Local health-care experts support traditional mammogram recommendations

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November 23, 2009

By JEFF MEYERS The Press Republican Mon Nov 23, 2009, 11:46 PM EST

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PLATTSBURGH — Officials from the region's biggest mammography clinic will stay on course with their recommendations for regular exams despite a recent report that suggests changes.

The U.S. Preventive Services Task Force, a government-appointed medical panel that analyzes information from various fields of medicine, released recommendations last week that suggest women ages 40 to 49 do not need annual mammogram screening for breast cancer.

"We went through this 10 years ago," said Plattsburgh radiologist Dr. Curt Snyder, noting that the distant debate on mammograms for that age group clearly showed the procedure was significant in helping to reduce mortality rates connected to breast cancer.

"We've seen a 20-to-25-percent decrease in overall mortality rates since 1990. If you have advanced breast cancer, you can control it, but you can't cure it. The only way to cure breast cancer is to find it early."

He noted that the American Cancer Society and National Cancer Institute didn't change their recommendations and still say women in their 40s should be screened.

"That is what we believe, as well," he said.

CVPH SCREENS 16,000
The CVPH Medical Center Women's Imaging Center averages 50 mammograms per day and screens around 16,000 women for breast cancer annually.

"Over 60 percent of women who develop breast cancer do not have a family history," Snyder said. "If we exclude people with average risk (of developing breast cancer), we will miss over half of the cases."

Regionally, 102 women were diagnosed with breast cancer in 2008, Snyder noted. Of those, 24 were under the age of 50, and 70 percent of the cases were diagnosed through annual mammograms.

ESTABLISH RECORD
One of the concerns highlighted by the task force is the possibility of over-diagnosing breast cancer and the added anxiety that puts on women who do not have cancer following a positive diagnosis.

But changing the recommendations to 50 will only shift that increased number of false positives, Snyder noted.

When women receive their first mammograms, they are starting to establish a record that doctors will be able to compare from year to year, reducing the chance for a false positive, he said.

YEARLY OR BIANNUAL?
The report also recommends that women between 50 and 74 be screened every two years rather than the yearly exams traditionally recommended. Biannual tests will still result in an 80-percent success rate, the report notes.

"Why settle for 80 percent when we already accomplish goals near 100 percent?" Snyder asked. "It's distressing to look at the success we've had and think that they want to mess with that."

Fay Ashline, manager of the Women's Imaging Center, said she personally knows a woman who was given a clean bill of health following a mammogram at 50 but then had a positive result a year later.

"I hate to think how much further (the cancer) would have developed if she had waited a second year."

Patients have voiced strong concern about the recommendations all week, Ashline noted, adding that only one patient canceled a scheduled mammogram all last week because of the recommendations.

INSURANCE IMPACT
Snyder said it's too early to know what impact the recommendations might have on insurance-company policy but noted that the Department of Health and Human Services has said it will not change policy for such programs as Medicare.

He also said he hopes doctors will continue to provide instructions for how to properly perform breast self-examinations, even though the report stated that self-exams do not reduce cancer mortality.

E-mail Jeff Meyers at: jmeyers@pressrepublican.com