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Area breast cancer survivors reacted with horror to a federal panel's finding that says women do not need routine mammograms to screen for breast cancer until they turn 50.
They were baffled by the panels' recommendation that doctors no longer teach women to do breast self-exams. These recommendations were issued early last week by the U.S. Preventive Task Force, part of the U.S. Department of Health and Human Services.
Many of her clients were in their 40s when they were diagnosed, Sobel said.
The task force also said that "current evidence is insufficient" to determine the benefit or harm of screening mammography for women 75 years and older. For women 50 to 74 years old the panel recommended mammograms every two years, instead of the accepted standard of annual screenings.
"You should talk to your doctor and make an informed decision about whether a mammography is right for you based on your family history, general health, and personal values," said Dr. Diane Petitti, vice chairwoman of the task force, in a statement.
But local doctors argued that the panel's recommendation will reverse decades of medical understanding about detecting and treating breast cancer as early as possible.
"Why are they even addressing an issue that was answered 25 years ago with multiple studies?" said Dr. Katherine Alley, the medical director of Suburban Hospital's breast program who said she does about 400 breast cancer surgeries a year.
In 2003, Montgomery County had just over 157 women per 100,000 diagnosed with breast cancer, the second-highest of any county in Maryland, according to the latest available statistics from the state's Department of Health and Mental Hygiene. Maryland as a state had the sixth-highest reported breast cancer mortality rate among women in the nation from 1999-2003.
The evidence is conclusive, Alley said, that there was a survival advantage to yearly mammograms for women age 40 and older. About 10 to 15 percent of breast cancers do not show up on mammograms, Alley said.
She has not changed her recommendation that women 40 and older get annual mammograms, and said it crossed her mind that cost considerations may have affected the panel's recommendations.
"That's not science-based medicine," Alley said.
Women always get the shaft when it comes to medical care, said breast cancer survivor Stacy Rabinovitz, 50, of Rockville.
"If this was prostate cancer they were talking about, this wouldn't be happening," she said.
Dr. Pam Wright, a breast surgeon at Suburban, said that of the biopsies done to analyze abnormalities appearing in mammograms, 20 percent show cancer. The procedure has also become simpler over the last decade, taking less time and requiring less tissue.
"We've had patients calling all day," Wright said on Thursday. "I have patients who have mammograms scheduled and they want to know if they should cancel."
Breast cancer survivor Meg Baker of Kensington, meanwhile, wondered how the affordability of mammograms for certain women could be affected down the road by the panel's recommendations.
"I'm just wondering if insurance coverage is going to become unavailable because of this," Baker said.
Damascus resident and breast cancer survivor Becky Keyser, 49, mentors breast cancer patients, the majority of whom are in their 40s, she said.
Keyser had no history of breast cancer in her family, was physically fit, did not smoke, did everything right, she said. Almost three years ago her annual mammogram found the cancer and saved her life. She had two types of breast cancer, one was invasive and aggressive.
"I think they're playing Russian Roulette with women's lives," Keyser said.
In a Nov. 16 statement on its Web site, the National Cancer Institute (part of the National Institutes of Health in Bethesda) responded to the panel's recommendations by saying: "NCI has had screening mammography recommendations for many years, and we need to evaluate them in light of the Task Force's recommendations — for all women, not only for those of average risk. It's too early for us to make any decisions right now."
In basic information provided on its Web site, the National Cancer Institute still recommends that women in their 40s without high-risk factors should get mammograms every one to two years.
Adventist HealthCare will hold a free community health forum, "Understanding the New Breast Screening Guidelines and What They Mean for Women," at 7 p.m., Dec. 3, in the Birch/Sycamore Rooms at Shady Grove Adventist Hospital, 9901 Medical Center Drive, Rockville. A panel of experts, including oncologists, radiologists, surgeons and breast cancer survivors, will share perspectives on the new guidelines and answer questions.
