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especially poor ones, is often outrageously out-of-date, if not bordering on the
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
Poor Get Poor Medical
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
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
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
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
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,
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.