STAMFORD -- Guidelines released Monday advising women to begin breast cancer screenings at age 50 drew criticism from some local doctors, who called the new recommendations a step backward in women's health care.
Manasseh and her co-director, Dr. Caren Greenstein, said they continue to recommend women begin annual screenings at age 40. That's also the age recommended by the American Cancer Society, American College of Radiology, American Society of Breast Surgeons and Society of Breast Imaging.
The controversial guidelines, which also recommend reducing the frequency of mammograms to every two years, were authored by the United States Preventive Services Task Force, an influential panel of experts appointed by the federal Department of Health and Human Services.
The task force found that starting breast cancer screenings at age 40 leads to too many false alarms and unneeded biopsies without substantially improving a woman's odds of survival. The guidelines do not apply to women with unusual risk factors, such as a family history of breast cancer.
Research showed that one cancer death is prevented for every 1,904 women age 40 to 49 who are screened for 10 years -- "evidence the net benefit is small" for this age group, the task force said in its recommendation statement.
"Women, for the most part, are willing to accept those negatives in order to find breast cancer at its smallest size," Frimmer said.
She added that screenings have aided in the diagnosis of hundreds of women younger than 50.
Greenstein said that in Stamford, about 25 percent of patients diagnosed with breast cancer are under 50, according to the Women's Breast Center's tumor registry.
Generally, she said, half of breast cancer patients have no family history of the disease. Greenstein couldn't specify how many of the women under 50 in her center's registry had no family history.
"Even if we detect it one year earlier, we may detect it before it spreads," she said.
Greenstein said reducing the average number of mammograms a woman receives over her lifetime from 40 to about 12 -- the new guidelines recommend having the test only through age 74 -- would save insurance companies a great deal of money, but "it's hard to worry about cost ... when we have a woman's life and health in our hands."
Manasseh added, "The problem is, there is a cost to women being diagnosed late. Women require more extensive therapy."
Doctors said they fear insurance companies may restrict coverage for preventive screenings for women in their 40s, and many women would be unwilling or unable to pay for the tests themselves.
The task force's recommendation may also convince women who are already hesitant about getting a mammogram not to have it done, Manasseh said.
As for the task force's concern about "overtreatment," she said, "they have to give us a little credit. That's what breast centers do. We discuss the difference for each patient; we don't make blanket recommendations."
Sarah Burke, of New Canaan, was diagnosed with breast cancer after an annual mammogram when she was 42. She had no family history of the disease, and drastic measures were needed to make Burke, now 47, cancer-free.
"It is counterintuitive to limit preventative measures, which have been proven to be cost-effective and lifesaving," she said.
"The anxiety to think that I wouldn't have seen all my children graduate from high school" outweighs any discomfort or worry during or after a mammogram, Burke said.
Manasseh said many doctors are outraged the task force released its statement without providing sufficient background information.
The recommendations are "putting us back decades in our care for cancer," she said.
Staff writer Devon Lash can be reached at email@example.com or 203-964-2242.