Health panel stirs debate

Responding to a government task force’s recommendation for women to wait until age 50 to get a mammogram, Sally Acton of Schneck Medical Center said the decision for a patient to receive a mammogram is still a very personal one that should be made between the patient and their family physician.

“They (physicians) are the ones who help us make decisions,” she said. “It’s very important for every woman to have a family physician.”

Acton, who has been an oncology nurse for 23 years, said the panel’s recommendation goes against what she believes.

“There is one thing that is an outstanding feature of cancer, is that if you catch it early, you can cure it,” Acton said.

The U.S. Preventative Services Task Force reported Monday that most women should wait until age 50 to get mammograms and then have one every two years. Also, the task force said breast self-exams do no good and women shouldn’t be taught to do them, according to a report from The Associated Press.

Acton said the American Cancer Society came out with similar information years ago.

“I can only tell you from experience that many of the cancers my patients have, they found themselves,” Acton said. She said if women notice any change in their body, they should see a doctor.

The American Cancer Society’s recommendation on breast self-exams changed in 2003, according to a press release dated that year on the Society’s Web site. “The reason for this change is that research has shown that BSE plays a very small role in detecting breast cancer compared with self awareness. Often, women who do detect their own breast cancer find it outside of a structured breast self-exam; they may detect a lump while showering or getting dressed,” the American Cancer Society press release stated.

The task force’s new recommendation is a reversal that conflicts with the American Cancer Society’s long-standing recommendation of annual screening starting at 40. For nearly two decades, the cancer society has been recommending regular mammograms beginning at 40, the AP said.

But the government panel of doctors and scientists concluded that getting screened for breast cancer so early and so often is harmful, causing too many false alarms and unneeded biopsies without substantially improving women’s odds of surviving the disease.

Acton said the task force looked at generalizations.

“Anytime a group of people is looking at national statistics, or looking at a group of people, certainly it is easy to say to you that the majority of breast cancer is occurring in women over 50,” Acton said.

“If I’m that 45-year-old with breast cancer and we don’t catch it early, then the odds of being cured aren’t as great,” Acton said.

Gayle Skaggs, a 10-year breast cancer survivor whose breast cancer was detected through a mammogram when she was 48, disagrees with the task force’s findings.

“I think that is totally wrong because those two years that if I would have waited, it would have been too late for me,” Skaggs said. She said her prognosis could have been at stage 3 if she would have waited for her mammogram.

Early detection is a priority for Skaggs, who is active in encouraging women to get mammograms. She is also involved in Relay for Life and Reach for Recovery.

“I think changing mammograms to 50 is not acceptable to me. I have had friends, four friends, who had breast cancer and they were all detected in their late 30s, early 40s by mammograms. If we would have waited for 50 we might not be here,” Skaggs said.

Telling the story of her cousin who died of breast cancer when she was 35 or 36 years old, Skaggs said her cancer was detected when she was 30 years old through a mammogram.

Skaggs said she was persistent with her own daughter about having her mammogram when she was 30 just as a precaution.

Since the release of the task force’s recommendation, groups and organizations have spoken out against the news.

Health and Human Services Secretary Kathleen Sebelius spoke publicly about the recommendations Wednesday. She said the task force “does not set federal policy and they don’t determine what services are covered by the federal government.”

Sebelius advised women to “keep doing what you’ve been doing for years – talk to your doctor about your individual history, ask questions, and make the decision that is right for you.”

It had been reported earlier in the week, by the AP, that the task force’s stance could influence coverage of screening tests by Medicare and many insurance companies. In a Monday story about the recommendation, Susan Pisano, a spokeswoman for America’s Health Insurance Plans, an industry group, said insurance coverage isn’t likely to change because of the new guidelines, however.

Scott Surface of Surface Financial Group in Seymour, however, said he would expect insurance companies to change their policies on mammograms.

“The (insurance) guidelines are all based on government recommendations,” Surface said. “If Medicare changes its guidelines, insurers would likely change theirs in terms of preventive care.”

Surface said over the past five to 10 years he’s seen more people seeking insurance coverage that provides payment for screenings and preventive care services rather than just for treatment.