New mammogram recommendations met with concern

As people across the nation voice their opinions about new recommendations released concerning mammograms, a few locals for whom the disease hits home also weighed in on the topic.

A U.S. government task force recently recommended that women wait until they’re 50 to get their first mammogram to check for breast cancer.

Guidelines released Nov. 16 by a panel of experts known as the U.S. Preventive Services Task Force recommended women ages 40 to 49 with an average risk for breast cancer talk to their doctor about when it would be best for them to begin mammography screening rather than getting an annual mammogram.

Women between the ages of 50 and 74 are recommended to have biennial screenings rather than an annual mammogram.

Dr. Takey Crist, OBGYN and director of the Crist Clinic for Women said he plans to continue to tell his patients to begin getting annual mammograms starting at age 40.

“I just think if you look at the data, and I have not seen their numbers … if the number of mammograms done from 40 that were positive saved women’s lives, how is that going to translate if we wait until 50?” Crist asked.

Financially speaking, Crist added the cost of treating breast cancer increases, sometimes drastically, the more the disease has progressed.

“For those women diagnosed at a later stage, they may experience more invasive techniques to remove the cancer because the disease was at a more advanced stage,” he said.

Elizabeth D’Angelo, chairwoman of the radiology department at Onslow Memorial Hospital, said she also plans to continue following guidelines set by the American Cancer Society and other organizations that recommend annual mammograms for women starting at age 40.

“Since 1990 when the American Cancer Society recommended mammography screening yearly for women (breast cancer) mortality has significantly decreased since then in ages 40 to 50,” she said. “I would encourage women to continue their mammography screening and to not cancel their appointments for mammograms because of this study.”

Jacksonville resident Charity Woolverton said she doesn’t think there should be an “acceptable loss” when making recommendations.

Woolverton, 38, was diagnosed with breast cancer in October after discovering a mass during a self-exam.

“So many of us aren’t included in the study, but it could have changed my entire outcome,” she said. “They’re basically turning us into an acceptable-loss category.”

While the study does not recommend for or against breast self-examinations, it says “poor evidence” was found to determine whether breast self-examinations reduce breast cancer mortality.

“Fair evidence” was found that breast self-exams are associated with an increased risk for false-positive results and biopsies, according to the study.

“For 35 years we’ve been following the guidelines of the American College of Radiology and the American Medical Association … which is that women need to be taught to do self-exams of the breast because if they find something abnormal and bring it to a physician they have a better chance of survival,” Crist said.

In all his years of practicing medicine, Crist said he has had better results in doing mammograms earlier rather than later.

“Breast cancer deaths are higher the longer it goes unchecked and unmonitored,” he said.

D’Angelo agreed.

“Whether or not the government funds any research or education on monthly breast self-exam, it is still very important for younger women to do monthly self-exams because when cancer is found in young women it is usually more aggressive and more rapidly growing,” she said. “Many of the breast cancers detected in younger women are found on breast exams and breast self-exams.”

From personal experience, Woolverton said she knows how difficult it can be to fight for one’s own cause, and she is concerned the study’s recommendations may only make that worse.

“How much harder is it when you go to the doctor if he thinks what this study says is the gold standard to be your own advocate?” she asked.

Woolverton said she also worries about the future if the study’s recommendations become standard practice, particularly because she planned to talk to her daughter about breast cancer and teach her about the benefits breast self-examination.

“What they’re talking about here will make it just sound like mom is paranoid,” she said.

Contact Molly DeWitt at 910-219-8455 or mdewitt@freedomenc.com.