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Dr. Antoinette Cortese reads diagnostic mammograms Wednesday at Sierra Imaging. Cortese says the new federal guidelines for mammograms are “dangerously flawed” and that it's “clear mammograms save lives.”
Sebelius: mammograms still vital in saving lives
WASHINGTON (AP) — Women should continue getting regular mammograms starting at age 40, Health and Human Services Secretary Kathleen Sebelius said Wednesday, moving to douse confusion caused by a task-force recommendation two days earlier.
Sebelius issued her statement following a government panel's recommendation on Monday, that said most women don't need mammograms in their 40s and should get one every two years starting at 50.
That recommendation was a break with the American Cancer Society's long-standing position that women should get screening mammograms starting at age 40.
The task force does “not set federal policy and they don't determine what services are covered by the federal government,” Sebelius said.
Medicare, which covers older Americans and some younger ones who are disabled, provides women on Medicare coverage for an annual mammogram at age 40 and older.
Sebelius noted that there has been debate about the age at which routine mammograms should begin, and how often they should be given.
“The task force has presented some new evidence for consideration but our policies remain unchanged,” she said. “Indeed, I would be very surprised if any private insurance company changed its mammography coverage decisions as a result of this action.”
“My message to women is simple. Mammograms have always been an important lifesaving tool in the fight against breast cancer and they still are today. 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,” Sebelius said.
In the meantime, she added, it is clear that more research is needed into ways to help women prevent and fight breast cancer.
The recommendations from the task force have left women across the country confused about which advice to take. It also quickly led to charges from opponents of changing health care policy that it is an example of what could be expected from government-managed care.
In its report the panel of doctors and scientists concluded that such early and frequent screenings often lead to false alarms and unneeded biopsies, without substantially improving women's odds of survival.
But their recommendation was loudly criticized by breast cancer survivors who were diagnosed at a young age.
Sebelius issued her statement following a government panel's recommendation on Monday, that said most women don't need mammograms in their 40s and should get one every two years starting at 50.
That recommendation was a break with the American Cancer Society's long-standing position that women should get screening mammograms starting at age 40.
The task force does “not set federal policy and they don't determine what services are covered by the federal government,” Sebelius said.
Medicare, which covers older Americans and some younger ones who are disabled, provides women on Medicare coverage for an annual mammogram at age 40 and older.
Sebelius noted that there has been debate about the age at which routine mammograms should begin, and how often they should be given.
“The task force has presented some new evidence for consideration but our policies remain unchanged,” she said. “Indeed, I would be very surprised if any private insurance company changed its mammography coverage decisions as a result of this action.”
“My message to women is simple. Mammograms have always been an important lifesaving tool in the fight against breast cancer and they still are today. 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,” Sebelius said.
In the meantime, she added, it is clear that more research is needed into ways to help women prevent and fight breast cancer.
The recommendations from the task force have left women across the country confused about which advice to take. It also quickly led to charges from opponents of changing health care policy that it is an example of what could be expected from government-managed care.
In its report the panel of doctors and scientists concluded that such early and frequent screenings often lead to false alarms and unneeded biopsies, without substantially improving women's odds of survival.
But their recommendation was loudly criticized by breast cancer survivors who were diagnosed at a young age.
Government group changes recommended age for mammograms from 40 to 50
Local cancer specialists Wednesday objected to the government task force recommendation that most women don't need breast cancer screening until age 50.That is a dramatic change from the policy in place the past 20 years, which recommended annual screenings and mammograms for women beginning at age 40.
“The task force recommendations are dangerously flawed,” said Dr. Antoinette Cortese, director of Women's Imaging for Carson-Tahoe Regional Healthcare.
“Prior to 1990, before regular screening mammograms, the mortality rate from breast cancer was unchanged for 50 years,” she said. “From 1990 to the present, mortality decreased 30 percent, and those benefiting the most are in the 40-49 age group.”
Cortese said she and other health professionals recommend that women begin annual mammography exams at age 40. She said she has been told by the American Cancer Society and the American College of Radiology that they will stick with that same recommendation as well.
Carla Brutico, the nurse who manages the Carson-Tahoe Cancer Center, said they have no intention of changing their guidelines.
“We want to assure the community we are going to be here and not going to abandon current guidelines,” she said. “We want to identify cancer early. What good does it do to identify it late?”
She said breast cancer cases are being found much earlier — when the women can be more easily treated without chemotherapy, radiation and radical surgery.
“This is all about saving money,” she charged of the new recommendation.
Cortese was even more emphatic, saying the task force report states one cancer is discovered for every 1,900 women in their 40s who are screened.
“They're making a judgment call that it's not worth screening those hundreds of women to save that life,” she said.
Ann Proffitt, who works at the Cancer Center, said that rule would have cost her her life.
“I was diagnosed in my early 40s,” she said.
Cortese said if the recommendations are adopted, it would open the door to health insurance companies cutting off mammography coverage for those women.
“This appears to be a means to reduce cost. It's going back to the days when women presented with advanced signs of breast cancer that we really don't see now. We're going to have women dying needlessly from cancer if these recommendations are uniformly accepted,” she said.
Both Cortese and Brutico pointed out that the task force didn't include a single specialist trained in mammography or a physician or nurse who provides cancer treatment.
“There's no one who takes care of cancer patients on that task force,” said Brutico.
Late Wednesday, federal Health and Human Services Secretary Kathleen Sebelius issued a statement saying the task force is an independent panel of doctors and scientists who make recommendations but don't set federal policy or decide what services are covered by the government.
Although she said federal policies remain unchanged, her government Web site no longer calls for mammograms beginning at age 40, instead stating that women “ages 50 to 74 need a mammogram every two years.”
Sebelius's statement also recommend women in their 40s consult with their doctor and review their personal and family history to decide whether they need mammograms.
Cortese said that assumes women who develop breast cancer have obvious risk factors.
“The vast majority of women who develop breast cancer don't have any risk factors,” she said.
They were joined Wednesday by Republican Rep. Dean Heller who said his family has been “touched by breast cancer.” He said he is concerned the task force will discourage women from tests that detect cancer early.
He said he joins advocates in their concern that the recommendations “may confuse Americans just as the education and awareness efforts undertaken in recent decades have finally helped turn the tide against this horrible disease.”
