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Format: 04/19/2014
Format: 04/19/2014

News

Pittsburgh Post-Gazette: Local experts disagree with downplaying mammograms

Wednesday, November 18th, 2009

By Pohla Smith, Pittsburgh Post-Gazette

Local breast cancer experts were "shocked" and irritated by a federal task force recommendation that women ages 40-49 do not necessarily need routine, yearly mammograms, as is currently advised. But they were equally concerned about the estimated 30 percent of those 40 and older who aren't tested.

"I think that's the most important message you can help us with: One of our biggest concerns is the one-third of women who don't do anything," said Dr. Nancy Davidson, director of the UPMC Cancer Center and the University of Pittsburgh Cancer Institute. "One of our biggest jobs is to bring them into the screening tent."

The U.S. Preventive Services Task Force report, in yesterday's Annals of Internal Medicine, found that although there is a potential benefit of reduced chance of dying from breast cancer that is related to screenings and early detection, there are potential risks such as "false-positive results that lead to treatment for cancer that would not have become clinically evident during the patient's lifetime, radiation exposure, false reassurance and procedure-associated pain."

Dr. Donald Keenan, breast surgeon at West Penn Hospital, said the trend toward getting the recommended mammograms "is downward."

Why? "In the old days a woman probably didn't have to go as far to get one. Mammography to a health care system is at best a break-even operation or a money-loser," he said. "The little ones all went under. Women had to travel for mammograms.

"A second thing is the economics of people who are underinsured, another reason they're not getting mammograms."

Even with coverage, many women do not get tested. Medicare and Medicaid cover the cost of mammograms for older women and qualifying low-income women -- and have an ongoing campaign that targets health-care providers to promote screening mammography among their patients. The campaign stepped up efforts to convince women 65 and older to be screened.

Dr. Adam M. Brufsky, interim co-director of the Magee Breast Cancer Program of UPMC Cancer Centers and medical director of the Women's Cancer Center at Magee-Womens Hospital of UPMC, also said the 30 percent of the women not getting their mammograms should be drawing more attention than the federal commission's statement.

"We ought be trying to figure out why," he said. "That's a far more important thing to address.

"There's a variety of reasons [women don't get mammograms]. They're afraid of it; they're afraid of radiation; what they're going to find -- they don't want to know."

The experts acknowledged they were surprised by the advisory and found it to be patronizing to women. But a few noted that this kind of recommendation has been made before.

"Shocked -- although one can say that with exclamation points," Dr. William R. Poller, director of breast imaging at Allegheny General Hospital, said yesterday of his reaction to the task force advisory.

 

To read the rest of the story, please visit the Pittsburgh Post-Gazette

 

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