Doctor advises regular mammograms
Dr. Heather Vega, a general practice physician in Uniontown, is on a medical mission – to remind all of her patients over age 40 that they need to schedule mammograms every year. “I know most women think you have to go to your gynecologist to get a prescription for a mammogram, but I write orders for mammograms every day,” Vega said during a recent interview at her office. “I even harass my patients when I check to see if they are up to date on their mammograms.”
If patients are hesitant to schedule mammograms because they are afraid of the discomfort or the procedures, Vega said she tries to convince them to change their minds.
“It’s such an important screening tool,” said Vega, who agreed to be interviewed about mammograms in recognition of National Breast Cancer Awareness Month in October. “I want to make sure that all of my patients are being screened for breast cancer because if it’s caught early, it is highly curable.”
Regular screening examinations enable early detection of breast cancer, which leads to a significant increase in the chance of recovery. Mammography is considered the best way to detect breast cancer in its earliest, more treatable stage, according to a pamphlet provided by the Uniontown Hospital.
Breast cancer is the most common cancer among women, except for skin cancer. The National Cancer Institute estimates that 269,730 new cases of breast cancer were diagnosed among women in the United States alone in 2005. That translates to one new diagnosis every two minutes.
The death rates from breast cancer have declined significantly, and medical experts attribute the decline to earlier detection and more effective treatments.
Despite recent controversies over its usefulness, especially in women younger than 50, Vega said experts believe mammography still is considered to be the gold standard for early detection of breast cancer.
“Women and doctors need to understand that we are more confident than ever in the benefits of mammography,” said Debbie Saslow, Ph.D., director of breast cancer and gynecologic cancers for the American Cancer Society. “The benefit is particularly clear for women in their 40s. We have much more evidence, and much more convincing evidence, that those women benefit.”
For this reason, the basic screening recommendation from the American Cancer Society remains unchanged. Women still are advised to get a mammogram every year, starting at age 40.
But the new guidelines put more emphasis on educating women – especially those at increased risk for breast cancer – about the benefits and limits of mammography and other screening methods.
Under the old guidelines, for instance, women with a higher than average risk for breast cancer (those who already have had the disease, or who have a family history of it, or with a genetic mutation that greatly increases their risk of developing it) were advised to discuss screening with their doctor.
The updated guidelines are more specific about who is at increased risk and their options for screening. Now, women and their doctors are encouraged to discuss the possibility of beginning screening earlier (at age 30, or in rare cases even younger). Another option might be to consider screening with breast ultrasound or MRI in addition to their regular mammogram.
Older women, too, are now provided with more specific advice about screening.
The previous guidelines did not address the issue of how long a woman should continue to get screened for breast cancer. The risk of getting the disease increases with age, but many older women also have serious health conditions that make screening less practical and beneficial for them.
“Some of my patients are telling me that their insurance companies will only pay for mammograms ever two years, but it is recommended that women receive the screening every year, and that is a problem,” Vega said.
Early detection and diagnosis is very important, she said. There is no fixed age at which women should stop getting mammograms.
“The truth is that if breast cancer is caught in its earliest stage, there is a five-year survival rate of 98 percent,” she said. “If the cancer hasn’t spread to the lymph nodes, there is a very good possibility that the woman will survive.”
If the cancer has spread to nearby lymph nodes (regional disease), the rate drops to 81 percent. If the cancer has spread (metastasized) to distant organs such as the lungs, bone marrow, liver or brain, the five-year survival rate is 26 percent.
“I tell my patients that even if they are over the age of 75, they still need to get yearly mammograms,” Vega said. “I just don’t understand that. Why wouldn’t a woman want to get a mammogram?”