Making Sense of Mammograms: Local Experts Offer Insight on New Breast Screening Guidelines - Adventist HealthCare

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Media Contact: Tom Grant

Published on December 02, 2009

Making Sense of Mammograms: Local Experts Offer Insight on New Breast Screening Guidelines

Adventist HealthCare Hospitals Host Community Forum on New Screening Recommendations

Download Breast Screening Guideline Information (English/Español)

Rockville, MD - Cancer care and women's health experts will provide important information and answers to questions about the newly released breast screening guidelines at a community forum hosted by Shady Grove Adventist Hospital and Washington Adventist Hospital on Thursday, December 3.

The new guidelines, which were released by the U.S. Preventive Services Task Force last month, recommend against mammograms for women under 50 and recommend mammograms only every two years for women over 50. They also recommend against clinicians teaching self-breast exam. These latest guidelines are a significant shift from longstanding breast screening guidelines that recommend mammograms for all women over 40 every year to two years, dependent upon risk, and also recommend monthly self breast exams for all women over 20.

"We recognize that these latest recommendations for breast screening are creating significant confusion and concern among women in our community," said Debra Pollak, Executive Director of Cancer Services for Adventist HealthCare, who will moderate the 90-minute forum. "As a local provider of health care, including a full range of oncology services, Adventist HealthCare has put together a panel of experts who can address the new recommendations, how and why the task force made these recommendations and what steps a woman can take to maintain optimum health, given these new guidelines."

The panel for the December 3 forum will include a range of experts including oncologists, surgeons and others who can help local women understand the new guidelines and what steps they might want to take to protect their health now and in the future. Shady Grove Adventist Hospital Cancer Care Navigator, Sharon Francz, will serve as moderator for the event along with Debra Pollak.

In a controversial point of departure from other, well-accepted guidelines, recommendations by the federal task force suggest that clinicians cease teaching patients how to perform breast self exams. The federal task force cited the ineffectiveness of this technique as the basis of the new recommendation. Many experts disagree with this recommendation, which will be addressed by the Adventist HealthCare panel on Thursday.

"While the breast self exams may not yield significant statistical results, when evaluated as an independent intervention, these monthly exams serve to be a consistent reminder to women to be aware of their bodies. These exams also help identify any changes in the breast(s) that can then be examined by a clinician, and appropriate follow up be implemented," notes Pollak. "We hope to provide some clarity for women about breast self exams at our forum."

In looking at the impact of the recent guidelines on more global women's health, many experts raise concerns about underserved populations, who may not have regular access to health services and care providers who can explain the risks and benefits of screenings.

"The latest guidelines are concerning for every woman, but they could be particularly devastating for underserved populations who are already at a greater risk of dying of breast cancer due to a lack of access to screening and information," says Dr. Cynthia Plate, Breast Cancer Surgeon at Washington Adventist Hospital, who will serve as a panelist at the December 3 forum. "Some women may hear only a headline and think they don't have to get a mammogram until much later or be responsible for checking their own breasts."

According to the American Cancer Society (ACS), breast cancer is the second leading cause of cancer death in women. The ACS notes that death rates from breast cancer have been declining since 1990, with larger decreases in women younger than 50, most likely due to earlier detection through screening and increased awareness as well as improved treatment. The seeming discrepancy between this finding and the task force's recommendations will be an important point covered by the Adventist HealthCare panel.

Shady Grove Adventist Hospital radiation oncologist, Dr. Cathy Salem, who will also be a panelist on December 3, notes there are other existing guidelines, including those from the American Cancer Society, which are anticipated to remain unchanged, that women and their physicians may decide to follow when determining an appropriate course of screening.

"While the task force felt that, based on statistical analysis, mammograms are not worthwhile for women under 50 and breast self exams are a waste of time for all women, other data demonstrates that since we have implemented guidelines recommending these screenings, breast cancer rates have dropped," explains Dr. Salem. "It is now up to care providers and women to look at the various recommendations, as well as their health risks and history, in order to make the best decisions about screening. Ultimately, these decisions may not follow the latest recommendations." Also noted by Dr. Salem is the fact that the newest guidelines are based upon data utilizing film mammography, which has been shown to be less effective than the current standard of care, digital mammography. The Digital Mammographic Imaging Screening Trial (DMIST) of 50,000 women demonstrated that digital mammography was significantly better than film mammography in screening women who were under the age of 50, or women of any age who had very dense breasts.

The Adventist HealthCare community forum on breast screening guidelines will take place in the Birch/Sycamore Rooms on the first floor at Shady Grove Adventist Hospital at 7:00 p.m. on December 3.

Adventist HealthCare, an integrated, health-care delivery organization based in Rockville, Maryland, is one of the largest employers in the state of Maryland. The mission of Adventist HealthCare is to demonstrate God's care by improving the health of people and communities through a ministry of physical, mental and spiritual healing. Adventist HealthCare includes Shady Grove Adventist Hospital, Washington Adventist Hospital, Adventist Behavioral Health, Adventist Rehabilitation Hospital of Maryland, Adventist Senior Living Services, Hackettstown Regional Medical Center, Adventist Home Health Services, and the Reginald S. Lourie Center for Infants and Young Children.

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