NORMAL -- Despite ongoing discussion nationwide as to whether women at average risk of breast cancer should begin yearly mammograms at age 40, Bloomington-Normal breast health experts have not wavered in their endorsement of screening mammograms for women in their 40s.
"There is no question that studies have shown that beginning mammography at age 40 saves lives," said Dr. Kathy Widerborg, a general surgeon with a special interest in breast health.
In her surgery practice and weekly breast tumor meetings with other doctors at Normal's Community Cancer Center, Widerborg knows of Central Illinois patients under age 50 with breast cancer detected through mammography.
The earlier breast cancer is detected, the easier it is to treat, agreed Jolene Clifford, a registered nurse and the cancer center's breast health navigator. That's noteworthy for younger patients, whose cancer generally grows faster than cancer in older patients, she said.
"Mammography remains the best screening tool we have," said Dr. Shermian Woodhouse, the cancer center's medical director. "We have a 90 percent success rate when women are treated early and appropriately."
A mammogram is an X-ray of the breast that can detect non-cancerous and cancerous changes.
The nationwide controversy began in late 2009 when the U.S. Preventive Services Task Force said women at average risk of breast cancer don't need mammograms until age 50 and then once every two years. The task force concluded that getting screened for breast cancer once a year beginning at age 40 causes too many false alarms and unneeded biopsies.
Woodhouse and Clifford agreed that mammograms in younger women could show something that later turns out to be non-cancerous. While that results in anxiety for women awaiting results of follow-up tests, breast health experts think the anxiety is better than the alternative of an early breast cancer diagnosis being missed.
"I have never had a woman upset that her biopsies are negative," said Clifford, noting that 80 percent of discovered breast lumps are benign.
The American College of Radiology, the American Cancer Society and the American College of Obstetricians and Gynecologists have reaffirmed their support of annual mammograms beginning at age 40. The Community Cancer Center has never changed its position.
Despite the affirmations, some Central Illinois women are confused, said Clifford. McLean County's declining mammography rate bears that out.
"Mammogram rates are not where they should be," Woodhouse said.
In 2008, 57 percent of eligible McLean County women age 40 and older got their annual mammogram to screen for breast cancer. Because that number was no better than the national average -- and because rates for minority populations were lower than for white women -- two local efforts began in an attempt to boost the numbers.
Pink Partners is a program in which female volunteers talk with women's groups to address why women don't get mammograms. In addition, a Multicultural Leadership Program effort worked to boost the low mammography rate among Latinas.
The good news is mammography rates among minorities increased in 2010 to 9.5 percent among Latinas, 20.7 percent among African-American women and 8.5 percent among minority women, including Asian-Americans.
But the rate for white women declined from 61 percent to 52 percent in 2010. That meant the overall mammography rate declined to 46.4 percent.
"I think the economy is playing a role," Clifford said. Women laid off from their jobs or worried about their jobs may not want to spend time and money on a screening test if they are not a high risk of breast cancer, Clifford and Woodhouse said.
"I would tell these women, 'Your overall health is important and your breast health is an important component of that,'" Woodhouse said. "Discuss your individual risk with your doctor."
Clifford said financial assistance for women in need is available from Susan G. Komen for the Cure through the cancer center.
Meanwhile, an analysis released in August found a decline in hormone therapy use among women age 50 to 64 is linked with lower mammogram rates among those women. A study in "Cancer," the journal of the American Cancer Society, suggests that when women stopped seeing their doctor for hormone therapy prescriptions after concerns were raised about them several years ago, the doctors no longer had the opportunity to remind women that it was time for their yearly mammogram.
"What this means," Woodhouse said, "is we still have a lot of work to do."