Breast Cancer Screening

The often confusing issue of screening for breast cancer just got more confusing. First, a major medical group disputed the need for regular mammograms for all women ages 40 to 49, as is currently recommended. Then a widely used computer system that was supposed to make mammograms more accurate was judged to make them less accurate. And guidelines just issued by the American Cancer Society recommend annual M.R.I. scans — in addition to mammograms — for all women at especially high risk of developing breast cancer, starting at age 30.

Nothing in the new material shakes the long-standing recommendation that all women age 50 or older should get regular mammograms. Women in their 40s, however, will need to weigh the pros and cons carefully. Most expert groups believe they should get mammograms every year or two. But clinical guidelines issued by the American College of Physicians take a more discriminating approach.

The guidelines acknowledge that regular mammograms for women in their 40s can reduce the risk of dying from breast cancer by a modest amount: for every 10,000 women screened, six might avoid death from breast cancer. But a very high percentage of the women screened, the college warns, will get false positive results that lead to unnecessary biopsies, increased costs and risk of injury. There is also a tiny risk that radiation from the screening might itself cause cancer. In the end, women deeply worried about breast cancer will want to get screened, while those who judge — with the help of their doctors — that they are at low risk may prefer to wait.

The latest verdicts on two advanced technologies were mixed. One new study found that M.R.I. scans could find tumors that mammograms had missed in a small percentage of women. The downside is that the costly scans are so sensitive they pick up lots of suspicious but harmless growths.

Another new study found that a costly computerized system to help radiologists read mammograms was no better at finding cancer than traditional mammography and led to many more false alarms that required needless biopsies. The computerized systems are used in some 30 percent of all mammography centers, where they are driving up costs for no clear medical benefit. Government and private insurers may need to reconsider whether the systems are worth covering.

Florida Girls Lift Weights, and Gold Medals

From New York Times

No other state has officially adopted weightlifting for girls, as the Florida High School Athletic Association did in 1997, a sign that the perception endures of weightlifting as a sport for he-men and the occasional bodybuilding queen who slathers her preternaturally bulging biceps with baby oil.

“I find it very surprising,” said Jackie Metcalf, the weightlifting coach at Sarasota High School. “because it’s a great way to get girls involved for gender equity. You don’t have to be a skilled athlete to do this.”

The presence on many teams of cheerleaders — who become better jumpers and fliers after lifting — has helped remove the stigma from the sport, several girls said. Many wear bows in their hair at competitions, and at a recent meet, one wore pearls with her singlet. They share weight rooms with boys who admiringly call them “beast.” T-shirts emblazoned with “Silly Boys, Weights Are For Girls” and the like are de rigueur.

Extracurricular club programs for girls have sprung up around the country since women’s weightlifting became an Olympic sport in 2000. But Florida, with 170 high school teams that have produced two Olympians and several dozen world team members, has “set the gold standard” for the sport, said Rodger DeGarmo, director of high performance and coaching for USA Weightlifting in Colorado Springs, the governing body that oversees Olympic lifting.

“I think it’s awesome for this group of girls because there’s so many times you have to be tall, slender,” said Judy Miller, Jessica’s foster mother. “With this, you can be any size.”

Some chugged bottles of honey before they lifted — the sugar high helps, they said — while others sat silently in a corner of the gym, summoning their strength. They ranged from 93.6 pounds to 379.1, from featherweight cheerleaders to hulking softball players and even girls who never before dabbled in sports.

“It doesn’t matter how much you lift,” said Jessica, a senior at Booker High School in Sarasota, after collecting her gold medal. “It just matters that you’re trying to make yourself better.”

Some coaches have to recruit aggressively to build a team, correcting misperceptions along the way.

“A lot of girls think if you do it you’re going to get all beefy,” said Alexa DeCristofaro, a senior at New Smyrna Beach High School who won first place in the 199-pound weight class. “Well, you really don’t. If you do it, you get toned, which is different from getting totally muscular.”

In the decade since high schools here began offering girls’ weightlifting, certain towns — Port Orange (near Daytona Beach), Port Charlotte (near Sarasota), Fort Walton Beach (near Pensacola) — have become known for their girl weightlifters. Tom Bennett, a coach at Spruce Creek High, said one of his former lifters won a slot at the Olympic Training Center in Colorado Springs and others are bent on joining her.

“The girls are very, very competitive — in some cases more than the boys,” said Mr. Bennett, whose team of 30 girls has won every state weightlifting championship since they began in 2004.

The sport is far more popular in North Florida than in Miami-Dade, Broward and Palm Beach Counties, possibly because South Florida has more wealth and its young athletes gravitate toward “upper class” sports like tennis and golf, Mr. Bennett said. Altha, a speck of a town in the Panhandle, sent six girls to this year’s state finals, while Miami sent none.

