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Director of Breast Care Clinic Agrees With New Guidelines: Yearly Mammograms, Starting at 40

Specialty bras for breast cancer survivors who have had a mastectomy are for sale in the Hulston Cancer Center; each is lined
Specialty bras for breast cancer survivors who have had a mastectomy are for sale in the Hulston Cancer Center; each is lined

There’s been a lot of confusion – and some disagreement – over when women should first begin having regular mammograms.  In the August issue of Obstetrics & Gynecology, a respected organization has revised its own guidelines on the matter.  KSMU’s Jennifer Moore went to visit a clinic in Springfield that serves 35,000 women a year to find out more.

Moore:   I’m sitting with Joanne Schahuber, director of the CoxHealth Breast Care Clinic in Springfield. Joanne, the American College of Obstetricians and Gyncecologists—we’re gonna call that the ACOG—released new guidelines this month on when women should begin having mammograms, and how frequent those mammograms should be.  Can you tell me a little about those guidelines? 

Schahuber:  Well, this college of physicians came out and stated their guideline preference. They’re agreeing with the American Cancer Society and many of the other organizations that are advocates for women’s health care: women need to see their physician every year after they’re 40 years old, have their physician or their health care provider provide an examination of their breast, which is called a “clinical breast exam.” And they also need a mammogram. Those two things together are the two tests that prevent women from dying of breast cancer. It helps us to find the disease when it’s really early.

Moore:   This comes two years after another agency—the US Preventative Services Task Force--recommended that women really don’t need to get mammograms until they’re 50, unless they have a family history of breast cancer.   And you disagree with that. Can you tell me why?

Schahuber:  Well, that study was done primarily to look at the financial efficiency of mammography. There’s a lot of difference between looking at whether it is financially efficient to do a test, and looking at the welfare of the women in our community.  Here at CoxHealth, we subscribe to the American Cancer Society guidelines, which have been followed for decades.  And because we follow those guidelines, we have been able to reduce the death from breast cancer dramatically in the last few decades.  

Moore:   What about women younger than 40?  We sometimes hear stories of young mothers or young professionals who are diagnosed with breast cancer, well under 40 years [of age].

Schahuber:  Breast cancer does occur all the way down into the teens. There is a small group of people in our society who are genetically predisposed to breast cancer.  Here at Hulston [Cancer Center], we have a genetics program, and specifically that program is to help us with people who may have a genetic predisposition--looking at their genetics and their family history—to see if they need mammography early.  If a woman has a first degree relative, mother, or sister, who has developed breast cancer before the age of 40, then she needs to start having her mammograms ten years before the onset of that breast cancer.  For instance, if her mother had breast cancer at 34, she should start annual mammography at 24.

The main message I want to get through to the women in our community is:  It’s very important to have a mammogram when you’re 40 years old. But it’s also important to have a mammogram every year after you’re 40. It really doesn’t help much to have one when you’re 40, then one when you’re 50. It needs to be every year, starting when you’re age 40.

Moore:  Joanne Schahuber, thank you very much.

Schahuber:  You’re welcome. Thank you for coming to visit.