When Nancy Ehmke heard about a federal task force’s new recommendations for breast cancer screening, she had 25 women on her mind.
That’s how many newly diagnosed breast-cancer patients younger than 50 Ehmke has seen this year in her position as oncology clinical nurse specialist at Parkview Comprehensive Cancer Center.
The U.S. Preventative Services Task Force’s new guidelines say most women should start routine breast cancer screening at age 50, not 40, and that women age 50 to 74 should have mammograms every two years rather than annually. The task force also recommends that doctors stop teaching women how to do regular breast self-examinations because the group found no evidence that such exams reduce breast-cancer death rates.
The task force said the new recommendations are aimed at reducing harm from over-treatment.
But other experts have opposed the revisions. The American Cancer Society recommends women receive a baseline mammogram by age 40 and annual mammograms after that. Those recommendations have not changed, and they were based on the same data used by the task force and additional data the task force did not consider, the organization said in a statement this week.
Parkview’s Ehmke said she’s worried women might become overwhelmed by conflicting guidelines.
“It does kind of disappoint us, because all it does is open up a big Pandora’s box in terms of confusion,” Ehmke said.
Ehmke said she meets with newly diagnosed breast cancer patients. Some of those 25 patients younger than 50 she has met this year had a family history of breast cancer, but not all of them, she said.
Ehmke says Parkview follows the recommendations of the American Cancer Society and the National Cancer Institute and will not alter its practices at this time, a position echoed Tuesday by other area health care providers.
Dr. Tom Stafford of Women’s Health Advantage said the large practice also follows the guidelines of the American Cancer Society and the American College of Obstetricians and Gynecologists, which also haven’t changed.
“For now, we’ll just do what we’ve been doing,” Stafford said.
Others came out in stronger opposition to the recommendation that women younger than 50 not have routine mammograms.
Rafat Ansari, president of Michiana Hematology Oncology P.C., based in Mishawaka, issued a statement Tuesday calling the recommendation “irresponsible.”
“Eighty-five percent of women diagnosed with breast cancer under the age of 50 have no family history of breast cancer,” he said. “And the fact remains that younger women often develop more aggressive breast cancers than older women, and therefore should be more proactive towards preventive measures, not less.”
Ansari also took issue with discouraging the teaching of breast self-exams, a recommendation that also puzzled Liz Carr, chief mammographer at the Center for Breast Health at Dupont Hospital.
Although most cancers are too small to be detected in a self-exam, there’s no cost or risk associated with a self-exam, so doing them is common sense, Carr said.
“I have seen many exceptions to that rule, when small breast cancers can be located early,” she said.
Sue Miller, 46, feels like early detection saved her. The Fort Wayne resident was in her mid-20s when her mother died of breast cancer, so she had her first mammogram and learned she had early-stage breast cancer.
She had a single mastectomy then and still gets annual mammograms.
After her most recent, she insisted on a needle biopsy even after doctors told her a lump in her breast was probably just a cyst.
“It was right for me,” she said. “Better safe than sorry.”
