New breast cancer guidelines cause stir

Published 5:41 pm Wednesday, November 18, 2009

Alabaster surgeon, Dr. Rex Sherer, said he needs to know much more about new mammogram guidelines released this week by a government task force before he makes any changes in how he practices.

Linda Wren, a Shelby woman and a breast cancer survivor, echoed that sentiment.

Wren, who has no family history of breast cancer, was diagnosed with the disease in her late 40s.

The U.S. Preventative Services task force, made up of government-appointed experts, recommends screening mammograms begin at 50 for those at average risk, rather than age 40, which has been the recommendation for the last decade.

In addition, those experts now recommend screening mammograms only once every two years for women aged 50 to 70.

The American Cancer Society has criticized the new guidelines, saying the survival rates of women between 40 and 50 who have been diagnosed with breast cancer have improved greatly over the last decade, thanks to early detection.

“I can tell you recommendations come and go. First it’s left, then, it’s right. From what I do know about it, there are lots of qualifying statements. They are broad guidelines and not something etched in stone,” Sherer said.

The recommendation that women get routine, annual screening mammograms beginning at 35 or 40 has always been controversial, he said.

“Any of these studies try to objectify something that’s subjective,” he said. “I don’t think things have really changed much. It’s still a judgment call.”

One of the new guidelines that got Sherer’s attention claims more research is necessary before deciding whether women over age 74 should receive screening mammograms.

“That’s kind of different. Does that mean insurance companies aren’t going to pay for screening mammograms for women over 74?” he asked. “The bottom line of it all is how much money do you have to spend to save one life? They are trying to make it objective, but it’s not.”

Sherer, who has been practicing in Alabaster for 24 years, suggested any woman who is confused or concerned about the panel’s recommendations should discuss that with her physician.

“You really do have to sit down with your physician and discuss your individual situation,” he said.

Wren, a breast cancer survivor for 16 years and someone who is active in Relay for Life, said the new guidelines, had they been in place in 1993 when she was diagnosed, would have been detrimental for her.

“I was diagnosed in my late 40s and I had no family history of breast cancer,” Wren said.

She found her tumor by self-examination, something the new guidelines discount as having significant value.

“I haven’t read all the details, but I want to know more about it before I change what I do,” Wren said. “I found my lump myself and went to my gynecologist. He ordered a mammogram, which verified it. In my case, these new guidelines wouldn’t have done me much good.”