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Mammograms — when? How often? |
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Monday, December 07 2009 |
By LINDA HOSKINS
for The Post and Mail
New recommendations from the United States Preventive Services Task Force state that women should start regular breast cancer screenings at age 50 rather than the previously recommended age of 40. The USPSTF also recommends that women between the ages of 50 and 74 only have mammograms every other year rather than every year, and that doctors stop advising women to self check. The task force, which has sway with doctors, insurance companies and policy makers, released these new guidelines in November.
USPSTF explains 1,904 women ages 40-49 must be screened to extend one woman’s life. For women in their 50s, the corresponding figure is 1,339 women. Given these results, it seems that the cancer society is reasonable in asking why the USPSTF drew a line at age 50. Yes, women in their 40s gain less risk reduction from screening, but only one-third less than women in their 50s. Is the difference enough to flip a positive benefit for women in their 50s to a negative benefit for women in their 40s?
These new recommendations have caused quite a lot of controversy worldwide, not only with women but with doctors as well, indicating we have a long way to go in making difficult benefit-risk cost decisions.
So what’s a woman to think?
Keep in mind the USPSTF has only made recommendations, not mandates. There is a huge difference between a recommendation and a mandate, and most doctors say women should keep doing what they have been doing and ignore the recommendations.
Timothy J. Grissom, M.D., F.A.C.R. of Fort Wayne Radiology, is radiology certified and specializes in primary radiology (x-rays). Dr. Grissom has been reading mammograms for approximately 25 years and does not see a change in women getting screened.
“I do not pay attention to the new guidelines; it makes no sense,” Dr. Grissom said. “Most high-risk patients are very knowledgeable. They understand, and their mind tells them what is right.”
Dr. Grissom says women between the ages of 50 and 74 should continue to be screened every year, instead of the new guidelines of every other year.
“Surgery, radiation and chemotherapy are much more intense for a tumor that has had two years to grow instead of one,” said Dr. Grissom. “I feel women 50 to 74 years of age should be screened every year.”
If you choose to do breast self-examinations, they should not replace regular clinical breast examinations by health professionals or mammograms. Self-examinations involve checking your breasts to help detect problems and/or changes. Some breast cancers are first discovered by women themselves, often by accident. Breast lumps can be non cancerous (benign) or cancerous (malignant) and can occur at any age, though they are most common in women older than 50.
Many women still follow the American Cancer Society’s long-standing position recommending women should get their mammogram starting at age 40, based on research of early detection benefits. Almost everyone seems to know someone who has been diagnosed with breast cancer at a young age, and, thanks to early detection, has been treated and recovered from the deadly disease.
As a Christmas gift to herself, South Whitley resident Beth Ann Sickafoose was loyal about getting her mammograms once a year. Two months after one of her annual tests, she discovered a very small lump in her breast. After a visit with her physician, the inevitable became reality. Sickafoose was diagnosed with breast cancer in 2005 and went through extensive chemotherapy and radiation.
“I lost all my hair. I cried, but I knew there would be better days,” Sickafoose said. “Every women should get mammograms along with self-examinations, and if something is found, never wait, doubt or hesitate to call your doctor.”
Five years later, Sickafoose is doing well and has battled the fight. She continues annual mammograms along with self-examinations. She was also prescribed a drug called Tamoxifen, which is used to treat and prevent some types of breast cancer.
Since her diagnosis, Sickafoose has learned to live life to the fullest, not waste energy on grudges, love people who may not love you and hope it will make a difference.
For an uninsured patient, the typical full-price cost of a mammogram ranges from $80 to $120 or more, with an average of approximately $102. Some providers charge more, and some offer an uninsured discount.
For women covered by health insurance, some plans require no out-of-pocket expenses, while others charge a co-pay, generally between $10 and $35.
“Not having insurance should not be an obstacle,” said Dr. Grissom. “I know the Whitley County Community Foundation will pay for mammograms for the uninsured, along with the hospital giving significant discounts.”
The Community Foundation, through its women’s health initiative, The Giving Circle, does provide a limited number of free mammograms yearly to local residents who otherwise might not be able to afford them. The number of free mammograms provided is contingent upon the amount of money raised through fundraisers for the program.
The American Cancer Society recommends using a facility that performs many mammograms each day and is authorized by the U.S. Food and Drug Administration to perform mammograms.
Women need to keep in mind the new recommendations pertain to routine mammograms. If you are considered high risk for breast cancer or have a history of lumps, cystic or otherwise, a mammogram is not routine for you; it is a diagnostic and insurance will always cover diagnostic mammogram. If you find a lump, make an appointment with your physician immediately. Do not postpone seeing your physician because you had a mammogram less than a year ago.
Whether or not to get a mammogram, given these statistics, is a question women will have to answer for themselves based on some combination of what their hearts and heads tell them.
Each year, approximately 203,500 American women are diagnosed with breast cancer and 39,600 die of the disease. Men can also get the disease, but at far lower rates. In addition to taking care of your own health and having regular early detection tests, there’s a lot you can do to fight this disease. For information call 1-800-ACS-2345. |
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Last Updated ( Wednesday, December 09 2009 )
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