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Mammogram report disputed
by Charles S. Williams
A North Wilkesboro radiologist is taking exception to a report from the U.S. Preventive Services Task Force (USPSTF) that recommends against routine mammograms and breast cancer screening for women under the age of 50.
The USPSTF also concluded that the current evidence is insufficient to assess the additional benefits and harms of screening mammography in women 75 years of age or older.
Dr. Jack McLarney, the chief executive officer of Valley Radiology Associates (which provides radiologic services for Wilkes Regional Medical Center), said, "It is the position of the radiologists of our group to continue to adhere to the existing guidelines as recommended by the American Cancer Society (ACS) and the American College of Radiology. "I am aware of the recommended revised guidelines, but until there is a consensus of medical professional organizations based on published scientific data, our existing screening guidelines remain unchanged beginning at the age of 40."
Dr. Otis W. Brawley, the chief medical officer for the ACS, said, "Our society continues to recommend annual screening using mammography and clinical breast examination for all women beginning at age 40. Our experts make this recommendation having reviewed virtually all the same data reviewed by the USPSTF, but also additional data that the USPSTF did not consider.
"When recommendations are based on judgments about the balance of risks and benefits, reasonable experts can look at the same data and reach different conclusions."
According to the USPSTF, women ages 40 to 49, who are at high risk for breast cancer, should consult with their clinician concerning the optimal time to begin regular, biennial screening mammography.
McLarney said that his group has documented 35 positive cases of breast cancer within Wilkes County in the past three years, or approximately one case every month, within the 40-49-year-old age group. That's 17 percent of the total of 209 cases here. The age group accounted for 22.6 percent of all exams.
"Those are 35 cases which would have probably gone undetected under the guidelines suggested by the USPSTF," said McLarney.
The radiologist explained that mammography is felt to be less accurate in young women because of higher breast density, which can obscure a cancer. But digital mammography, which is used at the Diagnostic Imaging Center of Wilkes Regional Medical Center, is felt to be more accurate in this age group, he said.
During the same three-year time period, Valley Radiology reported finding 41 positive cancers in 3,270 exams of women ages 70-79, and 29 among 920 exams of women 80 years and older.
"They saved my life"
One person who highly recommends mammograms for women in the 40-49-year-old range is Sandra Miller, a Wilkes Regional employee and breast cancer survivor.
"I just don't want women to have to wait until they are 50 years old to have a mammogram because of government involvement and insurance restrictions," she said.
"I discovered I had breast cancer when I was 44 years old and during a routine mammogram. There were no signs or symptoms. I was called back three days later because the radiologist found a change in my breast tissue, and within two weeks my whole world was turned upside down."
She added, "I went through surgery twice, as well as chemotherapy and radiation, and five years later I'm great. Everything is perfect. There are no signs that the cancer has returned.
"I had a very aggressive form of cancer. It was a deep tumor located near the chest wall, and had I waited until I could feel a lump, I'm sure the outcome would have been much different. Absolutely it could have spread. We just had to move quickly to get it out. It had already started to infiltrate the other tissue.
"I definitely think the mammogram saved my life," she said. "My mother is a breast cancer survivor as well. Women today can't afford to wait because of possible government restrictions. I have two daughters, and if they restrict them, it could affect their lives, even though they would probably be exempt because of family history."
Mrs. Miller was featured in a promotional campaign for the hospital for the recent Breast Cancer Awareness effort. The message on the billboard was simple: "They found my cancer, and saved my life." |
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