2009-11-26

Mammogram kerfuffle

The US Preventive Services Task Force’s (USPSTF) new breast cancer screening guidelines were published on Nov. 17, creating a storm of confusion within the medical community and the public in general.

Their guidelines suggested delaying a screening mammography until age 50 and then only screening every other year from age 50 to 74. I was pleased the Secretary of Health and Human Services Kathleen Sibelius quickly clarified that the USPSTF is an independent group funded by the government – not a policy-making arm of HHS.

This report is not related to current congressional efforts to reform the nation’s health care system. It does not appear that Medicare or Medicaid programs will alter their policies regarding payment for breast cancer screening based on this recent report.
The breast cancer screening guidelines present by the USPSTF have been poorly received in the medical community.

The American Cancer Society and the American College of Radiology have been sharply critical of the new guidelines. Both groups have recommended keeping the same guidelines that we have used for the past decade. Both organizations recommend that a woman should begin annual screening mammography (at age 40) and continue while she remains in good health.

It is my personal opinion that monthly self-exam remains an important component of early detection programs for breast cancer although that recommendation has lost favor within the past five years.

For the past two decades, I have cared for hundreds of women with breast cancer and I have no doubt that early detection has resulted in improved outcomes for a great many of my patients.

For now, I urge women to remain vigilant with breast cancer screening as they have in the past. Most importantly, women should discuss these issues with their primary care physicians, as many women have increased risk factors, which may benefit from an even more rigorous screening program. In time, an improved early detection program will evolve and will be widely embraced.

Until then, let us not throw the baby out with the bath water.
Valerian Chyle Jr., MD
Radiation oncologist
HC Center for Cancer Care, Kerrville