A man should be careful talking about mammograms. But the report issued this week by a panel of doctors who recommended less frequent testing for breast cancer in women under 50 comes as Congress and the country debate health care coverage.

Since the report came out, news accounts and blogs have featured hundreds of personal stories from women in their 40s who say—just this bluntly—that these new guidelines would have killed them by letting their cancer grow without detection.

I know enough about mammograms to know that they're not marshmallow treats. They're painful and humiliating tests that squash a woman where it hurts most. Most men—myself included; maybe even Daniel Craig included—would cringe to have a mammogram.

And when the results are what they call "false-positive," a week or more of worry and anxiety follow, along with a stinging biopsy. It's good news if nothing is found, but still a punishing experience. I can understand why a lot of women would almost welcome a medical excuse to avoid an annual mammogram.

The Washington Post ran a piece Friday by two physicians who worked with the doctor's task force. Douglas Kamerow at Georgetown University, and Steven Woolf, at Virginia Commonwealth, defended their recommendation, noting that every 1,900 screenings in women ages 39 to 49 produced just one case in which cancer was discovered and arrested.

They suggested that between bad results and biopsies, annual tests lead to a lot more worry and pain than cures. And, yes, cost a lot of money that might be directed elsewhere.

Of course: what if you are that one woman in 1,900? Or that one woman is your wife or mother? And if you screen just 1 million women between the ages of 39 and 49, statistics suggest you may catch cancer before it can grow in 526 women.

Maybe we shouldn't be shocked, shocked to think some doctors might find the chance to save one life in 1,900 to be small result for so much effort. A lot of us play with our odds of survival by smoking, overeating, or talking on the phone while driving.

People on all sides of the health care debate like to talk about how money can be saved in their particular plan by reducing the number of medical tests that seem redundant or unnecessary. This week, we may have seen what happens when someone suggests a way to actually do that. A lot of people decide they can't live with that.

Thank you, Scott.

Keeping audience attention is more important and more difficult than grabbing audience attention. A reader emailed me:

“What can I do to keep the audience’s attention through the whole of my presentation. There are always people who don’t seem to be listening.”

Seven tips from Olivia Mitchell.

There is no question more women than ever before are surviving breast cancer. This is happening because of early screening and better and more aggressive treatment. So I was absolutely shocked today to hear that the United States Preventive Services Task Force (a committee appointed by the U.S. Department of Health and Human Services) is now recommending that women do not get regular mammograms until their fifties and even then limit screening to every other year. In addition they are suggesting that breast self exams not be taught. ARE THEY CRAZY?

There is no way to completely express my feelings about this. I was diagnosed with stage 3 breast cancer at the age of 44, and the tumor was discovered through self breast exam and confirmed through a mammogram. This was only 18 months since a previous mammogram that was negative. My story is not unique.

I am wondering if the members of the Preventive Services Task Force have been living in a cave for the past decade. We have come so far. We can predict breast cancer through genetic screening. We have digital imaging along with mammograms to help detect tumors earlier. Efforts to raise breast cancer awareness and research funds is amazing. What on earth is this group thinking?  It all sounds so backwards, especially now that we are seeing some progress on health care reform.

This is an assault against women. There is no other way to describe it. Although breast cancer strikes men as well, breast cancer is identified as a woman’s disease and these guidelines are targeted at women’s health.

I am angry and I hope you are too. I will be contacting my representatives and I intend to be relentless.

Kathy-Ellen

I think that last suggestion is the important one--make sure Congress hears from you that this recommendation should not be implemented.