Medical groups, survivors disregard changes in mammogram guidelines

By Tammy Roberts

Roberts@hometownnewsol.com

Fran Melenwick of Melbourne may not be alive today if she took the advice of a governmental task force.

A two-time breast cancer survivor, Ms. Melenwick was first diagnosed with the disease at age 41, after a radiologist told her that a lump she found during a self-exam was most likely scar tissue.

"I saw another doctor for a second opinion, and he confirmed my instincts," she said. "I knew something wasn't right."

The U.S. Preventative Services Task Force generated a stir of controversy this month after advising against routine breast cancer screening for women younger than 50, who are not at increased risk for the disease.

Among other findings, the study, performed by an independent group of doctors and scientists, was also against the teaching of breast self-examination, claiming the method does not reduce breast cancer mortality.

Critics of the new guidelines said they would stick to what they know about the disease, but worried that the findings would result in denied insurance coverage for women in their 40s, labeled not at risk.

After reviewing similar data regarding the issue, the American Cancer Society vowed it would not change its position regarding mammography detection.

"This is one screening test I recommend unequivocally and would recommend to any woman 40 and older, be she a patient, stranger or family member," said Dr. Otis Brawley, chief medical officer for the ACS, in a media statement.

The task force reported that screening 1,339 women in their 50s to save one life makes screening worthwhile in that age group, Dr. Brawley said. Yet, the group also said screening 1,904 women ages 40-49 in order to save one life was not worthwhile.

"With its new recommendations, the (task force) is essentially telling women that mammography at age 40-49 saves lives - just not enough of them," Dr. Brawley said. "The American Cancer Society feels that in both cases, the lifesaving benefits of screening outweigh any potential harms."

Dr. Richard Levine, a hematologist and oncologist, who operates four Space Coast Cancer locations throughout Brevard, agreed.

"We will continue to recommend screenings with our current (ACS) guidelines," Dr. Levine said. "If insurance companies begin denying these claims, at which time, the issue will be dealt with on a patient-by-patient basis."

As for the self breast-exam, Dr. Levine said he's treated many patients who have discovered breast abnormalities this way.

"It is an inexpensive, non-invasive method that is in no way harmful," he said.

Ms. Melenwick, a longtime retail associate at the Satellite Beach Post Office, said she was shocked when she heard the government's report.

Especially during Breast Cancer Awareness Month, Ms. Melenwick and her co-workers are known for encouraging women of all ages to schedule annual mammograms.

"I'm disregarding those findings and sticking to what we've been told all these years," she said. "It's better to be safe than sorry. If we don't keep that awareness going, we're going to see a lot more deaths."

Vicki Croswell, executive director of imaging services, cardiology and radiology for Health First, said the new findings are devastating to thousands of women.

In just the past year, she identified 25 cases of breast cancer in women ages 40-49 at Cape Canaveral Hospital, where she is based.

"The (task force) is basically telling these folks that screening isn't important to them, and they don't matter," Ms. Croswell said. "It evaluates the lives of many women. These findings set us back 20 years in the progress we've made with the fight against breast cancer."

As for the self-exam, Ms. Croswell said she, too, knows of many patients and even staff members who have been diagnosed after discovering a lump on their own.

"If these women had not felt a lump or had a physical exam performed, the disease could have gone undetected," she said.

Health First has no plans to change its position on breast cancer detection and will continue to encourage women as young as 40 to schedule regular mammograms, Ms. Croswell said.

"We've come a long way in fighting this disease and have no intention of turning back now," she said.

While the task force is an advisory governmental panel, the U.S. Department of Health and Human Services said the group does not set federal policy or determine what services the federal government covers.

"The task force has presented some new evidence for consideration, but our policies remain unchanged," said HHS Secretary Kathleen Sebelius in a news release.

"What is clear," she said, "is that there is a great need for more evidence, more research and more scientific innovation to help women prevent, detect and fight breast cancer."