Member of panel defends findings

An admittedly controversial government recommendation on mammograms should not preclude women younger than 50 from getting them but should lead to a discussion with providers on whether the exam is worthwhile, said an Augusta member of that panel.

Lucy Marion, dean of Medical College of Georgia School of Nursing, said the U.S. Preventive Services Task Force knew the decision would spark debate, as do most recommendations about screenings, but that was what the science said.

"We knew it was controversial," she said. "It has been controversial for some years."

Groups such as the American Cancer Society had pushed for women to start screening mammograms at age 40 but the government panel recommended against routine annual screening of normal risk women ages 40 to 49. A paper supporting the decision of six different models of mammogram screening at different ages found that starting at age 40 decreased mortality by 3 percent, about 1 less death per 1,000 women, but substantially increased the rate of false positive tests, some of which resulted in biopsies. The panel recommended screening every two years starting at age 50.

"We did not say discontinue all screenings from 40 to 49. We said we no longer recommend routine screening of all women starting at age 40," Dr. Marion said. "But we recommend that women start that conversation with their provider and look at the positives and negatives."

Weighing the benefits of any screening is often controversial and difficult for even well-trained clinicians to evaluate, she said. The panel commissioned two different studies to help it reach a decision and spent about two years weighing the issue, Dr. Marion said. The panel did not take into account whether its recommendations might alter whether some insurance companies cover screenings, she said.

"We have been asked to be an independent body and make recommendations based on the science," Dr. Marion said.

The recommendations and resulting debate are already causing some women to question whether they should get mammograms, said Pamela Anderson of University Hospital's Breast Health Center.

"I think there are those people who will take this and use it to not get it just because they will think it is OK," she said. "I think mammograms save lives, whether it is one life or 20 lives."

Mrs. Anderson would be a good example of someone who might be missed -- she was 45 years old when she was diagnosed with breast cancer and had none of the factors that would have put her at high risk. The panel's recommendations have enraged many breast cancer survivors and clinicians and will likely drive them to crusade against changing the standards.

"Then there are those women who will probably use it as an excuse not to, because we already know women don't really like to get them," Mrs. Anderson said. "It scares me. Our mammography rates aren't that good anyway. We're just going to have to work harder to make sure that we educate women on what we believe is the right thing for them to do."

Reach Tom Corwin at (706) 823-3213 or tom.corwin@augustachronicle.com.

ADVICE UNCHANGED

WASHINGTON --- Women should continue getting regular mammograms starting at age 40, Health and Human Services Secretary Kathleen Sebelius said Wednesday, moving to douse confusion caused by a task-force recommendation two days earlier.

-- Associated Press

 

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