Wednesday, November 25, 2009

Important Information on Mammograms

Being the mammographer that I am, I would like to share some information about the new announcement on screening guidelines that was shared with me. Please read, it is very important to your life.
On Monday, November 16, the U.S.Preventive Services Task Force (USPSTF) announced a change to their mammography screening guidelines. Specifically, their new quidelines recommend screening mammograms every 2 years from age 50-74 versus their old guidelines which recommended screening mammograms every 1-2 years starting at age 40. The USPSTF is an independent panel of doctors and scientists in primary care and prevention that systematically reviews the evidence of effectiveness and develops recommendations for clinical preventive services. The Tast Force reports up through the Agency for Health Care Research and Quality (AHRQ) and to the Department of Health and Human Services (HHS). Since the announcement, many parties have issued statements, reiterated guidelines and have commented in the press that they are not in support of these new guidelines. Here are some more relevant statements with key parts highlighted in red.
Department of Health and Human Services (HHS): Statement issued by Secretary Kathleen Sebelius on November 18, 2009 and the USPSTF reports into the HHS....."There is no question that the USPSTF 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. The USPSTF is an outside independent panel of doctors and scientists who make recommendations. They do not set federal policy and they don't determine what sevices are covered by the federal government. The Task Force has presented some new evidence for consideration but out policies remain unchanged. Indeed, I would be very surprised if any private insurance company changed it's mammography coverage decisions as a result of this action." What is clear is that there is a great need for more evidence, more research and more scientific innovation to help women prevent, detect, and fight breast cancer, the second leading cause of cancer deaths among women. My message to women is simple. Mammograms have always been an important life-saving tool in the fight against breast cancer and they still are today. Keep doing what you have been doing for to your doctor about your individual history, ask questions, and make the decision that is right for you."
American College of Radiology - Statement issued on November 16, 2009..."If cost-cutting USPSTF mammography recommendations are adopted as policy, two decades of decline in breast cancer mortality could be reversed and countless American women may die needlessly from breast cancer each year. The recommendations - created by a federal government-funded committee with no medical imaging representation - would advise against regular mammography screening for women 40-49 years of age, provide mammograms only every other year for women between 50 and 74, and stop all breast cancer screening in women over 74. These unfounded recommendations ignore the valid scientific data and place a great many women at risk of dying unnecessarily from a disease that we have made significant headway against over the past 20 years. These new recommendations seem to reflect a conscious decision to ration care. If Medicare and private insurers adopt these incredibly flawed USPSTF recommendations as a rationale for refusing women coverage of these life-saving exams, it could have deadly effects for American women. The USPSTF recommendations are a step backward and represent a significant harm to women's health. At least 40% of the lives saved by mammographic screening are of women aged 40-49.
American Cancer Society - Statement issued by Chief Medical Director Otis Brawley on November 16, 2009...."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. When recommendations are based on judgments about the balance of risks and benefits, reasonable experts can look at the same data and reach different conclusions. We specifically noted that the overall effectiveness of mammography increases with increasing age, but the limitations do not change the fact that breast cancer screening using mammography starting at age 40 saves lives. As someone who has long been a critic of those overstating the benefits of screening, I use these words advisedly: this is one screening test I recommend unequivocally, and would recommend to any woman 40 and over, be she a patient, a stranger or a family member. With it's new recommendations, the USPSTF is essentially telling women that mammography at age 40 to 49 saves lives: just nost enough of them. The task force says screening women in their 40s would reduce their risk of death from breast cancer by 15%, just as it does for women in their 50s. But because women in their 40s are at lower risk of the disease than women 50 and above, the USPSTF says the actual number of lives saved is not enough to recommend widespread screening. The most recent data show us that approximately 17% of breast cancer deaths occured in women who were diagnosed in their 40s and 22% occurred in women diagnosed in their 50s. Breast cancer is a serious health problem facing adult women, and mammography is part of our solution beginning at age 40 for average risk women. And as scientists work to make mammography even more effective, the American Cancer Society's medical staff and volunteer experts overwhelmingly believe the benefits of screening women aged 40 - 49 outweigh it's limitations.
As a mammographer, I've seen many women 49 and under who have been diagnosed with breast cancer.....and most of their lives have been saved by early detection because of mammography. Please take all this into consideration when making a decision about your mammogram.