Tuesday, March 25, 1997
The last word for women
on breast cancer

The Cincinnati Enquirer

It really wasn't very complicated.

Breast cancer can kill you.

There's a test to find out whether you have it. The test is safe, easy to get, inexpensive. Mammograms are bloodless and painless. (Maybe it pinches a little. But not much.)

Get the test.

Simple. Then the government - those fabulous folks who threatened to reorganize the health care system - decided to help. A panel convened early this year by the National Cancer Institute (NCI) examined pounds of paper and hours of testimony and found itself unable to decide whether women in their 40s should have mammograms.

So they said they would leave it to us.

Bureaucratic idiocy

For insurance carriers who wanted to refuse payment, the NCI had just pronounced mammograms an elective procedure. And guess who is least likely to ''elect'' to have it. Poor, uneducated, uninsured women.

Adding insult to bureaucratic idiocy, the panel said women in their 40s are not only ''statistically insignificant'' but that prolonging their lives is not cost-effective.

This same government, however, insisted on automobile air bags that decapitate small children. These air bags, according to the National Highway Traffic Safety Administration, have saved 1,600 lives and caused the deaths of 36 children and 20 small adults.

I could find no proven cases of mammograms knocking anybody's head off, but, as I said, they do pinch a little.

Furthermore, you can get 15 or 16 years' worth of mammograms for the cost of one passenger-side air bag.

Those are merely statistics. Here are some numbers you can put your arms around.

''I have felt,'' writes Susan Major of Mount Washington, ''like I had a ticket and was waiting in line.'' Her mother and aunt died of breast cancer, but ''still my gynecologist had to sell me on the idea of having a baseline mammogram done.''

Eventually, when she was 51, Ms. Major's doctor removed a malignant lump ''smaller than a pea, yet containing 1 billion cells, give or take a few.''

Every day for 31 days, ''I left work for an hour for radiation therapy. It was not my idea of a dream summer, but I'm told I have a 95 percent chance of having 10 more summers and 10 more after that.''

The ultimate obscenity

Gina Derringer's first mammogram detected a malignant lump. ''For the past seven years, I have been fighting for my life - radiation, chemotherapy and I now await a stem cell transplant. I have two daughters I want to see walk down that aisle. I am quite sure that if I had not had that mammogram at age 42, I wouldn't be here to write this letter.''

Breast cancer survivor Helen Fox of Mason tells a story of her 5-year-old son, angry at her refusal to allow him candy before a meal. He called her a name, the worst thing he could think of to express his rage. ''You breast cancer,'' he blurted as he ran from the room.

Six months have passed. She has completed radiation therapy, and ''my oldest son has moved on to more objectionable language, but I am glad I'll be around to hear it.''

Breast cancer strikes about 180,000 American women each year and will kill 44,000 this year. Nearly 6,000 of these will be in their 40s. Wives. Mothers. Daughters. The Sandwich Generation caring for both parents and children.

The American Cancer Society said Sunday that women in their 40s should be screened for breast cancer every year. A similar recommendation is expected later this week by the NCI, reversing its earlier position. More than 150 of you wrote, telling me your stories. I forwarded your letters to the NCI, adding your voice to thousands of others. Maybe they didn't pay attention to us. But I prefer to think that they did.

A mammogram won't guarantee us forever. But surely it gives us better odds on some extra years. We'll take that. And it's nice to feel as though somebody out there is listening.

It is about time.

Laura Pulfer's column appears in The Enquirer on Sundays, Tuesdays and Thursdays. Call 768-8393 or fax at 768-8340. She can be heard Monday mornings on WVXU radio (91.7 FM), and as a regular commentator on National Public Radio's Morning Edition.