New studies differ on when women should begin getting mammograms - WDRB 41 Louisville News

New studies differ on when women should begin getting mammograms

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Dr. Lane Roland Dr. Lane Roland
Vera Hobbs Vera Hobbs

LOUISVILLE, Ky. (WDRB) -- Vera Hobbs has been the James Graham Brown Cancer Center's mammography coordinator for 16 years.  

In that time, she's seen countless women get the worst news imaginable, that they have breast cancer. But, when she had her first mammography at age 40, she was the one getting the bad news.

"Calcifications showed up in the mammogram," Hobbs said. "And then we did some additional tests, and they did biopsies, and I was diagnosed with breast cancer."

Vera was lucky. It was caught early, and she says it's only because she got an exam at what had been the recommended age of 40.

"I was not going to work in this environment and not do what I ask my patients to do, which is to get a mammogram at the age of 40 ... every year after the age of 40."

But Vera and doctors at the Brown Cancer Center worry that women will be less likely to do that now that two respected cancer organizations have changed their recommended age to get a mammogram.  

One of those organizations, The American Cancer Society, has raised that age from 40 to 45 after a new study looking at the risk-to-benefit ratio.

"The commonality, if you will, of breast cancer becomes greater as a woman ages," said Dr. Elizabeth Fontham with the American Cancer Society. "So, for women ages 40 to 44, it's not that common. We think the best optimal balance of benefits and harms is about age 45."

Those "harms" she's talking about refers to overdiagnosis: women getting biopsies, only to find out they don't have cancer. But oncologist Beth Riley says that inconvenience is far outweighed by the potential dangers of not getting an exam.

"If you talk to most women, they're more comfortable going through an episode of overdiagnosis or an extra biopsy and less comfortable with not being screened earlier for breast cancer," Dr. Riley said.

Meanwhile, another group, the U.S Preventative Services Task Force, is now recommending women wait to age 50 for a mammogram, and even then to get one only every two years.  

Brown's co-director of breast imaging says that is based on what she calls "old data."

"Do more people in their 50s get breast cancer than in their 40s? Yes, our risk goes up as we age," said Dr. Lane Roland, breast imaging director at Brown Cancer Center. "But, the risk jumps up significantly. Even at 40, it's about twice what it was in your 30s."

Dr. Roland says already only about half of the women who should be getting screened are. And she fears these new guidelines will only make things worse.

"If somebody tells me, 'Well, you don't have to get this until you're 50, don't have to go get your breast compressed and deal with potentially having to come back,' yes, I think some women may opt out of that," she said. "And it may cost them their lives."

Early last year, the Brown Cancer Center got tomosynthesis, 3D imaging technology that Dr. Roland says has greatly reduced the amount of overdiagnosis.  

But, she says the new guidelines didn't take this technology into consideration.

She recommends every woman begin getting annual mammographies at age 40, regardless of their suspected cancer risk.

"If we only screened high-risk women, we would miss most breast cancers, because 80 percent of women have absolutely zero risk," Dr. Roland said.

Much like Hobbs, who doesn't like to think of what would've happened if she had waited.

"I absolutely know that if I had not gotten that mammogram, that the outcome would have been very different."

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