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Tamoxifen Citrate Says No To The Shift In Breast Cancer Whose Guidelines Confuses Women And Doctors

Tamoxifen Citrate says no to the shift in breast cancer whose guidelines confuses women and doctors

On the 16th of the month we remind our viewers to perform a breast self-exam and get a mammogram if it's time.

But new recommendations by the American Cancer Society would change that recommendation, leaving many women terribly confused. That's because the guidelines we long followed for screenings and breast checks have changed for millions of us.

Dr. Kristine Hatcher is a radiologist with the South Bend Clinic who, sadly, has to tell lots of women between the ages of 40 and 45 they have breast cancer. "We detect about one person per month in that age group, and just in the last year we had nine women under the age of 45," she says.

And that's at the South Bend Clinic alone. That number doesn't include other hospitals and clinics in Michiana.

So what has changed? After nearly two decades of aggressive and universal screenings for women starting at age 40, the American Cancer Society has called for a major shift which would scale back breast cancer screenings for younger women.

There are actually now three sets of guidelines to confuse women and doctors, starting with the first major change in a 2009 recommendation by the U.S. Services Preventative task force.

Dr. Hatcher explains what that recommendation was. "Don't have any mammograms until you're age 50, then have a mammogram every other year. Don't bother to do self breast exams."

And then the newest guideline last month by the American Cancer Society suggest, "Begin your mammogram at age 45, have one every year until 55, then every other year. Don't do self breast exams."

The ACS guidelines apply to only women of "average risk," but as surgeon Dr. Gregory Credi of the South Bend Clinic points out, how is a woman to know her risk, especially when only one quarter of breast cancers are hereditary? He suggests, "If we make these leaps, jumps to say, 'this is how we're going to do this,' then I think we have to be able to tell you that you can come into a multidisciplinary clinic and we'll do a risk factor analysis." I asked him, "So in other words, just don't release something and have women have to go through it and figure it out," to which he replied, "correct."

And their biggest fears lie with their patients, like Erica Jones, whose breast cancer was found at 43. No known risk factors, but below the age for the new recommended screening.

Erica explained, "I just happened to go get my yearly mammogram and they called me back and said they wanted to test again." Erica had breast cancer.

Now cancer free for a year, Erica is back at work but knows without an early mammogram she could be dying or worse.

Hilary Ruiz is a young South Bend mother who had a scare at the age of 36, right after her baby was born. "I found a lump, I found a large lump, underneath my armpit."

A mammogram showed Hilary did not have cancer, but she thinks it's ludicrous to suggest women her age, who are not considered at risk, be ignored. "It doesn't matter, cancer hits at any age."

Both Hatcher and Credi believe mammograms and self breast exams are life savers, and Credi says since younger women are getting breast cancer, he believes anyone following the new guidelines and waiting until 45 for screening might want to have their cancer risk assessed.

Credi explains "We have the ability to offer a Gail model, sit down and look at your risk factors and say, you know what, you are safe to fall into that group."

Hatcher says insurance companies are still allowing younger women to get mammograms, and she hopes these new recommendations don't prompt Congress to try and change that, but admits money plays into the bottom line.

Hatcher says, "A lot of it is based on trying to save money to the system. It seems very callous to me, and I would argue that those women believe that the cost of screen, that age group, is worth their life."

Hilary says she won't change what she's doing and hopes other women will do the same. "I'm going to keep going and I'm still going to have them done. I think it's ridiculous."

Erica agrees and believes her mammogram at 43 saved her life. "I am a one-year survivor, free and clear."

And survival is what Credi and Hatcher want for all their patients, regardless of age.

Dr. Credi says, "Is there a one size fits all process that fits that all? The answer is no."

And Dr. Hatcher's fears are about their lives. "We're going to start losing these young women."

Right now insurance companies have not changed covering mammograms for women as young as 40, but Dr. Hatcher says some doctors may try and tell their patients they don't need one. She says if that's the case, insist.

Her biggest fear is that if Medicare decides to follow the ACS guidelines, private insurers may follow, and she says that's when women may have to become more political, insisting on coverage. 

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