Mammogram advice raises concerns

Cayman medical professionals are examining a report from a US health task force that recommends women get fewer and later mammograms that can detect breast cancer.

resistance breast cancer

Children and adults place miniature pink pins on a giant pink ribbon in Heroes Square during Breast Cancer Awareness month last month.

The US Preventive Services Task Force said Monday that women with no family history or not at increased risk of breast cancer should wait until they are 50 before having regular mammograms, instead of starting at 40, and should receive them every two years rather than once a year.

The task force said the benefits of earlier screening are minimal compared to the risk of false alarms and the damage from biopsies.

In another reversal of advice doctors have been giving women for decades, the task force also stated that self breast examinations do no good and women should not be taught how to do them.

Doctor Sook Yin, the medical director of the Cayman Islands Cancer Society said she was surprised and alarmed by the recommendations.

‘We’re going to have to look closely at these recommendations. Our practice is not going to change right away and we will stick with screening women over 40,’ she said, adding that the use of digital mammograms in Cayman had caught several women with breast cancer at an early stage.

She added that the medical profession in Cayman, the Cancer Society, the Lions Club of Tropical Gardens, the Breast Cancer Foundation and others had spent years educating women about breast cancer and raising awareness of the disease and the importance of self-exams and mammograms.

‘To change this completely around now is very confusing to both doctors and patients,’ Dr. Yin said.


Lorraine Doherty, a 50-year-old breast cancer survivor who was diagnosed this summer when she was still 49 following a mammogram as part of her routine check-up, described the recommendations as ‘a disaster’.

‘I cannot believe they’re doing that,’ said Ms Doherty. ‘I’m fine now, I’ve been given the all clear, but if I’d had to wait another year before getting a mammogram, I would have been at least at stage two.’

Ms Doherty said she was grateful that the medical community in Cayman pushes female patients to get mammograms once they turn 40 because this was unearthing cases and saving lives.

She said she now feared that insurance companies might use the recommendations to refuse to pay for routine mammograms for women under the age of 50.

Another breast cancer survivor, who is a patient of Dr. Yin, was diagnosed following her third mammogram two years ago.

‘They found the cancer at a very early stage… I never would have thought that I’d get cancer at the age of 46, there was no history or risk of it in my family, so there was no reason I would have had a mammogram except that it was recommended for women over 40,’ she said, adding that she now gets mammograms every six months.

The patient, who asked not to be identified, said that if the recommended age to begin getting mammograms had been 50 and over, she would probably have waited until then to have one because they were uncomfortable and painful.

In the UK, where the National Health Service Breast Screening Programme offers mammograms to women aged between 50 and 70. However, that programme will be extended and the lower age limit will be 47 from 2012, according to the NHS.

Self-exams needed

Christine Sanders, the executive director of the Cayman Islands Cancer Society, said the society would continue to recommend women get mammograms at 40 and up.

She said she also believed women must continue to carry out examinations of their own breasts to check for lumps. ‘We tell women to become familiar with their breasts. We tell them you need to know your body and what is normal for you.’

In the US, the American Cancer Society said it would continue to advise women to get mammograms after they turn 40.

‘With its new recommendations, the [US Preventative Services Task Force] is essentially telling women that mammography at age 40 to 49 saves lives; just not enough of them,’ said Otis W. Brawley, chief medical officer of the American Cancer Society.

‘The task force says screening women in their 40s would reduce their risk of death from breast cancer by 15 per cent, just as it does for women in their 50s. But because women in their 40s are at lower risk of the disease than women 50 and above, the [task force] says the actual number of lives saved is not enough to recommend widespread screening,’ he added.

He said the most recent data shows that approximately 17 per cent of breast cancer deaths occurred in women diagnosed in their 40s, and 22 per cent occurred in women diagnosed in their 50s.