If Ellen Broom had followed new government recommendations regarding breast cancer screening, she said she would most likely be dead.
Broom, a psychology lecturer who had a double mastectomy and received chemotherapy treatment to combat the disease, said news of the recommendations made her sick to her stomach.
Broom had no family history of breast cancer but was diagnosed with two aggressive forms of the disease at age 36 after she found a lump during a self-examination. The new recommendations advises against self-exams and routine mammograms in women under 50.
The U.S. Preventive Services Task Force (USPSTF), a government panel consisting of doctors and scientists, released a statement last week changing previous recommendations on breast cancer screening. The organization now recommends against routine mammograms in women ages 40 to 49 and recommends screenings for women between ages 50 and 74 be done every two years, rather than annually.
According to the report, the USPSTF found evidence that suggests teaching self-examination does not reduce breast cancer mortality. Instead the committee found that false-positive mammograms, which are common for women in their 40s, can lead to psychological harm such as anxiety and unnecessary tests and biopsies.
Dr. Suzy Lockwood, director of the Center for Oncology Education and Research, acknowledged that false-positive tests can create distress, but she said the tests are worth it.
“I would rather much rather go through that anxiety than not having had any testing and finding out later that I did have breast cancer that wasn’t detected early enough,” Lockwood said.
Ann Greenhill, executive director of the Tarrant County affiliate Susan G. Komen for the Cure, agreed that mammograms are beneficial in spite of the risks.
“(Mammography) certainly is not perfect, but it’s the best thing we have right now, and it does save lives,” she said.
Lockwood said she strongly recommended that women perform monthly self-examinations at the same time each month, one week after a woman’s menstrual cycle ends. She recommended the same advice for college-aged women.
She said that without self-examinations, many breast cancer cases would not have been detected as early as they were and the survival rates would most likely be different.
Greenhill said Susan G. Komen for the Cure also recommends self-examination, which lets women be aware of changes in their bodies. The organization suggests that women get annual mammograms starting at age 40.
Jacqueline Lambiase, an associate professor of strategic communications, was diagnosed with an invasive breast cancer at age 43 after an annual mammogram.
Lambiase said the debate that has ensued since the release of the recommendations has treated the topic as a black-and-white issue, when, in reality, there is no right answer. Each woman needs to take responsibility for her own health, Lambiase said.
“If I were.a 40-year-old woman, I would probably go get the yearly mammogram,” she said. “I would be still doing monthly breast self-exams. I would want to stay in touch with every part of my body to know what is going on with it and what’s changed.”
The USPSTF said it stands by its previous recommendation that the exact age at which mammogram benefits justify potential harms is a subjective judgment. Patient preference should be taken into account when deciding when to start screening.
Lockwood said women should discuss screening options with their health care providers to determine the best course of action.
According to the USPSTF statement, breast cancer is the second-leading cause of cancer-related death among women in the United States, and an estimated 193,370 women will develop the disease this year.
The American Cancer Society recommends annual mammography screening beginning at age 40, and the World Health Organization recommends mammography every one to two years for women ages 50 to 69, according to the USPSTF report.
The guidelines are for women of the general population and do not include those who are at risk for the disease because of family history or genetic mutations.
U.S. Preventive Services Task Force recommendations
-The USPSTF recommends against routine screening mammography in women aged 40 to 49 years.
-The USPSTF recommends mammography screenings every two years for women aged 50 to 74 years.
-The USPSTF recommends against teaching breast self-examination.