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Radiologist: Don’t exclude under 50

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Radiologist: Don’t exclude under 50

Radiologist Dr. Mario Sattah, M.D. takes a moment to speak on the suggested frequency and ages of women who routinely undergo breast mammography examinations.

GLENN KAHL/The Bulletin


POSTED November 29, 2009 2:13 a.m.
Breast mammography exams definitely saves lives, Doctors Hospital of Manteca staff members agree in their continuing efforts to meet the needs of women in the community mystified by recent studies upping the age for a breast exam to 50.  

Asked why women under 50 should be excluded from having mammograms, radiologist Dr. Mario Sattah, M.D. didn’t hesitate.  

“They shouldn’t,” he said. “I’ve seen breast cancer in the 20s – there is no magic age cutoff – women get breast cancer when they get breast cancer.”

Manteca cancer survivor Tamara Foreman said she feels the suggested age should be at 30.  “I absolutely do not believe it should be 50,” she said, having discovered her breast tumor at 45.

Dr. Sattah said he didn’t feel saving money entered into the equation in the recent decision of the national health committee that called off the need to have younger women checked.  

“The guidelines or recommendations that have come up from the government – The U.S. Government Services Task Force – are based on studies they have reviewed,” the Manteca radiologist said.

“Now these studies are basically just looking at numbers, statistics:  how many women get breast cancer from 40 to 49, how many get breast cancer 50 to 74, how many have their mammogram and at what size did they find the cancer.  Their guidelines are based on statistics only,” he said.  

They are not taking into account any kind of the human element or the individual patient – they are referring to the “average woman” 40 to 49 in their study.  “Who is the “average woman” 40 to 49? –  it is very difficult to figure that out,” Dr. Sattah said.  

7 out of 39 cancer patients so far this year under 50
“I think if you go by statistics alone you could make a decision that would not make sense to the population.  From our personal experience, we do see a lot of cancers in women 40 to 49 – seven out of 39 breast cancers this year alone were women under 50.  We wouldn’t have found the cancers if we hadn’t been doing the screening,” he said.

He concluded that those seven women that tested positive at Doctors under 50 would not have done well without the early screening – two actually being in their 30s.

“I think it is important to find cancer at a smaller size, and screening women at earlier ages you will tend to find those cancers at a smaller size.  I hope this recommendation is not a cost issue or a radiation exposure issue, because the amount of radiation exposure from mammograms today is very low,” Dr. Sattah said.

He said it is interesting that mammograms are questioned today amid the current talks on health care expenditures.   “What I have heard so far is that they are leaving this up to patient-doctor individuality – a decision that they will make together – which I think is the right thing to do.”

The radiologist added, “It is sending a mixed message to the public as the American Cancer Society and other societies are still recommending 40 and above,  and here comes a task force that says ‘no’ 50 and above.”

DHM cancer patients range from 30 to 90
In a look at DHM’s recent statistics, some 40 women found with breast cancer ranged in age from their 30s to 90s, according to the Radiology Department registered nurse Debbie Aventi.

In the wake of the task force recommendation that mammography should now be limited to women over the age of 50 – except for those at high risk –  the hospital’s results provided a measure for concern.

Of those 39 cases diagnosed this year, seven were under 50, and two of those reflected women in their 30s, Aventi said.  “We do see a significant number of patients who are younger and raising families who are definitely in need of early detection – so that’s where I come through all of this.”

She added, “We do have the numbers – it’s not just one or two.”    

Aventi said they look for a five-year survival rate, noting most of breast cancer patients are not going to die from the disease if it is caught in time – that is not what is going to take their lives.

Between the ages of 50 and 60 there were nine women with malignant tumor diagnoses and 15 between 60 and 70 years old.  The statistics further noted five cancers of the breast were found in women between 70 and 80 and two between 80 and 90.

Nurse Debra Peters said when she first started at the hospital 28 years ago, in the early ‘80s, the screening age was set at 35.   The imaging device was like a Xerox machine, with her having to fill it with blue powder.  There was a magnetically charged plate that the lady’s breast was placed and we took an X-ray, and obviously the radiation doses were a lot more than they are today, she said.

You would put the plate on the Xerox copy machine and it blew the powder on the magnetic plate putting it against a piece of paper with the image coming out on the paper.  They were blue and white and actually very pretty, she said.  

Some radiology labs first used a balloon rather than the compression technique.  The film has changed over the years and has gotten better, she added.   While film is still used,  DHM has gone completely digital.  There have been many different types of film made specifically for mammography work, she said.

As for any concern that the radiologists are making a “tons of money” with mammograms, it’s just not happening, Peters said.  The average mammogram – cash out the door – runs just over $200. 
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