
It's about time the medical profession began taking seriously the costs as well as the debatable benefits of annual mammograms for women over 40 (among other routine screening procedures). If the controversial new set of guidelines constitutes rationing, it may be one form of rationing that's overdue; the challenge is for women who consider "clean" mammograms clean bills of health to recognize that their value is limited, partly by the ability of doctors to interpret them.
I've been a little lax about obeying the annual mammogram mandate for some years, since reluctantly submitting to a biopsy because of an anomaly in a hard to read film. "It doesn't look evil," an oncologist assured me, and nothing that looked evil was revealed subsequently by two ultra sounds and an MRI. Against my instincts (and the judgment of one radiologist who advised a series of follow-up mammograms), I was eventually persuaded to undergo a needle biopsy -- an unpleasant procedure that entailed an overnight hospital stay (of which I have no memory, thanks to some wonderful drugs). "In Europe, they wouldn't operate; their protocols are different," the surgeon acknowledged, when I discussed my doubts about our protocols with him.