November 18, 2009

After Participating in Public Awareness Campaign to Encourage Women Over the Age of 40 to Receive Mammograms, Gillibrand Urges Fed to Clarify New Recommendations

Many Doctors, Experts Object To Recommendations, Giving Women Conflicting Messages on How to Protect Themselves

Washington, DC - After having participated in a public awareness campaign to encourage women over the age of 40 to receive mammograms, U.S. Senator Kristen Gillibrand today called on the federal government to clarify new recommendations for women on how to prevent breast cancer.  New guidelines released this week by the U.S. Preventative Services Task Force suggested that only women over 50 need to get routine mammograms as part of breast cancer screening. Many doctors and experts objected to these recommendations, sending conflicting messages to women about how they can prevent breast cancer.

"I am concerned that women are being given differing messages about how to prevent breast cancer," Senator Gillibrand said. "In addition to getting my own mammogram each year, I have been involved in public awareness campaigns to encourage other women my age to do so.  I understand that there were many independent scientists involved in making this decision, but that there are also many respected medical experts that are disagreeing with the recommendations. I plan to seek some answers here so that women are getting a uniform message about how to protect themselves."

Doctors, medical experts, and news reports from around New York have raised concerns about the new recommendations.

"I think this would be a huge mistake," said Dr. Paul Fisher, a radiologist at the Carol M. Baldwin Breast Care Center at Stony Brook University Medical Center. "There's almost unanimity that mammography saves lives."

Dr. Jane Carleton, an attending physician specializing in breast cancer at the Don Monti Cancer Center at North Shore University Hospital in Manhasset, said cutting back on mammograms could allow some small breast cancers to become larger, more lethal growths. "We continue to see tragedies in women who present with much larger breast cancers because they have not had mammograms," Carleton said.

At Nassau University Medical Center in East Meadow, Dr. Victor Scarmato, chairman of radiology, questioned the new recommendations.

"Their conclusions are against the conclusions of the American Cancer Society and other cancer and screening advocacy groups," Scarmato said."There are many in that population whose lives are saved because of the procedures [mammograms] even if the yield is not as great as in older women," Scarmato said. "We are very concerned that the insurance companies will use this to restrict coverage for screening, taking away the option for what women and their doctors feel is best for them," said Hillary Rutter, LCSW, Director of the Adelphi NY Statewide Breast Cancer Hotline & Support Program.

Dr. Derek tenHoopen of West Ridge Obstetrics and Gynecology said that his colleagues would continue to recommend screening for 40- to 49-year-olds until the data used by the U.S. Preventive Services Task Force was better analyzed.

Holly Anderson, executive director of the Breast Cancer Coalition of Rochester, said that screening guidelines trigger anxiety. "We've been dealt a breast cancer diagnosis. It sounds very scary to hear these guidelines and the recommendation is to not be screened in the 40 to 49 window."

Full text of the letter is below.

Secretary Kathleen Sebelius

The U.S. Department of Health and Human Services
200 Independence Avenue, S.W.

Washington, D.C. 20201

Dear Secretary Sebelius:

Earlier this week, the United States Preventive Services Task Force (USPSTF) came out with new recommendations that suggest that women ages 40-49 no longer need routine mammogram screenings.  As I'm sure you're aware, this has caused mass confusion among women who, like myself, have long been told that every woman over 40 should receive a mammogram every year.  As a 42-year-old woman and Senator, I volunteered my time to speak in Public Service Announcements to remind women my age that they need to get screened.  Therefore, I share my constituent's confusion over this new message coming from the government.

I understand that these new recommendations were developed by independent scientists, however many respected medical experts and advocacy organizations such as the American Cancer Society, disagree with the recommendations. I, therefore, implore you to work with these respected patient advocacy groups, radiologists and oncologists across the nation to come up with a clear message to women about how best to protect themselves.

I would also encourage you to consider the weight that recommendations have across the medical and insurance industry.  When the government changes their recommendations for screening, insurance companies will often choose to change their reimbursement policies as a result.  I do not want women that are a high risk for breast cancer, because of their genes or family history, to be denied screenings because insurance companies refuse to reimburse the doctors.

I would encourage you to convene a meeting of interested parties so that this confusing message can be resolved and so that women can receive the best medical care that science can provide.  Thank you for your attention to this urgent matter.