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November 19, 2009

The Survivors Club is receiving a lot of head-scratching emails about stunning health recommendations from a government-appointed panel that is urging major changes in breast cancer screening in the US.

In newly revised guidelines, the panel -- called the U.S. Preventive Services Task Force (USPSTF) -- recommends against routine mammography screening for most women in their 40s.  The panel also recommends that women 50 to 74 should have mammograms every two years instead of every year. Routine screening is not recommended for women older than 74.

In addition, the panel recommends against breast self-exams based on findings from two large studies showing the practice to have no value.

The reaction to the new guidelines has been loud and confusing.  Dr. David Dershaw, director of breast imaging at Memorial Sloan-Kettering Cancer Center in New York City, told TIME magazine: "I am appalled and horrified. There is no doubt that mammography screening in women in their 40s saves lives. To recommend that women abandon that is absolutely horrifying to me."

Even Health and Human Services Secretary Kathleen Sebelius admitted today there's "a great deal of confusion" about the new recommendations.

"My message to women is simple. Mammograms have always been an important life-saving tool in the fight against breast cancer, and they still are today," Sebelius said in a statement.

"Keep doing what you have been doing for years -- talk to your doctor about your individual history, ask questions and make the decision that is right for you."

So? What should you do?

The new guidelines were based on extensive analysis of the research exploring the benefits and risks of breast cancer screening.

Task force vice-chairwoman Dr. Diana B. Petitti told the health website WebMD that the new recommendations do not mean average-risk women younger than 50 and older than 74 should never be screened.  Rather, they are meant to foster discussion between these women and their doctors about the risks vs. benefits of routine screening.  Potential risks include anxiety, unnecessary biopsy, and unnecessary treatment of cancers that would never become life threatening.

"A woman who still wants to be screened after having the conversation with her clinician and considering the balance of benefits and harms should absolutely be screened," Pettiti told the health Website.

Meanwhile, the American Cancer Society rejected the new guidelines and will continue to recommend annual routine mammography screening for all healthy women age 40 and over, according to ACS Chief Medical Officer Dr. Otis Brawley, MD.

"This is one screening test I recommend unequivocally, and would recommend to any woman 40 and over, be she a patient, a stranger, or a family member," he notes.

“With its new recommendations, the (government panel) is essentially telling women that mammography at age 40 to 49 saves lives; just not enough of them,” he notes.

For more information about surviving breast cancer, please visit The Survivors Club Breast Cancer Support Center.

 

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