by
Olga Deshchenko, DOTmed News Reporter | June 03, 2010
Today, confusion and divisiveness continue. An editorial published in the Annals of Internal Medicine in February pointed to a split between doctors and patients on the subject. In a poll about the guidelines, 67 percent of the physicians who responded said they would stop providing routine mammograms to women in their 40s. However, nearly all of the patients who responded to the poll were adamant about scheduling annual mammograms in that age group.
Differences in opinion aside, have the recommendations affected screening volumes? No comprehensive, scientific data are yet available on the impact. Some breast cancer experts say it is too early to assess the aftermath of the guidelines, although anecdotal evidence suggests that screening volumes have decreased. Others note that any declines in screening volume can also be credited to other reasons, such as changes in coverage, points in insurance cycles or unemployment.
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The ETMC Breast Care Center in Texas did a phone survey of their patients, reaching 276 women who have not yet scheduled a mammogram for this year. It found that 30 percent of those women did not make an appointment because of the guidelines.
"The problem with that was that these were women in their 60s and 70s. They thought the Task Force recommendations applied to them and they didn't need a mammogram," says Dr. Michael Klouda, the center's medical director.
Dr. Klouda's facility does not seem to be the only one seeing fewer women.
"Based on word of mouth and talking to other breast imaging experts, they are seeing a decline in the number of patients presenting for mammography," says Dr. Klouda. "I just think that this is a significant step backwards in reducing breast cancer mortality."
The Hoag Breast Care Center also experienced a decline in screening volume over the past year.
"Our center is down 15 percent, which is far less than the national average but it's still down, and it's the first time that we ever had a decrease in our screening volume," says Dr. Levine. "You have to realize that screening can be an uncomfortable procedure for our patients and if you give a patient a reason not to come in for a screening mammogram, a significant number of them are going to take it."
