Although a new task force report says most women don't need mammograms in their 40s, some health agencies, national organizations and local doctors are sticking with earlier recommendations for yearly mammograms starting at age 40.
The U.S. Preventive Services Task Force recommended on Monday that most women don't need yearly mammograms starting at age 40 unless they have a family history of breast cancer. Instead, women age 50 to 74 should get a mammogram every two years, the task force recommends. The Task force said evidence is insufficient to recommend or not recommend mammograms for women older than 75.
The task force comprises 16 health-care professionals who review medical data.
None of the task force members are oncologists, doctors who treat cancer, nor are there any obstetrician/gynecologists, said Dr. Brent Johnson, a radiologist and managing partner for Prescott Radiology LLC. Much of the data the task force looked at dated back to the 1960s; none was from 2005 and more recently, Johnson said.
"Mammography has become so much better since then," said Johnson, who has read at least 50,000 mammograms.
"We still go with Centers for Disease Control guidelines, and they have not changed," said Lee Ann Collins, the Yavapai County Community Health Services Coordinator for Well Women's Health Check. "They recommend annual mammograms starting at age 40."
Many women questioned which of the conflicting guidelines to follow, leading Health and Human Services Secretary Kathleen Sibelius to issue a statement Wednesday on her agency's website.
"Keep doing what you have been doing for years - talk to your doctor about your individual history, ask questions, and make the decision that is right for you," Sibelius said.
"There is no question that the U.S. Preventive Services Task Force Recommendations have caused a great deal of confusion and worry among women and their families across this country. I want to address that confusion head on," Sibelius said. "The U.S. Preventive Task Force is an outside independent panel of doctors and scientists who make recommendations. They do not set federal policy and they don't determine what services are covered by the federal government."
"The Task Force has presented some new evidence for consideration but our policies remain unchanged," Sibelius said. "Indeed, I would be very surprised if any private insurance company changed its mammography coverage decisions as a result of this action."
But Johnson is concerned that insurance companies and the government will change their mammogram coverage decisions based on the task force's findings.
"I feel this is a cost cutting measure," Johnson said.
"I think these new guidelines are detrimental to our goals of getting early detection and prompt treatment for women with breast cancer," said Dr. Elizabeth Vliet, who runs a women's medical practice with an office in Tucson. "I think this is just the start of government-mandated guideline-based rationing of health care."
The American Cancer Society still recommends that women get a screening mammogram at age 40 and one every year afterward.
"The American Cancer Society continues to recommend annual screening using mammography and clinical breast examination for all women beginning at age 40. Our experts make this recommendation having reviewed virtually all the same data reviewed by the USPSTF, but also additional data that the USPSTF did not consider," Otis W. Brawley, M.D., chief medical officer of the American Cancer Society said in a statement on the agency's website.
"With its new recommendations, the USPSTF is essentially telling women that mammography at age 40 to 49 saves lives; just not enough of them," Brawley said.
Johnson said he was concerned that the task force members overlooked another very important facet of breast cancer in younger women.
"Breast cancers found in women 40 and younger tend to be more aggressive than those found in 80-year-old women," Johnson said.
Johnson stressed that advances such as digital mammography and breast MRI increase the chances of finding smaller breast cancers in the denser breast tissue that younger women tend to have.
Women over 50 tend to have less dense breast tissue, which makes it easier to detect cancer with a traditional mammogram, Johnson said.
"If we find a small cancer 10 years earlier, we can treat it with a small lumpectomy instead of a full mastectomy 10 years later," Johnson said.
Posted: Monday, November 23, 2009
Article comment by:
educateyourself,stopthewitchhunt
the key here is that family history is the most important factor. some md. make their bread and butter on doing mams. on women with no family history of b-cancer. If you are in a high risk category a mamogram is the most inaccurate test you can have, you need a MRI (10 times more accurate) but most insurance comp. won't cover them.
Posted: Monday, November 23, 2009
Article comment by:
Christopher
An independent scientific group looks at the data, and the right-wingers jump to conclusions about Democratic leadership and sinister motives. That's some amazing long distance conclusion jumping!
Posted: Monday, November 23, 2009
Article comment by:
Scotty
When the Government starts providing toothpaste, I fully expect a government panel to report brushing you teeth after every meal is unnecessary, and to recomend brushing your teeth every other day.
Posted: Monday, November 23, 2009
Article comment by:
Not a doctor
The U.S. Preventive Services Task Force is simply a group tasked with making the health care industry more cost efficient.
They are a precursor to the "death panels" that the Obama administration swore up and down would not exist or impact the quality of care.
They found that by raising the age limit of screenings, it could significantly decrease costs, even though they were aware it would cost lives.
This is what we will get under a government-run health care system.
Posted: Saturday, November 21, 2009
Article comment by:
Dr. Kildare
Those disregarding the wisdom of OPR (Obama-Pelosi-Reid) may find themselves in jail alongside those who, in their exercise of the right to life, liberty, and the pursuit of happiness, choose not to have health insurance. Defy the King & his Court and there will be a price to pay.
Posted: Saturday, November 21, 2009
Article comment by:
trippetta
When did a cancerous mass become a need for a task force? I wonder how many of these factories profiteering off of this disease are releasing carcinogenic chemicals into the environment under the guise of a cure. This is personal to me & offensive in some ways to wit:
http://www.findagrave.com/cgi-bin/fg.cgi?page=gr&GSln=Huggett&GSfn=Velma&GSbyrel=in&GSdyrel=in&GSst=24&GScnty=1238&GScntry=4&GSob=n&GRid=34698633&
My grandma dead at 29 5 children due to chemicals sprayed in where she lived in Michigan.
