New breast cancer standards are dangerous

Published 3:35 pm Friday, November 27, 2009

To the editor:

I’m submitting this letter on behalf of two physicians: Kelley Allison, M.D., a radiologist specializing in breast imaging, and Richard Hoefer, D.O., a surgical oncologist. They are co-medical directors of the Dorothy G. Hoefer Comprehensive Breast Center.

As physicians who treat and care for breast patients every day, we are deeply alarmed by the new recommendations for breast cancer screening from the U.S. Preventive Services Task Force.

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There is universal agreement in the medical community that screening mammography saves lives. Women who undergo screening mammography decrease their chance of dying from breast cancer by 30 percent. Any change in the current screening recommendations would only reverse that trend and cause direct harm to women’s health.

Let us stress that the Task Force recommendations are a reinterpretation of 1980s data using analog mammography machines. Today, digital mammography is widespread and a much more powerful tool for detecting breast cancer in younger women.

The task force failed to consider more recent studies, such as one published in the New England Journal of Medicine in 2005 by Dr. Etta Pisano in which digital mammograms were found to be more effective when used to screen for breast cancer, specifically in younger women with dense breasts.

Despite the Task Force recommendation against them, self breast exams are the easiest free test around that could save lives. In addition to self breast exams, we strongly urge women and their physicians to follow the American Cancer Society guidelines of yearly screening mammography beginning at age 40

During the last year alone, more than 250 women in their 40s were diagnosed with breast cancer within the Sentara Cancer Network. These women are raising children, working, and caring for their parents. These women matter.

Nearly 20 percent of all breast cancer cases found nationally and within the Sentara system occur in women ages 40-49. Frequently, younger women are diagnosed with more aggressive cancers. The recommendations of this task force would put younger women diagnosed with breast cancer at greater risk of death.

A full 56 percent of all breast cancer cases are detected at stage 0 and 1 (the earliest stages for diagnosing cancer), according to the National Cancer Data Base. At these early stages the five-year survival rate approaches 100 percent. By delaying screening mammograms 10 years, from age 40 to 50, breast cancers will be detected at later stages, when mortality rates are higher.