Mr. Bennett’s team practices at least 12 hours a week. Like other coaches around the state, he recruits from the school softball, soccer, cheerleading and basketball teams, with the promise that weightlifting will improve athletic performance in general.

“It definitely makes them faster, more explosive, more flexible, stronger,” said Richard Lansky, a member of the board of USA Weightlifting who runs an extracurricular club in Sarasota.

Abortion Plan in Mexico City Shakes a Heavily Catholic Land

Dominated by liberals, Mexico City’s legislature is expected to legalize abortion in a few weeks. The bill would make this city one of the largest entities in Latin America to break with a long tradition of women resorting to illegal clinics and midwives to end unwanted pregnancies.
But the measure has stirred a vicious debate and shaken this heavily Roman Catholic country to its roots.
The contours of the debate are familiar to veterans of similar battles in the United States. But Mexico City’s law would be groundbreaking in Latin America, where most countries allow abortion only under strict conditions, like when the life of the mother is in danger or when she is a victim of rape or incest. Only in Cuba, Puerto Rico and Guyana can women have abortions on demand during the first trimester. Three countries — Chile, Nicaragua and El Salvador — ban it without exception.
The Mexico City bill would make it legal to have an abortion during the first trimester for any reason. The procedure would be free at city health facilities. Private hospitals would be required to provide an abortion to any woman who asks for one, though doctors with religious or ethical objections would not be required to perform abortions.
Catholic leaders and church officials have denounced the proponents as “baby killers” and have warned that the law could provoke violence against doctors who agree to provide the service. A group of Catholic lawyers are pushing for a citywide referendum on the issue, hoping to avert the vote in the city Legislative Assembly.
“Women are dying, above all poor women, because of unsafe abortions,” said María Consuelo Mejía, the director of Catholics for the Right to Decide. “What we would like is that these women never have to confront the necessity of an abortion, but in this society it’s impossible right now. There is no access to information, to contraceptives. Nor do most women have the power to negotiate the use of contraceptives with their partners.”
Conservatives respond that abortion is tantamount to murder. “This law is a law that will cost many lives,” said Jorge Serrano Limón, the head of Provida, an anti-abortion group. “If it is signed, it will spill a lot of blood, the blood of babies just conceived in the maternal womb.”
Mr. Serrano Limón and other opponents also dispute that the law will end illegal abortions. The procedure carries such a stigma here, they say, that whether legal or not, many women will seek out underground clinics to keep their condition secret from their friends and families anyway.
“People are talking about abortion openly for the first time in Mexico,” said Lilian Sepúlveda, a lawyer with the New York-based Center for Reproductive Rights who tracks the issue in Latin America. “It is historic.”
“They say that it’s a problem of a woman’s rights over her body, but they ignore the right over their bodies that all the aborted girls and boys have,” he said later in his homily. “They deny them the fundamental right, which is the right to life.”
Many women here are watching the political battle with a mix of trepidation and hope. Like many laws in Mexico, the abortion law is honored as much in its breach as its observance.
Government officials estimate at least 110,000 women a year seek illegal abortions in Mexico, and many abortion rights groups say the number is much higher. At least 88 women died in 2006 from botched abortions, the Health Ministry says, though it is far from clear that all cases were reported.
For the poor, unwanted pregnancies often mean finding a midwife or an underground clinic, abortion rights advocates say. Some young women also resort to huge doses of drugs for arthritis and gastritis, available over the counter, that can cause miscarriages. Others use teas made from traditional herbs to cause miscarriages. All of these methods carry dangers.

THE GLOBAL GLASS CEILING

The highest percentage of women in senior management can be found in the Philippines, according to a report by Grant Thornton International, a consultancy. This reflects a tradition of wide participation in society there. Similarly, the egalitarian legacy of communism could explain the high proportion of women near the top of companies in China and Russia.

Texas House Rejects Order by Governor on Vaccines

Six weeks after Gov. Rick Perry issued an executive order making Texas the first state to require that sixth-grade girls be vaccinated against a sexually transmitted virus that causes cervical cancer, the State House of Representatives voted 119 to 21 yesterday to approve a bill that would nullify the order.
But Mr. Perry’s spokeswoman said the efforts to overturn the order would create a dangerous situation in which far fewer women might receive the vaccine.
The order mandated shots of the Merck vaccine Gardasil as protection against the human papillomavirus, or HPV, starting in September 2008. While it was praised by health advocates, it caught many by surprise in a largely conservative state where sexual politics are often hard fought and where both houses of the Legislature are controlled by Republicans.
Ms. Moody said in a statement that the order “would help to protect 95 percent of young women in Texas against the strains of HPV that cause cervical cancer.”
According to the Centers for Disease Control and Prevention, there were nearly 10,000 cases of cervical cancer last year and about 3,700 deaths from the disease.

http://www.nytimes.com/2007/03/14/us/14vaccine.html?ex=1331524800&en=8a43ce71ac57404d&ei=5088&partner=rssnyt&emc=rss