
Other Treatments
Exist, But Are Costly
If a doctor was trained before 1981,
his patient is much more likely to have a mastectomy. Obviously
old medical habits die hard. Research is clear that lumpectomies are as
safe as a mastectomy for most women with early stage disease. The offending
doctors should be hauled in front of a medical inquiry. They are needlessly
disfiguring women and causing them to endure possible further problems,
including pain and illness, associated with breast reconstruction, which
can involve risky breast implants.
Studies show that this appalling trend to perform
mastectomy exists in most parts of the country.
You have to wonder what type of information many women
are receiving from their doctors and why they agree to radical surgery.
"Limited information and biased recommendations
are undermining breast cancer patients' choices," says Zuckerman.
"After all the research that has been done,
why are so many women undergoing mastectomies they don't need?"
Not Discussed,
Though Known
An excellent question. Why is it that performing unnecessary
mastectomies is not a priority question in women's health care? Where
are the activists to challenge this medical stupidity? Where are the women's
groups that are engaged in educating women to examine their breasts? Is
this subject matter a little too confrontational for them? Is breast self-examination
a gentler and kinder issue?
Both activists and the medical establishment should
be condemned for their silence. And it wouldn't hurt to have a little
more media attention focused on this issue. Come on medical reporters.
It's really not that complicated a story.
Let's get our priorities straight on treatment for
breast cancer. This butchery must stop.
ABC
News Second Opinion October 27, 2000
Nicholas Regush produces medical features for
ABCNEWS. In his weekly
column, published Thursdays, he looks at medical trouble spots, heralds
innovative achievements and analyzes health trends that may greatly influence
our lives. His latest book is The Virus Within.
Help support the Website:
CLICK
HERE to view "The Virus Within" by Nicholas Regush at BarnesndNoble.com.
| 