Doctors Answer Questions About Mammograms & New Recommendations

10:13 PM, Nov 17, 2009   |    comments
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Dr. Rebecca Zurrbier (second from left) and Dr. Cathy Salem (far right) answer viewer questions during 9NEWS NOW at 5pm & 6pm.
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  • WASHINGTON, DC (WUSA) -- For decades, women have been told by the American Cancer Society, and other medical experts, to start getting routine screening mammograms every year, at age 40.

    They've also been advised to do monthly self-exams to look for new or suspicious lumps.

    But the U.S. Preventive Services Task Force now says this all amounts to screening overload.  Instead, the task force advises most women should start getting screening mammograms at age 50, and get a mammogram every other year versus every year.

    Dr. Jeanne Mandelblatt is with Georgetown's Lombardi Cancer Center. Lombardi is one of six cancer centers that recommended these guidelines to the task force.  It was the task force who ultimately made the recommendations.   Mandelblatt tells 9NEWS NOW's health correspondent, Anita Brikman, the models scientists used from around the world came to the same conclusion:  screening women in their forties produces too much unnecessary anxiety, biopsies, and even treatment for tumors so slow-growing they could be left alone.

    As you can imagine, these new guidelines have women confused about what to do.

    On 9NEWS NOW at 5pm and 6pm, Dr. Rebecca Zurrbier and Dr. Cathy Salem answered viewer questions.  Dr. Zurrbier is Chief of Breast Imaging for Sibley's Sullivan Center for Breast Health.  Dr. Salem is a Radiation Oncologist at Shady Grove Adventist Hospital.

    Below are some of the most frequently asked questions that came into the 9NEWS NOW Breast Cancer Call-In Line; along with the doctors' answers:

    QUESTION #1: I have a mammogram scheduled for next week/next month. Based on new guidelines, should I do it?

     

    ANSWER: "Absolutely. These guidelines are clearly flawed. Get a mammogram annually at age 40. Period. The task force agrees it saves lives."--Dr. Rebecca Zurrbier, Chief of Breast Imaging for Sibley's Sullivan Center for Breast Health

     

     

    QUESTION #2: I have dense breasts. Do I fit the new guidelines for yearly mammograms or not? Am I considered high risk?

     

    ANSWER: "Denser breasts are harder to examine and the mammograms are harder to interpret. I would recommend that you undergo annual digital mammography with a follow-up MRI if the digital study shows anything questionable." --Dr. Cathy Salem. Radiation Oncologist at Shady Grove Adventist Hospital

     

     

    QUESTION #3: I have dense breasts, should I get a regular mammogram or digital? Which is best for what?

    ANSWER: "Denser breasts are harder to examine and the mammograms are harder to interpret. I would recommend that you undergo annual digital mammography with a follow-up MRI if the digital study shows anything questionable. Digital mammograms are a better tool for screening or follow-up than are film mammograms." --Dr. Cathy Salem, Radiation Oncologist at Shady Grove Adventist Hospital

     

     

    QUESTION #4: When do I do an ultrasound vs. a mammogram? What's the difference?

    ANSWER:  "Ultrasound is used as an adjunct, never a replacement for screening mammography. U/S uses sound waves and is not proven to save lives from breast cancer. We use it to characterize further a breast lump or a mass found on a mammogram." --Dr. Rebecca Zurrbier, Chief of Breast Imaging for Sibley's Sullivan Center for Breast Health

     

     

    QUESTION #5: I have pains every now and then under my arm, and my breasts itch a lot.  Is this anything to be worried about? I have done mammograms fairly regularly.

    ANSWER: "If your physical exam, or your mammogram show anything suspicious or that cannot be explained then an MRI should be considered. The itching is not a concern and may be due to dry skin. The pain in the underarm area is a bit worrisome and warrants at least a physical exam by your primary care physician or your gynecologist." --Dr. Cathy Salem, Radiation Oncologist at Shady Grove Adventist Hospital

     

     

    QUESTION #6:  What about men and breast cancer? How to the guidelines affect men?

     

    ANSWER: "There are no guidelines for men for screening studies for breast cancer. While breast cancer in men is rare it can be deadly. Most men do not have enough tissue to technically do a mammogram. Masses are usually picked up on self or physician exam. A mass in a man's breast requires immediate attention and consideration of a biopsy to rule out breast cancer. All too often men ignore breast masses believing incorrectly that they cannot get breast cancer." --Dr. Cathy Salem, Radiation Oncologist at Shady Grove Adventist Hospital

     

     

    QUESTION #7:  I'm over 70 should I still keep getting yearly mammograms? Is there an cut off age?

     

    ANSWER: "No. The task force admits they do not have data to recommend for or against, but yet they recommend against! Most would say continue screening as long as you are healthy. You should have the option." --Dr. Rebecca Zurrbier, Chief of Breast Imaging for Sibley's Sullivan Center for Breast Health

     

     

    QUESTION #8:  My daughter/granddaughter (teenager & 22 yrs old) has lump under arm, what should I do? Is this too young for cancer?

     

    ANSWER:  "It is never too young but highly unlikely. Have it checked but would suspect more likely infection or inflammation from shaving and/or deodorants. An ultrasound may help decide if it is a lymph node that is abnormal or not." --Dr. Rebecca Zurrbier, Chief of Breast Imaging for Sibley's Sullivan Center for Breast Health

     

    It is important to note the new guidelines issued on Monday aren't sweeping, to include every American woman.

    Those with higher personal risk factors are still being told to look for breast cancer earlier, and more aggressively. This includes women with a family history on either the mother's or father's side. If that family member was diagnosed before age 40- the risk is higher.

    Clearly, any woman who knows she carries the BRCA 1 OR 2 breast cancer genes needs more vigilant screening.

    Many specialists also recommend it for women with dense or fibro-cystic breasts that make cancer difficult to spot.

    Finally, reproductive history is something many women overlook. If you started menstruating early, before age 12, and have no children or had your first child at a late age- that can also impact your breast cancer risk.  For more risk factors click here.