Sacramento doctors, cancer survivors pan new mammogram rules
Technician Tina Luthge, left, guides Corinne Gulas, 48, as she has a mammogram Tuesday at the UC Davis Medical Center's Lawrence J. Ellison Ambulatory Care Center in Sacramento. A federal task force says women in their 40s should stop having the test every year and older women should have an exam every other year.
No one is thrilled at the prospect of getting a mammogram, but is getting fewer of them a good thing?
With a government task force's announcement early this week of radically new mammogram guidelines, anger and confusion over the widely used breast cancer screening tool have begun to replace women's anxiety and dread about the test.
Sacramento breast cancer survivors and medical experts alike are shocked at the new recommendations regarding mammograms and breast exams.
"This is outlandish," said Dr. Michael Norton, breast imaging medical director for the Radiological Associates of Sacramento, which performs 80,000 mammograms each year.
"I think it's irresponsible," Norton said. "I think it does a disservice to women."
For almost two decades, mammograms have been considered the gold standard of breast cancer screening, with the test recommended each year for women starting at age 40.
Under the new guidelines, the U.S. Preventive Services Task Force – whose policies influence Medicare and insurance coverage – says that women in their 40s don't need routine mammograms at all and that women past 50 should have them every other year, not every year.
In addition, the task force found no benefit in breast self-exams or clinical exams.
"So how are you supposed to find it if you're not doing a breast exam, your doctor's not doing a breast exam and you don't get a mammogram?" said Dina Howard, 43, a breast cancer survivor who lives in Carmichael. "You're waiting until the lump is so large it hits your chin."
While the incidence of breast cancer increases with age, 17 percent of women who died of the disease in 2006 were in their 40s, according to the American Cancer Society.
That organization and other medical groups such as the American Radiological Society and the American College of Obstetricians and Gynecologists continue to urge women to have annual mammograms beginning at age 40.
"Today I operated on six women," said Dr. Ernie Bodai, Kaiser Permanente Sacramento's director of breast surgical services. "Two were in their 40s, and their lesions were found through mammography. To start checking at 50 is ridiculous."
What about the task force's suggestion that mammograms' false positives can cause anxiety?
"So does cancer," said Bodai.
While some breast cancer advocacy groups welcomed the federal panel's decision, citing the fact that mammograms before menopause are less likely to detect tumors because of breast density, Dina Howard worried that it's unwise to take the disease off younger women's radar screens.
"The option in my mind is that every woman under 50 should get an MRI, as opposed to doing nothing," said Howard, who was diagnosed at age 39 after she found a lump in her breast.
According to the cancer society, breast cancer will account for 192,000 new cancer cases and 40,000 deaths in this country this year.
Early detection saves lives. Because breast cancer in younger women tends to be more aggressive, annual screening is vital, said Dr. Karen Lindfors, a radiologist and chief of breast imaging at the UC Davis Cancer Center.
"It's absolutely erroneous to suggest that women in their 40s should not have mammograms," Lindfors said. "The reduction in mortality in women in their 40s who have cancer screenings is more than 40 percent."
Her patients were concerned, she said.
"They're totally confused," Lindfors said. "These are all 40ish women I'm seeing today. They're saying, 'Of course, I'm coming in for my screening. Of course, I want to know if I have something.' "
Recommendations on mammography and breast exams change every decade – proof, Bodai said, that the medical experts still have a lot to learn.
While Norton worried that the panel's new guidelines could amount to a first step toward health care rationing and Howard said she considered the controversy a way for insurance companies to raise rates, Bodai pointed out that delayed breast cancer treatment costs a lot more than early detection and intervention.
And in Citrus Heights, breast cancer survivor Dianne Davis and the other women in her water aerobics class had definite thoughts on the matter.
"It's ridiculous," said Davis, 72, who was diagnosed eight years ago. "We were talking in the pool this morning. The consensus of these eight ladies was, leave it the way it is."
Corinne Gulas, 48, left, undergoes a mammogram Tuesday at the Lawrence J. Ellison Ambulatory Care Center in Sacramento as technician Tina Luthge administers the exam.
If you enjoyed this post, please consider to leave a comment or subscribe to the feed and get future articles delivered to your feed reader.
Comments
No comments yet.
Sorry, the comment form is closed at this time.