[Debbie L.]

The logging-in thing is getting worse. I didn't even leave the site this time, and was logged out. I'm still wondering if it's not something to do with a Firefox update. Are others who are using other browsers having this trouble?

I'd like to propose a few counter-arguments to the prevailing ones here. I'd like to keep these discussions respectful and civil and try to stay away from sarcasm, criticism, and suspicion. I think that the science to support the guidelines is able to stand alone, and should be argued alone.

One recurring theme (1.) is that these guidelines are about saving money, and another (2.) is that releasing them now is politically-motivated and/or related to health care reform. I don't think either of those arguments are true. But IF they were - I would say that they don't make a lot of sense:

1. It could be argued that IF these guidelines were to cause too many people to be diagnosed at a later stage and/or to die - that would cost us MORE money. Mammograms are (relatively) dirt cheap. Treatment to cure primary breast cancer is fairly expensive. Treatment of metastatic breast cancer is wildly expensive. We could probably do mammograms on half a small state with the money spent on treating one person's metastatic cancer. We could treat (cure) many primary breast cancers for the price of one person's metastatic treatment (and that cost rises nearly daily, as more medicines with highers costs come online). The fact that we have so many good options for treating metastatic disease is of course a wonderful thing. But no one can deny that it's also an expensive thing. So IF staying with current screening guidelines would prevent treating more metastatic disease, it could reasonably be argued that that might SAVE money. Several "if's" there and the biggest one is that this task force has repeatedly stressed that they do not take cost into consideration when they evaluate evidence. There is no evidence in their report that they did so. But had they done so - they could have concluded that it's more cost effective to do more mammograms and treat fewer mets, IF more mammograms indeed did prevent more mets. But the evidence shows that they do not.

2. I don't think that those who support and hope for health care reform were glad to see the release of these guidelines right now. While they may agree with the guidelines, it's clear that the public clamor over them is hurting, rather than helping, the acceptance of health care reform strategies. It could be argued that releasing these guidelines right now may prove to be one of the strongest detriments to acceptance of health care reform. IF this were some kind of big conspiracy to save money and/or get rid of people, don't you think they'd have waited to release the information when health care reform was a done deal?

It's hard to keep posting here in the face of near-total opposition. But I do think that each of us needs to hear both sides of this story, so I keep coming back to offer that other side. I don't think that questioning the motives of those who think differently about this is helpful. I'm pretty sure that everyone who has an interest in these guidelines has that interest because they want there to be fewer deaths from breast cancer.

Debbie Laxague