The abrupt reversal of what experts have long urged women to do — have monthly self-exams, yearly screenings beginning at age 40 and a yearly clinical exam — has sent shockwaves through the medical community.
The American Cancer Society quickly responded with a statement by its chief medical officer, Dr. Otis Brawley, saying it unequivocally recommends the screening test for any women 40 and older.
“Our experts make this recommendation having reviewed virtually all the same data reviewed by the U.S. Preventive Services Task Force, but also additional data that [the task force] did not consider,” Brawley said. “Mammography has limitations...but the limitations do not change the fact that mammography starting at age 40 saves lives.”
The American College of Radiology also announced strong opposition to the task force’s recommendations, which it associated with health-care rationing.
“I can’t help but think that we are moving toward a new health-care rationing policy that will turn back the clock on medicine for decades and needlessly reverse advances in cancer detection that have saved countless lives,” said James H. Thrall, chairman of the American College of Radiology Board of Chancellors.
Locally, Hallmark Health asserted that it, too, would stick with the current guidelines.
Hallmark’s Chief of Radiology Eric Henrikson said the task force study is just downright harmful in that it gives women who are already afraid of having a screening another excuse to wait — and that could also cost lives.
“To me, it’s just stunning,” he said of the report. “It’s a drastic step backwards.”
Henrikson, who has been board certified in radiology for 25 years, said about 17 percent of women in the 40-50 age group develop breast cancer, less than one in 70. But, he added, every single one of those women still matters.
“That one in 70 might not seem like a lot, but these are young women with families and their whole lives ahead of them,” he said. “These are valuable people, not only to their families but their communities.”
Henrikson added the report goes on to say that to find one instance of cancer in women between 40-50, about 1,900 screenings have to be conducted. The number drops in women 50-59 to 1,340.
“I look at it as this report asking if it’s really worth it,” he said. “It might seem like a low yield, but in the end there is that one — you — and you deserve the best breast care and treatment you can get.”
He said other reasons given in the study that mammograms cause anxiety and hurt are ridiculous, especially given the consequences. Flu shots hurt and other things in life cause anxiety, he added, but the risks of not having a screening come down to a cancer that is further advanced than it might have been if caught early.
“If you have a biopsy done, of course you’re going to worry,” he said. “But you have to take care of yourself.”
The U.S. Preventative Services Task Force study came from the Agency for Healthcare Research and Quality, a small arm of the federal Department of Health and Human Services. Henrikson said for the task force to call itself independent is incorrect considering it works directly for the federal government and this study smacks of reducing costs at the risk of lives.
“Don’t get me wrong, I’m all for healthcare reform,” Henrikson said. “But I say give it to more people and not less.”
Henrikson said right now, the study is just that — a study with recommendations. He said women should continue with breast care as they have by following through with regular screenings, self-exams and clinical exams.
However, he warned that with all the changes in healthcare going on in Washington right now, everyone should be vigilant of what’s going on.
He said this isn’t the first example of recommendations for screening to be pared back. Several years ago, a new screening for colon cancer was quickly quashed after providers insisted the only test administered should be a standard colonoscopy.
“We did seven in the system before they didn’t want to do more,” he said. “They didn’t want to pay because they said it was experimental.”
But Henrikson said a few years ago he ran into the first patient on whom he performed the screening. The woman credited the test with saving her life.
“They’ve been messing around with that test for about six years now because they simply don’t want to pay,” he said. “People need to understand that that task force did no research of its own. It just looked at the same old studies that have been done. They just came out with the opposite conclusion.”
While the face of healthcare is about to change, Henrikson said now is the time for everyone to sit up and take notice of what other services will be recommended for cutbacks.
“I’m hopeful about healthcare, but this isn’t the route to go,” he said. “This was a loud warning shot across the bow of the boat. We need to stand fast and continue to do what we do with breast care. This was a single recommendation, a single voice in a choir that happens to be out of tune.”