The U.S. Preventive Services Task Force's (USPSTF) controversial mammography recommendations that were issued last month have already affected some Florida facilities.
After concerned women asked to cancel their appointments, receptionists successfully convinced some of the women to keep their appointments—though some still cancelled their screenings, says Andrea Harley, RT(R)(M), mammography consultant with ABCs of Digital Mammography, LLC, in Fort Myers, FL.
USPSTF's November 16 announcement, which two officials have since said was partly misread, suggested these changes to the recommendations:
- Women between 40 and 49 no longer be screened for breast cancer unless they had an increased risk of the disease
- Women between 50 and 74 get screened every other year instead of every year
- Women over age 74 not be screened at all
So what can your organization do to better educate women about the recommendations?
Bonnie Rush, RT(R)(M)(QM), president of Breast Imaging Specialists in San Diego, says there are a number of steps you can take to counteract potential negative effects from the mammography recommendations:
Spread the message that mammography works. Mammography may not be a perfect tool, but it does make a difference. According to the American College of Radiology (ACR), there are several points that should be considered:
- Mammography has reduced the breast cancer death rate in the U.S. by 30% since 1990
- One invasive cancer is found for every 556 mammograms performed in women in their 40s
- Mammography only every other year in women 50 to 74 would miss 19% to 33% of cancers that could be detected by annual screenings
- Starting at age 50 would sacrifice 33 years of life per 1,000 women screened that could have been saved if screening had begun at age 40
- 85% of abnormal mammograms require only additional images to clarify whether cancer is present. Only 2% of women who get screening mammograms require a biopsy.
Focus on what Kathleen Sebelius, HHS secretary, said in her statement. “My message to women is simple. 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.” Gather links to articles by HHS which has not changed its position statement along with information provided on this topic by the ACR and American Cancer Society (ACS) positions and the Association of Breast Surgeons.
Offer information from noted breast imaging experts. This can be garnered through a Web search. Acquire a list of links and quotes. The information gathered can also be disseminated through multiple channels – via e-mail, posted on your Web site, printed in your newsletter, distributed at health fairs or hosted in a conference/forum.
Form partnerships. Work closely with your local ACS and such organizations as the Komen Foundation, which still supports the previous recommendation, in order to provide other resources women trust.
Work with the news media. “Contact local news media and have a local breast imaging or breast surgeon provide a forum for women to call in with questions or just discuss the findings [of the committee] and conclusions and rebuttals,” says Rush. Also work to get information into the local print media.
Alert your referring physicians. "Offer to speak with their referrers directly to help them determine how they will counsel women,” Rush says. Your marketing department should get out and talk with the physicians’ staff members, Rush adds.
Train internal staff members. Provide your breast imaging staff, including schedulers, information on how to answer questions from patients. Or set up a protocol that directs women to contact their physicians. If you refer women to their physicians, make sure the physician is willing to take this responsibility and has the necessary facts. If he or she chooses not to counsel patients, your facility must be prepared.
Educate patients directly. Use your Web site to allow women to read position statements on this topic directly. Hold an educational seminar for the community possibly in conjunction with your local ACS or Komen Foundation.