New Charts On Health Care Reform HR 3200

Health Care for America Now has some new fact sheets available about HR 3200, the U.S. House of Representative's bill that NOBCCF supports for health care reform.

It explains a little more clearly the options that will be available for everyone.

Link to charts (pdf)

Ohio Health IT Meeting Sept. 25 in Columbus

Breast cancer advocates should stay involved and provide input into how new electronic medical records programs are developed. Patient privacy is an important issue.

Governor Ted Strickland has issued a statement announcing health information technology efforts aimed at reducing health care costs and improving the quality of health care in Ohio. A public forum will be held on Friday, September 25 from 10 a.m.- 11:30 a.m. to discuss the state’s health IT vision and to solicit feedback. The public forum is open to all interested parties and will be held at the Riffe Studio One Theatre, 77 S. High Street, 4th floor. Speakers at this event will include state leaders, the Ohio State Medical Association, the Ohio Hospital Association, the Ohio Osteopathic Association, and By Ohio. There will also be plenty of time for Q&A following the presentation.

Please click here to view the release issued by the Governor’s office regarding the Health IT effort. Please contact ohiohealthit@ins.state.oh.us with specific questions regarding Health IT.

Sen. Harkin Appointed Chair of Senate HELP Committee

Congratulations to Senator Tom Harkin who has been appointed chair of the Senate Health, Education, Labor & Pensions (HELP) Committee in the US Senate. He is filling the vacancy resulting from the recent passing of Senator Ted Kennedy, who chaired the committee for many years.

Senator Harkin, of Iowa, has been a passionate, dedicated advocate for many years on cancer and health care-related issues. He has experienced the loss of his own sister and niece to breast cancer and has vowed to do everything in his power to help end the disease. One of his most significant accomplishments was helping create and establish the Dept. of Defense Breast Cancer Research Program, which has provided over $2 billion for innovative breast cancer research in the US.

Those who have attended National Breast Cancer Coalition's Annual Advocacy Conference & Lobby Day have likely met Sen. Harkin. He has received numerous awards from NBCC for his work and loves to visit with advocates and encourage their work. His fiery, passionate speeches at NBCC's Lobby Day reception are the highlight of everyone's trip, leaving everyone to wipe away a few tears as they shout and cheer.

Congratulations, Senator Harkin!

Updated NCCN.com Summaries Provide Patients with Information to Accompany Professional Guidelines

National Comprehensive Cancer Network provides one of the most critical and helpful resources to breast cancer patients. Their patient-centered Professional Guidelines provide the most up to date information about best practices for breast cancer screening, risk assesment, diagnosis, treatment and follow-up care.

If you're a newly diagnosed patient, NCCN's Guidelines are a critical resource in understanding what diagnostic tests you may need and what kinds of treatment are most recommended for your type of breast cancer. Its an enormously helpful tool in helping you make decisions about surgery, chemotherapy/hormonal therapy, and radiation therapy.

Take the time to check out the guidelines and share the link with others. Mention this resource to your oncologist, too.


NCCN eBulletin - Updated NCCN.com Summaries Provide Patients with Information to Accompany Professional Guidelines

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Great cartoon!

More Mastectomies, Fewer Lumpectomies - Not A Positive Trend

A recent editorial in the Journal of Clinical Oncology asks some valid questions about the troubling trend of increases (31% to 43% from 2003 to 2006) in mastectomies for patients who could benefit from breast-conserving therapy (BCT). The editorial raises the question of whether increased use of MRI at time of diagnosis is creating undue fear resulting in women with early stage breast cancers choosing mastectomy when their breast could be preserved without increasing risk of recurrence. Are MRI's at the time of diagnosis really helpful?

More Mastectomies: Is This What Patients Really Want?

The obvious question is: What has changed? Increased awareness of and testing for BRCA1 and BRCA2 mutations indicating breast cancer predisposition are often cited as factors that have appropriately increased use of mastectomy. But these mutations occur in only 5% to 10% of patients with breast cancer, and the proportion of women in the Mayo Clinic series with a first-degree relative with breast cancer did not increase over time, whereas the mastectomy rate did, making this an unlikely explanation for a large part of the effect observed in this and other studies.

...

On the basis of these performance characteristics, it had been widely assumed that use of breast MRI for the selection of patients for BCT would reduce the need for re-excision, reduce local recurrence, and even improve long-term survival. At present, no studies have provided support for any of these improved clinical outcomes.12–14 However, breast MRI has been shown to result in additional biopsies and costs, increased patient anxiety, and delays in the start of definitive treatment. Although it is accepted that MRI-detected abnormalities should be biopsied before altering surgical treatment plans, it has been documented that some patients have chosen to forgo these biopsies or additional work-ups and proceed with mastectomy because of concerns about delaying definitive therapy.15 A recent prospective randomized clinical trial16 demonstrated no reduction in the rate of re-excision in women randomly assigned to undergo preoperative MRI compared with those who were not.17 Despite these known disadvantages and the lack of established improvement in any clinical outcome, use of breast MRI at time of diagnosis has been—in our judgment, regrettably—increasing.

...

Thus, despite the many intuitively obvious advantages of breast MRI in aiding surgical planning, there are no established benefits and several substantial disadvantages, one of which includes the needless increase in mastectomy rates. The history of breast cancer treatment is replete with interventions that seemed intuitively obvious but were eventually shown to be ineffective or harmful. The use of high-dose chemotherapy with bone marrow transplantation rescue is just one glaring recent example; an accumulating body of evidence suggests that use of MRI in selecting patients for surgical therapy is another.

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I must say I agree with the authors, increased use of mastectomy in early stage cancers is cause for concern, particularly in an era of more "personalied medicine" for breast cancer and when there appears to be no benefit in long term survival. Women today know far more about their risk of recurrence at the time of diagnosis and can benefit more from having less invasive surgery. It appears use of MRI at the time of breast cancer diagnosis is showing no benefit and some harm to patients.

What do you think?

Fiscal Responsibility and Health Care Reform

Fiscal Responsibility and Health Care Reform

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