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Borgaard: New mammogram advice is 'phooey'

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The news earlier this month that a federal panel of doctors and scientists have issued new guidelines regarding what age and how frequently women should have mammograms is confusing and alarming for many of us.

Especially for those of us who have boobs.

The U.S. Preventive Services Task Force is recommending women not begin regular mammogram screening until they are 50 years of age, and then every other year up until age 75. The American Cancer Society’s long-standing recommendations are starting at 40 and having the test every year after age 50 and up.

The USPSTF concluded that such early and frequent screenings often lead to “false-positive” misdiagnoses, causing pain from biopsies, anxiety and distress and radiation from repeated X-rays.

If I was writing this as a news story, I would provide that statement as part of a fair and balanced story. But in this column, I’m calling “Phooey!”

I had my first mammogram when I was 40 on my doctor’s recommendation to establish a base line for a comparison with future mammograms. At age 50, I started having them every year — and yes, every time I would complain to fellow female workers about the stretching and the smooshing.

Five years ago, it was “Bingo!” and not in a good way. A suspicious mass, albeit tiny, showed on the mammogram. A needle biopsy concluded it was cancer. Fortunately, it was confined to a milk duct and easily removed by a fairly noninvasive lumpectomy. As my surgeon said, “If you’re going to have breast cancer, this was the best kind to have.”

Normally, for this type of cancer — ductal carcinoma in situ — no further treatment of radiation or chemotherapy would have been necessary. However, since my maternal grandmother had breast cancer when she was in her 80s, and my mother had it when she was in her 60s, my surgeon and oncologist — and I — decided radiation was in order, followed by a five-year regimen of taking tamoxifen, a drug that has been shown to reduce the risk of cancer coming back.

So, had my doctor and I been following the USPSTF’s guidelines, and 2004 had been my “off” year for not having a mammogram, would the cancer have grown beyond the milk duct? Would it have spread into the lymph nodes? Would I also have needed chemo?

And what of my grandmother? Because she was past the age of 75, beyond the age the USPSTF recommends, would her cancer have gone undetected, cutting her life shorter than the 90-plus years she lived?

Would my mother’s cancer gone into more lymph nodes than it already had at the time of her detection because it wasn’t her “every other year”?

I have two daughters in their late 20s. Because I’ve had breast cancer and we apparently have a family history of it, I was genetically tested to see if my girls needed to take any extra precautions, such as starting mammograms in their 30s? Thankfully, the test was negative, and according to Dr. Christine Katterhagen of the Columbia Regional Breast Center in Longview, because my grandmother, mother and myself were all post- or peri-menopausal when we had our cancers, it doesn’t increase the risks for my daughters.

But that doesn’t mean that in 11 and 13 years, respectively, when they reach 40, I’m not going to insist they get that first mammogram.

USPSTF be damned.

Reporter Cheryll A. Borgaard may be reached via e-mail at cborgaard@tdn.com or by phone at (360) 577-2586.

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