Since early last week when an independent board of physicians on the U.S. Preventative Services Task Force issued new recommendations for breast cancer screening, there’s been mass confusion, even anger in some cases, on behalf of women and doctors.

The new recommendations suggest against mammography for women ages 40-49 and self-breast exams. The USPTF now recommends women should begin getting mammograms starting at age 50 and every two years thereafter. National organizations have already spoken out against the recommendations including the American Cancer Society, which has rejected the USPTF new recommendations.

A little closer to home, officials with the Montana Cancer Control Programs say screening women will continue through their Montana Breast and Cervical Health program as usual and no changes have been made. Many doctors have decided not to change their practice just yet and instead are waiting until more research is conducted. Sidney Health Center Dr. Constantine Scordalakes, obstetrician and gynecologist, said he has no plans to change his screening practices anytime soon. “I was a little bit surprised,” he said about the news. “It’s definitely confusing and frustrating for the physicians and the patients.” Scordalakes follows the American College of OB/GYNs guidelines, which does not support the new recommendations until they can be further assessed.

In coming to their decision, the task force said that because breast cancer is less prevalent in women in their 40s and the breast tissue is more dense, mammograms will have more false positives in that age group, which results in more biopsies, more procedures and more tests.

They determined the risks of mammography (which the task force defined as stress and physical pain from the mammograms) outweighed the benefits in that age group. However, it is known that the benefit of screening women ages 40-49 is a 15 percent reduction in deaths from breast cancer. It is this reduction in breast cancer death that Dr. Scordalakes says makes it problematic for him and other physicians to accept the USPTF recommendations.

The task force also recommends against performing self-breast exams. Scordalakes says that although studies have shown self breast exams do not decrease the chance of dying from cancer, it can’t hurt to do them. “There are many patients who have found their own cancers,” he said, “and so it’s hard for me to discourage patients from checking their breasts.”

It’s important to understand the new guidelines are for low-risk women who have no history of breast cancer in first-degree relatives. That’s why it’s also necessary to individualize each case. “The new recommendations are going to force the physicians to think more, to individualize more,” Scordalakes said. “What I try to do in my practice is give the patients the information and let them decide if they think that they want to have the testing done.”

Like most doctors, Scordalakes says he will still recommend to his patients to begin mammograms at age 40 followed by mammograms every one or two years until age 49, then annual screening starting at age 50 in addition to yearly clinical breast exams by a physician.

“I’d be surprised if a lot of doctors changed their practice anytime soon,” he said.

reporter@sidneyherald.com