Bothwell oncologist: Data used for panel's mammogram recommendation 'unreliable'

A local oncologist refutes a government task force’s new recommendations regarding mammograms and breast self-exams.

For nearly two decades, the American Cancer Society has recommended women begin yearly mammogram screenings at the age of 40. But the government panel of doctors and scientists are recommending women wait until 50 to get mammograms and then have one every two years. The task force also said breast self-exams do no good and women shouldn’t be taught to do them.

Dr. William Decker, a radiation oncologist with Bothwell Regional Health Center, said the new guidelines are “a new computer model using old data” and are therefore “unreliable.”

Decker, who has practiced at BHRC for five years, said his first thought when hearing about the task force’s recommendations was that not screening women could result in more deaths.

“Not screening women would result in more women dying from breast cancer,” Decker said, “and would also result in more aggressive cancers forming.”

Decker said hundreds of well-regarded studies related to mammography screening have been conducted and since screening has been recommended the death rate for breast cancer patients has decreased by 30 percent since 1990.

“With an early diagnosis the cancer is easier to treat,” Decker said, “and we are more likely to cure.”
Decker is also in favor of women performing breast self-exams.

“A breast self-exam is easy to do and extremely inexpensive,” he said, “and it finds breast cancers and leads to procedures that find breast cancer.”

The panel concluded early breast cancer screening is harmful and causes too many false alarms and unneeded biopsies.

“The benefits are less and the harms are greater when screening starts in the 40s,” Panel Vice-chair Dr. Diana Petitti said.

The new guidelines were issued by the U.S. Preventive Services Task Force, whose stance influences coverage of screening tests by Medicare and many insurance companies.

The guidelines released are not for women with a high risk of breast cancer due to family history or gene mutations.

The new advice says women in their 40s should not get routine mammograms, women between 50 and 74 should get a mammogram every other year until the age of 75, the value of breast exams by doctors is unknown and breast self-exams are of no value.

The new guidelines and research supporting them were released earlier this week and were published in the Annals of Internal Medicine. The task force advice is based on its conclusion that screening 1,300 women in their 50s to save one life is worth it, but screening 1,900 women in their 40s to save a life is not, according to American Cancer Society Chief Medical Officer Dr. Otis Brawley.

“That stance is essentially telling women that mammography at age 40 to 49 saves lives, just not enough of them,” Brawley said. “The cancer society feels the benefits outweigh the harms for women in both groups.”

Despite the task force’s findings, U.S. Health and Human Services Secretary Kathleen Sebelius says federal policy on who should get breast cancer screening has not changed.

“The task force does not set federal policy and they don’t determine what services are covered by the federal government,” Sebelius said. “Mammograms are an important life-saving tool and women should keep doing what you have been doing for years.”

— The Associated Press contributed to this story