In mid-November, the U.S. Preventive Services Task Force issued recommendations that women should delay getting regular mammograms until age 50 instead of age 40.
The task force further recommended that women between ages 50 and 74 get screened every two years instead of annually, and that doctors should no longer encourage women to obtain clinical breast exams or conduct monthly self-exams.
Minot area physicians, along with breast cancer survivors, spoke out against the recommendations, citing screening mammograms as a key diagnostic tool.
Article Photos
Submitted Photo - - Breast cancer survivors and women who volunteer as advocates in the fight against breast cancer participated in the Tough Enough to Wear Pink Campaign this year. Pictured from left are Marilyn Grosz, Mona Prellwitz, Holly Eidsness, Connie Sundby and Laura Volk.
"We are keeping to the guidelines as the way they were before, for several reasons," said Dr. Kevin Collins, oncologist for Trinity Health of Minot. "No. 1, cancers can be picked up through mammograms before they are clinically detectable, and this translates into diagnoses at an earlier stage, which further translates into the need for less therapy and the chance for improved survival."
Many breast cancer survivors in the Minot community agreed that routine screening makes a big difference in defeating cancer.
Carla Lee was diagnosed with breast cancer through a routine screening at age 46.
"I got regular screenings, once a year," Lee said. "I had no hint that this (cancer) was going on. When I was diagnosed, I was very scared."
"I tell anyone that will listen, get a mammogram," she added. "I had a lump and didn't feel it. I come across people all the time that because of fear, they don't go. This is one time when waiting could be a death sentence if you wait too long."
Holly Eidsness began routine screening mammograms with a baseline mammogram at age 40, and was 52 when she was diagnosed with breast cancer.
"I absolutely was surprised at the diagnosis. I was just doing the mammograms as a prevention, because I was supposed to. When I was diagnosed, it was already at stage one. It had probably already been there in my late 40s," Eidsness said.
Sharon Kiessling was diagnosed at age 49, again through a routine screening.
"Fortunately, this mammography suite here in Minot, they detected a tumor that was underneath my breast into the chest wall. It wasn't something I could feel. The mammogram caught it," Kiessling said.
Connie Sundby, another survivor, was 48 when she detected a lump.
"With breast cancer, there aren't a lot of signs that give you a wake-up call," Sundby said. "Had I not been diligent about checking myself and going to my doctor regularly, it would have been too late."
Collins said early breast cancer detection saves lives. He said that when the task force recommendations were issued, he looked up reports on Trinity's statistics going back 11 years. He found that of all the women diagnosed at Trinity with breast cancer, 19 percent of them were under age 50.
"That means that one out of five women who are diagnosed at our facility are under age 50," he said. "We do know that when cancers become palpable (able to be felt), they are generally more advanced, and generally have spread to lymph nodes. We also know that in women who have lymph node involvement, many of them have cancer spread elsewhere."
"Waiting for something to become palpable results in a decreased survival," he said. "With these recommendations, you've taken one out of five people with breast cancer and doomed them to wait until they become palpable."
'Frustrating'
The new recommendations have frustrated physicians and breast cancer survivors, who believe progress gained in the fight against breast cancer is being set back.
"Our biggest push was to get mammograms, to get tested," Eidsness said. "Now it seems we're going backward. That's scary to me."
"We've come so far in 10 to 15 years, I feel, in teaching women to be in tune with their bodies and to be diligent," Sundby said. "Now it's like these proposed task force recommendations have thrown us back. It's sending a mixed message to people."
Collins also felt the recommendations have resulted in significant confusion, and represent a setback.
"It's frustrating to me," Collins said. "We've gained so much ground, and now we're going to lose ground. Today, a mammogram uses very little radiation, so there's very little exposure, and very little downside to a mammogram.
"We're not asking women to have a risky procedure or a risky test," Collins said.
Trinity physicians are standing by the screening mammogram guidelines set in place by the American College of Surgeons, the American Cancer Society and the American Society of Clinical Oncology. Collins explained it's still important for women to begin having screening mammograms at age 40.
"These are women that are actually at their peak of contribution to our society," Collins said. "They are mothers, they are workers, they are professionals, and they are wives. For us to ignore saving some of these women it just astounding to me."