By Melisa Teran
For Sherri Romanoski, self-breast exams and annual mammograms were never optional. Two years after her mother was diagnosed with breast cancer, Romansoki found a lump in her own breast. And after four months of doctor visits and wondering whether she had the same disease, she was diagnosed at age 48.
“The first thing that crossed my mind is that I wouldn’t live to see grandbabies. I’m really glad I got that mammogram before I was 50,” said Romanoski.
A recent recommendation by the United States Preventative Services Task Force, suggests that women should begin annual breast cancer screening by means of mammograms starting at age 50, as opposed to the former guidelines that suggested women begin at age 40. It also proposed that women get mammograms every two years instead of annually, unless women are at high risks for breast cancer.
The new guidelines have garnered much opposition, especially from women who have survived or are living with breast cancer. Some believe the extra 10 years could mean the difference between life and death.
“That panel [US Preventative Services Task Force] is a group of epidemiologists that looks at populations and large numbers,” said Romanoski. “But people aren’t large numbers. We are individuals and we are not a statistic.”
The need for women to get annual screening before age 50 all depends on the patient, according to Dr. Maria Elena Martinez, professor of epidemiology at the University of Arizona’s Mel and Enid Zuckerman College of Public Health.
Martinez, who is also the co-leader of the Cancer Prevention and Control Program at the Arizona Cancer Center, says there is some need in women younger than age 50 to receive annual mammograms but women should talk to their doctors concerning their personal risk of breast cancer. This is where confusion begins as to who exactly should screen for cancer.
“When we talk about screening, we are talking about the general public,” says Martinez. People with a family history should have separate guidelines because they are at higher risks.
The task force cited the potential danger in annual mammograms linked to exposure to radiation during the procedure, which involves taking an X-ray of the soft tissue of the breast.
“There is a potential that a woman in their 40s can get some radiation but it’s a low risk and it is up to the woman to decide if that risk is worth it,” Martinez said.
Another possible negative consequence of mammography is the risk of over diagnosis.
“There is an over promise in what mammography can catch in time,” Martinez said.
In an opinion column published in the Arizona Daily Star, Dr. Victoria Maizes, a doctor who fully supports the Task Force’s suggestion, said, “Screening tests are meant to reveal diseases at a stage when they can be entirely prevented.”
As the lead researcher for the ELLA Binational Breast Cancer Study, Martinez has found that the type of breast cancer in Hispanic women tends to be more aggressive.
“When [Hispanic women] do discover abnormalities in their breasts they tend to wait longer to seek care, partially because of no insurance. But the message is, whether something is picked up by mammograms or self-breast exams, women should not wait to seek advice because the longer you wait, the worst the diagnosis could be,” Martinez said.
The study, which includes data taken from more than 317 Hispanic participants from Arizona and Texas, shows that 68 percent of breast cancer was found through self-detection, and 22 percent was found by a mammography.
This finding emphasizes the importance of performing self-breast exams, something that has not been subject to change by the new guidelines.
“There is no data that says that self-breast exams are detrimental. It is still a good idea because women should know their bodies and breasts. If they feel a lump they need to get it checked out,” Martinez said.
Still, the idea of pushing screening methods back 10 years is an opinion that some believe could affect the perceived importance of cancer screening.
“Because my mom had breast cancer, I was more in tune with getting screened, but I probably wouldn’t have been as vigilant if we had no cancer in our family,” Romanoski said.
It is too early to tell if the newly suggested guidelines will have any effect on the number of women who opt for preventative screening. The issue is still whether insurance companies will continue to cover the cost of screening for women who do not meet the prescribed age requirements.
For Romanoski, resolving issues regarding health insurance is simple.
“People have to be active participants in their healthcare. They have to ask questions. It’s being a good consumer of health insurance.”
Regardless of what guidelines are implemented, Romanoski continues in her effort to maintain her remission by choosing to see an oncologist for mammograms every six months, even when it is recommended to go once a year.
“It is so important that people get screening prior to age 50,” Romanoski said. “People are individuals. We are moms, wives, mothers and grandmothers. That’s what we can’t lose sight of.”
