SEBELIUS STATEMENT ON NEW BREAST CANCER RECOMMENDATIONS
HHS Secretary Kathleen Sebelius issued the following statement today on new breast cancer screening recommendations from the U.S. Preventive Services Task Force:
"There is no question that the U.S. Preventive Services Task Force Recommendations have caused a great deal of confusion and worry among women and their families across this country. I want to address that confusion head on. The U.S. Preventive Task Force is an outside independent panel of doctors and scientists who make recommendations.
They do not set federal policy and they don't determine what services are covered by the federal government.
"There has been debate in this country for years about the age at which routine screening mammograms should begin, and how often they should be given. The Task Force has presented some new evidence for consideration but our policies remain unchanged. Indeed, I would be very surprised if any private insurance company changed its mammography coverage decisions as a result of this action.
"What is clear is that there is a great need for more evidence, more research and more scientific innovation to help women prevent, detect, and fight breast cancer, the second leading cause of cancer deaths among women.
"My message to women is simple. Mammograms have always been an important life-saving tool in the fight against breast cancer and they still are today. Keep doing what you have been doing for years - talk to your doctor about your individual history, ask questions, and make the decision that is right for you."
NAPLES — Southwest Florida radiologists and breast cancer activists are angry that successes with early breast cancer detection may fall by the wayside if new recommendations stick that most women don’t need mammograms before the age of 50.
“This will not go down. We will fight it to the ninth degree,” said Dr. Mary Kay Peterson, director of women’s imaging for Radiology Regional Center with locations in Fort Myers, Naples, Cape Coral and Lehigh Acres. “I’m just flabbergasted.”
Joined by the American College of Radiology in opposition to a new government task force recommendation that says most women don’t need mammograms in their 40s, Peterson spent much of her day Tuesday talking to patients in their 40s who have breast cancer and urging them to speak out. With early detection, the five-year survivability is 97 to 98 percent, Peterson said.
At Radiation Regional, 21 percent of all breast cancer in the past year involved women between the ages of 40 and 49, she said.
“Of all the recommendations, this is probably the most obscene, the most absurd,” Peterson said. “It is amazing to me we will go backward on this.”
New guidelines from the U.S. Preventive Services Task Force that most women can start getting mammograms at age 50 and every other year thereafter set off a firestorm of debate Tuesday with women’s cancer support organizations and professional radiology organizations lining up for battle. Especially disheartening to them is how the insurance industry will react and move to reduce reimbursement.
“I can tell you it will be a real disaster,” said Dr. Jan Forszpaniak, a surgeon at Naples Breast Cancer Surgery Center. “We will lose something we have been fighting for for so many years.”
The guidelines are for the general population and not those at high risk because of family history or gene mutations that predispose some women to breast cancer.
The task force also said breast self exams do no good for women and lead to a lot of unnecessary testing.
“I’ve been talking to a lot of different authorities, very knowledgeable on this who say it is beneficial for women between 40 and 49 to have mammograms,” said Miriam Ross, spokeswoman for Susan G. Komen for the Cure in Southwest Florida. “All I can say is we are sticking by our guidelines that we feel it is important for women.”
The task force’s recommendations carry weight with the insurance industry, which will look to reduce coverage, and that means more women will face paying more out-of-pocket fees for mammograms unless they have a family history of breast cancer, Ross said.
The Dallas-based Komen foundation, the world’s largest breast cancer advocacy organization, issued a statement that mammography, while not perfect, remains the best tool for early detection and it would stand by its policy that women start routine mammograms at 40
Dr. Chaundre Cross, a Naples radiation oncologist with 21st Century Oncology, said the task force guidelines will not change his practice of recommending yearly mammograms for women starting at 50 and for younger women based on family history and race. African American women are more predisposed for breast cancer and should start mammograms at 45, he said.
“We always look at the task force recommendations but as a practitioner, we will make decisions that are best for our patients,” Cross said.
The American College of Radiology said screening mammograms for women aged 40 and older “is one of the major health care advances of the past 40 years” and said two decades of declines in breast cancer mortality could be reversed if the task force recommendations are adopted.
Peterson, of Radiation Regional, said she absolutely expects the insurance industry to use the recommendations to cut reimbursement for mammograms.
“Hands down they will,” she said. “Anytime they can sink their teeth into stopping payments, they will.”
Mark Wright, spokesman for Blue Cross and Blue Shield, said Tuesday there will be no change in coverage for mammograms.
“We have no plans to change the coverage we provide,” Wright said “As far as this is concerned, this is between a doctor and his patient.”
Florida law stipulates that insurance policies must cover a baseline mammogram for women ages 35 to 39 and then every two years for women between 40 and 49, according to the Florida Office of Insurance Regulation.
Linda Romeo, supervisor of mammography for Naples Diagnostic Imaging Center, is outraged about the new guidelines because a lot of breast cancers will be missed if women don’t have mammograms earlier than 50.
“I think it is horrible,” she said. “I think it is an injustice to women to make recommendations of doing even less than what is recommended now.”
Romeo understands the rationale behind the numbers of screenings that would have to be done to detect one case of breast cancer but “what if you are the one or two women,” she said. “And if we find it early, you are not given a death sentence. Breast cancer is highly survivable if caught early. The whole point was to catch it early.”
Dr. Joseph Gauta, an obstetrician/gynecologist in Naples and president of the Collier County Medical Society, said the one study won’t set in motion a complete change in policy. The task force was examining costs, radiation exposure to younger women and risks, he said.
Still, Gauta said the American College of Obstetrics and Gynecology recommends starting mammograms every other year at age 40 and then annually from 50 on.
“It is a nice compromise,” he said. “I will stick with it.”
He does expect the insurance industry to capitalize on the task force guidelines to cut coverage on mammograms for younger women.
“I think they are looking at every excuse to save money,” Gauta said.
Connect with health-care reporter Liz Freeman at www.naplesnews.com/staff/liz_freeman