Three years ago tomorrow, I stepped into the shower, soaped up and changed for what is beginning to feel like forever.

You know the drill. Two days later I saw my gynecologist. Five days after that a mammogram and diagnostic ultrasound. Three days after that my newly found breast surgeon said to me, “Don’t leave this office thinking you do NOT have cancer.” The next three years were filled with chemo, radiation, tests and seven surgeries.

Now it’s October again. I hate October. An inundation of pink so bad that I can’t even watch the Giants lose to the Seahawks without the constant reminder of the last three years (yes, those were pink gloves, pink mouth pieces and pink lines on the field you saw!).

Apparently, I’m not alone. According to CBS News, people, including survivors are getting tired of the pink. Of course the Komen Foundation defends the need for pink in its marketing to raise funds. I get that but as I said in an old post on my other blog, somewhere you have to draw the line. Samantha King, author of book Pink Ribbons, agreed with me when she stated, “the Komen Foundation crossed the line a few years ago, when they partnered with KFC on a pink bucket of fast food.”

The CBS article was based upon this one from the Associated Press that also questions where you draw the line on marketing for products with a pink ribbon. Companies put a pink ribbon on a product and consumers buy it, no questions asked, believing they’re helping to find a cure or support those with breast cancer. But how much of that purchase really goes towards a breast cancer charity? A dollar? Fifty cents? And how about companies that are capping their donation? So if they sell more of their product than expected, it wouldn’t matter – perhaps your dollar wouldn’t count. And which products should get to use this marketing scheme? What if it’s harmful, or may cause cancer itself?

Look, I’d like to find a cure to this disease or better yet a prevention as much as the next person. Statistics tell us 40,000 people will die from this over the next twelve months while 230,000 people will be diagnosed. Having lived it, still living it, I can tell you iy sucks! I just can’t abide by companies using this as a marketing scheme and charities being okay with that because in the end they’ll benefit. I think we all need to be a little more discerning over where we spend our money in support of the cause. Do you really need that perfume, bra, or bucket of fat, greasy food or are you buying it to show support. And if it’s the latter, wouldn’t your money be better used in a direct donation to a certified 501c3 breast cancer charity (hint, hint, The Amy Foundation)?

Oh, and can we get the pink off the football field? Come on, if it didn’t look so silly, you’d have a football team whose colors were pink and white but you don’t, do you?

You can’t turn on the news this week without hearing about American College of Obstetricians and Gynecologists’ recommendation that women get mammograms regularly (i.e., each year), starting at age 40. Now The American College of Radiology (ACR) supports that recommendation. Of course they all agree with a bunch of other groups that came out before them (e.g., The American Cancer Society) with these recommendations. All of this contrary to the United States Preventive Services Task Force (USPSTF) which recommended regularly screenings starting at age 50, and whose recommendation started this uproar.

I remember when the USPSTF came out with their recommendation last year. A few days later we were having dinner with my father in-law, a man notorious for trying to bate me into arguments because we have opposing viewpoints on so many things. Actually, he likes to bate me and then he backs off. I think he likes to just rile me up. Anyway, at dinner that night he turns to me and asks, “What do you think about the new mammogram guidelines?” I simply looked at him and said, “That’s bullshit from a bunch of people who are trying to save money.”

“Discussion” ensued.

Before I continue, you should know, mammography did not save my life (a self-exam and the loss of 90 pounds did but that’s another story) but that may have been because I was overdue for my mammogram (like two years), but again, another story.

Anyway, back to the USPSTF recommendation. From what I can tell, it’s all based upon statistics and modeling and their recommendation for starting at age 50 is arbitrary (i.e., let’s play with the numbers and pick an area where it seems like a good fit to reduce the number of deaths), it’s not based on biology or physiology or really anything tangible. Here, I think this quote gives you an idea of what I mean:

In an unscreened population, the models predict a cumulative probability of breast cancer developing over a woman’s lifetime starting at age 40 years ranging from 12% to 15%. Without screening, the median probability of dying of breast cancer after age 40 years is 3.0% across the 6 models. Thus, if a particular screening strategy leads to a 10% reduction in breast cancer mortality, then the probability of breast cancer mortality would be reduced from 3.0% to 2.7%, or 3 deaths averted per 1000 women screened.

Here’s one more quote for you:

We also examined the incremental benefits gained by extending screening from ages 50 to 69 years to either earlier or later ages of initiation and cessation (Table 3). Continuing screening to age 79 years (vs. 69 years) results in a median increase in percentage of mortality reduction of 8% (range, 7% to 11%) and 7% (range, 6% to 10%) under annual and biennial intervals, respectively. If screening begins at age 40 years (vs. 50 years) and continues to age 69 years, all models project additional, albeit small, reductions in breast cancer mortality (3% median reduction with either annual or biennial intervals) (Table 3). This translates into a median of 1 additional breast cancer death averted (range, 1 to 2 deaths) per 1000 women screened under a strategy of annual screening from age 40 to 69 years (vs. 50 to 69 years). Thus, greater mortality reductions could be achieved by stopping screening at an older age than by initiating screening at an earlier age.

So here’s what it all sounds like to me (and why I made that comment to my father in-law), it seems that the USPSTF is saying we may only save an additional 1 or 2 women (per 1000) if we start screening from age 40 to age 50, but if we continue screening later in life instead, (i.e., screen until age 79 instead of 69) we could save an additional 80 women per year without all of the increases in false-positives and biopsies and diagnostic ultrasounds they incur.

But here’s my question, why not both? Why not screen from 40 until 79? Why are those lives saved by starting early, though not as numerous, not worth saving? And would you feel the same if they were your sister? Mother? Daughter? What if it was your life saved?

How many lives do we have to save in order to justify the cost?