By KATHY KIRBY
kkirby@muncie.gannett.com

(Published Monday, Nov. 23, 2009) FARMLAND — Lonna Long of Farmland isn’t too happy.

In fact, like other breast cancer survivors and experts, she’s downright worried and upset.

This past week, the U.S. Preventive Services Task Force recommended that most women don’t need mammograms in their 40s and should get one every two years starting at age 50.

The recommendation is a break with the American Cancer Society’s longstanding position that women should get screening mammograms starting at age 40.

“It’s like taking a step backward,” said Long, 59, a breast cancer survivor who is now fighting bone cancer. “They need to think about the one woman that could be affected.”

Diagnosed in 1982 with breast cancer at age 32, Long had a mastectomy on her left breast. The cancer was detected with a mammogram after she experienced itching in one spot.

“I had no idea it could happen to me, especially at such a young age,” she said.

Cancer-free for 23 years, Long was diagnosed with bone cancer in 2005.

Her mother, Juanita Long, died in 2001 after battles with breast, lung, bone and colon cancer.

“I hope that insurance companies continue to fund mammograms for women before age 50,” she said.

Years too late

At Ball Memorial Hospital, cancer experts were taken aback.

“We were rather appalled,” said Colleen Madden, physician and director of the BMH Breast Center. “We are very passionate about it, but someone needs to be.”

About 230,000 women in the United States are diagnosed with breast cancer each year, she said, 50,000 of them younger than age 50.

If women wait until age 50 or older to get mammograms, “those cancers are going to be much more advanced,” she said. “We see so many patients under age 50 diagnosed with breast cancer on a regular basis, and a lot of patients in their 30s.”

Madden pointed to one case on Friday, in which a 47-year-old woman was diagnosed with breast cancer at her facility.

“If she had waited three more years to be screened, the likelihood is great the cancer would’ve metastasized to her lymph nodes or other parts of her body,” she said, adding it also would have reduced the woman’s rate of survival and increase her cost of treatment and care.

The American Cancer Society predicts 3,710 Hoosier women will be diagnosed with breast cancer this year, with 860 dying from the disease.

The society continues to recommend annual screening using mammography and clinical breast examination for all women beginning at age 40, according to Otis Brawley, the group’s physician and chief medical officer.

“As someone who has long been a critic of those overstating the benefits of screening, I use these words advisedly: this is one screening test I recommend unequivocally, and would recommend to any woman 40 and over, be she a patient, a stranger or a family member,” he said this past week.

Vicki Pritz, 56, Albany, started getting annual mammograms in her mid-30s.

At age 54, breast cancer was detected.

“I had two lumpectomies,” said the two-year breast cancer survivor. “They (the lumps) were small enough I didn’t need a mastectomy.”

Pritz disagrees with the task force’s new recommendation.

“You definitely need to start sooner than age 50,” she said. “I have lost an aunt on my mother’s side and another on my father’s side to breast cancer. You just can’t take chances.”

‘Worrisome’ advice

Cheryl Mathews, education and client services coordinator at Cancer Services of East Central Indiana/Little Red Door, said screenings should begin at age 40. She said the new recommendation “is worrisome.”

Her agency helps a lot of uninsured or underinsured women in their 40s get a screening mammogram through a grant-funded program, “Reaching Out Breast Health.”

“With some, problems wouldn’t have been found had they not been screened,” she said. “At this point, we aren’t changing what we do, and encourage women to be aware of changes in their own breasts. If a physician is going to write an order for a woman to have a mammogram, our grant funds will provide that regardless of her age.”

On Wednesday, Health and Human Services Secretary Kathleen Sebelius urged women to continue getting regular mammograms starting at age 40. She said the task force does “not set federal policy and they don’t determine what services are covered by the federal government.”

She advised women to “keep doing what you’ve been doing for years: talk to your doctor about your individual history, ask questions and make the decision that is right for you.”

Another change?

And if the mammogram issue weren’t enough of a concern, new guidelines this past week by the American College of Obstetricians and Gynecologists stated most women in their 20s can have a Pap smear every two years instead of annually to catch slow-growing cervical cancer.

Locally, Madden is a little less concerned about this recommendation.

“This is a different matter,” she said. “With the new vaccine, cervical cancer is becoming less and less common. And since it’s also related to having multiple partners, people are also changing their behavior.”

Contact feature writer Kathy Kirby at 213-5821.