Health professionals are critical of recommendations issued by the U.S. Preventive Service Task Force on Nov. 16, but the group says their motives are being misinterpreted.
It seemed the task force was recommending two things: women should start getting mammograms at age 50 instead of age 40 and to stop doing breast self-examinations.
However, an article printed in the Wall Street Journal on Nov. 20 explains the group's reasoning. It doesn't really suggest that all women wait to get their first mammogram, but rather that they talk with their doctor first to see if it's really necessary. The task force said they are trying to cut down on the number of women who are misdiagnosed with breast cancer.
Also, the second recommendation was not really to stop women from conducting self-examinations. It just said this method is not considered to be very helpful for detection because a lump would have to be fairly large to be detected by touch.
The task force included a panel of primary care physicians appointed by the federal Department of Health and Human Services.
Larry Edwards, radiologist at Midland Memorial Hospital in Midland, Texas, said in an article by News West 9 that mammograms are only 85 to 90 percent effective in screening against cancer because they look at a picture of the breast and not at the cellular level.
A mammogram is an X-ray examination of the breast, usually conducted to look for tumors that lead to breast cancer.
Kent Bullis, medical director at the Amelia T. Wood Health Center, said the recommendations make a fair amount of sense.
"A vast majority of positive mammograms lead to more testing, which causes discomfort, fear, anxiety and expense," he said. "[Talking to a doctor first] is a way to decrease the amount of things women go through."
He said genetics, number of pregnancies and anxiety are some factors that put women at a higher risk for breast cancer.
Bullis said the Health Center does not offer mammograms, but he has ordered women to get them. He has never made a diagnosis for breast cancer, he said.
Thomas Tigges, breast surgeon at St. Vincent Hospital in Indianapolis, said he will continue to endorse the old ideology that women start getting mammograms around age 35. He said the task force has no power to implement the recommendations.
"I don't know why they are making these recommendations that many groups disagree with, but clearly it would cost less money," he said. "It's much like socialized countries, where statistically their care rates are lower than ours."
He said in socialized countries the effect is limited cost of screening care, but also more women are dying younger because breast cancer is not being detected.
Regarding the comment that breast self-examinations aren't very useful, he believes that women should go ahead and do it.
"My position is that if you have the opportunity to do something as quick and easy [as this] without side effects, I don't know why a person wouldn't," Tigges said.
He said breast cancer can affect a woman at any age and obesity is now being considered another catalyst to developing breast cancer. He said one in nine women are diagnosed with breast cancer. The most common age to get breast cancer is 50, but it is most devastating to younger women, he said.
Tigges said the rate of women being diagnosed with breast cancer is going up because women are getting tested more often.
He said breast cancer is usually non-evasive, which means it stays localized. It is possible for breast cancer to begin as evasive cancer cells that spread to other parts of the body. Half of the cases that begin as non-evasive cells will progress into evasive cancers, he said.
Fast facts —
- One in nine women are diagnosed with breast cancer
- 50 is the most common age to be diagnosed
- A woman is more susceptible to getting breast cancer if she is overweight, has close relatives who have been diagnosed with breast cancer, has had multiple pregnancies or has anxiety.
How a mammogram works, according to Radiologyinfo.com —
- A radiologic technologist will position the breast in the mammography unit
- The breast will be placed on a special platform and compressed with a paddle
- The technologist will gradually compress the breast
- The technologist will walk behind a wall or into the next room to activate the X-ray machine
- The woman will be asked to change positions between images
- The routine views are a top-to-bottom view and an oblique side view
- The process will be repeated for the other breast
- The examination process should take about 30 minutes
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