Don’t wait, skip years: screen early for breast cancer | Dr. Ulissey

As most of you may already know, a few weeks ago the American Cancer Society (ACS) modified its guidelines for breast cancer screening – adding discord and uncertainty, initially started by the U.S. Preventive Services Task force (USPSTF).

November 18, 2015 7:45 pm
The graph demonstrates that breast cancer begins to take off at age 39. That is where the slope of the line takes a fast and steady uptake until about age 78.
The graph demonstrates that breast cancer begins to take off at age 39. That is where the slope of the line takes a fast and steady uptake until about age 78.

As most of you may already know, a few weeks ago the American Cancer Society (ACS) modified its guidelines for breast cancer screening – adding discord and uncertainty, initially started by the U.S. Preventive Services Task force (USPSTF).

Instead of recommending mammograms on women from age 40 onward, it pushed the start age to 45, causing virtually every specialist in breast imaging and breast cancer to wonder why.

The nuts and bolts of what the ACS said are: women should begin to have mammograms at age 45 and get them yearly to age 55, then skip years, but they should have the ability to get mammograms beginning at age 40 on a yearly basis if they want to. How wishy-washy is that?

Perhaps the most frustrating issue is that the ACS and the USPSTF state their reasons for changing their recommendations as follows: women will suffer mental stress during the process of screening and diagnosing breast cancer. They treat women like they have some fragile mental psyche that can’t handle anxiety for a few days. I think this attitude is demeaning to women, and they should object vigorously.

Most women I have done breast biopsies on are a whole lot stronger than the men I have done prostate biopsies on. And that is no joke.

Also keep in mind, these are women who have the most years to live, who may now miss important milestones of seeing their kids grow up, graduate, get married and maybe have kids of their own.

The reason I recommend women begin mammograms at age 40 is because of research and outcome data.

The earlier cancer is detected, the better chance that woman has for survival.

If we don’t catch breast cancer before it has spread to lymph nodes or beyond, it will be a disaster instead of a speed bump. About 10,000 women per year ages 40-45 get breast cancer. If we follow the ACS guidelines, those very women will be diagnosed years later with a higher stage, more advanced cancer, and the ACS says those are acceptable losses.

Women now hear a cacophony of confusion from so-called scientists. I fear that some will simply throw up their hands up in frustration and get a mammogram whenever they feel like it, which in my opinion would be a big mistake.

Michael J. Ulissey, M.D., is a partner at the Breast Diagnostic Centers of Auburn and Federal Way. In addition to taking care of patients locally, he continues to participate in research as an adjunct professor at the University of Texas Health Sciences Center. You can reach him at Mike@breastdiagnostic.com.