Breast screening policy will "remain unchanged," says HHS

By Sheilah Downey

The Department of Health and Human Services said they aren't buying into the new recommendations issued by a government Task Force that advised women to wait until age 50 for a mammogram.

"The Task Force has presented some new evidence for consideration but our policies remain unchanged," said HHS Secretary Kathleen Sebelius, in a statement today.

Resounding alarm and dissension has registered across the country since the Task Force issued new breast cancer screening recommendations this week. The American Cancer Society issued a two-page statement against the guidelines, congress has already announced mammogram hearings, and the internet has been flooded with questions about mammogram insurance concerns.

"There is no question that the U.S. Preventive Services Task Force recommendations have caused a great deal of confusion and worry among women and their families across this country," said Sebelius.

The Task Force, an outside independent panel of 16 doctors and scientists, advised that women wait until age 50 for mammograms, that those aged 50 to 74 only get a mammogram every two years instead of every year, and that breast self-exam is a waste of time.

The Task Force recommendations are aimed at reducing the harm associated with mammogram screening, such as false-positives, which they said cause unnecessary treatment and over-diagnosis.

In response to concerns that insurance coverage may change in light of the new guidelines, Secretary Sebelius said the task force only makes recommendations and that they "do not set policy and they don't determine what services are covered by the federal government."

"Indeed, I would be very surprised if any private insurance company changed its mammography coverage decisions as a result of this action."

The Department of Health and Human Services recommends women begin annual breast cancer screening with mammograms and clinical breast exam at the age of 40.

Sebelius recommended that women stay within their comfort level and listen to their individual needs rather than listen to guidelines that might not apply to them.

"My message to women is simple," she said. "Mammograms have always been an important life-saving tool in the fight against breast cancer and they still are today. Keep doing what you have been doing for years -- talk to your doctor about your individual history, ask questions and make the decision that is right for you."

In their statement, the American Cancer Society also announced that they were sticking with their recommendation that women start breast cancer screening and clinical exam at the age of 40.

They also took issue with the Task Force's recommendation that screening 1,339 women in their 50s to save one life is worthwhile, but screening 1,904 women ages 40 to 49 to save one life is not worthwhile.

"With its new recommendations, the (Task Force) is essentially telling women that mammography at age 40 to 49 saves lives, just not enough of them," according to the ACS statement.

While the Task Force said women in their 40s are at a lower risk for breast cancer than women in their 50s, the ACS pointed out that 17 percent of breast cancer deaths occurred in women who were diagnosed in their 40s.

"Breast cancer is a serious health problem facing adult women and mammography is part of our solution beginning at age 40 for average risk women," said the ACS statement.

The Task Force criticized the use of mammography for its limitations and faults, including the false positives it can produce.

Both the American Cancer Society and Secretary Sebelius' statement acknowledged limitations with breast cancer screening and a need for further scientific studies and advancements.

"The American Cancer Society acknowledges the limitations of mammography and we remain committed to finding better tests, and currently are funding a large study to improve the accuracy of mammography."

The ACS stated that although technologies need to improve, the benefits of screening women aged 40 to 49 outweigh the limitations.