Thursday, December 10, 2009
Clearing up misconceptions on recent mammogram recommendations

By Dr. Anthony Policastro

Recently an announcement about mammograms caused quite a stir. A new report suggested that the age to begin mammograms is at age 50 rather than 40. Many people thought that the report was just a way to reduce medical care costs. For that reason there was a lot of concern over the report. There are a few things that were not clearly addressed with that report. The first of those has to do with the fact that there was not much mention made of self breast exams. Women should be performing self breast exams once a month to look for lumps. Mammograms do not replace that exam. Anyone who is concerned about the age to begin mammograms needs to be more concerned about getting the monthly breast exam done. The mammogram does not replace the breast exam. The second thing that was not clear in the report has to do with mammogram results. Mammography is not an exact science. The best way to ensure a good reading is to see if there is a difference from year to year. For that reason, it is important to get a number of mammograms so there are old ones for comparison. It is important to make sure old mammograms are available for comparison. That means the more mammograms you can have in one location, the more they have for comparison. When mammograms are read, it is often difficult to tell for sure whether something in the images is a problem or not. For that reason there are times when they are read as positive when they are not. Actually that seems to occur about 5% of the time. What that means is that one of every 20 mammograms is read as abnormal when it is not. When that happens, the woman has to go through the emotional trauma of worrying if there is a problem until further tests are done. She also has to go through the further tests. She may need to have a biopsy to be sure everything is OK. There are possible complications from those biopsies. The most common one is bleeding into the breast. This occurs in about 1 in 15 biopsies. The result is that when mammograms are started at age 40, there are more women with false positives and the associated complication. No one is saying that they should not be done at an early age for women with a history of breast cancer in their families. However, routine screening mammograms at age 40 could result in all the issues associated with a false positive finding. The idea that the medical establishment has created a conspiracy to keep women from having mammograms to save money is nonsense. The reality is twofold. The first is that mammograms do not replace self breast exam. The second is that false positive results in women who are at low risk for breast cancer carry their own set of issues.

DBCC comments on recent change to mammogram recommendations

New guidelines released by the U.S. Preventive Services Task Force (USPSTF) recommend against routine mammograms for women ages 40-49; recommend biannual (rather than annual) mammograms for women ages 50-74; and conclude that current evidence is insufficient to assess the benefits and harms of screening mammography in women age 75 and older. In addition, USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of clinical breast examination (CBE) beyond screening mammography in women 40 years or older, and recommends against teaching breast self-examination (BSE). In our operating practices the Delaware Breast Cancer Coalition (DBCC) relies on evidence-based information regarding breast cancer. Clearly, however, there are conflicting messages from breast cancer advocacy groups and medical experts about the recommended changes to screening guidelines, and we have only begun to hear from breast cancer survivors. We acknowledge and respect the research and differing opinions on this very controversial issue, while continuing to support the existing guidelines. We will carry on with our mission of raising awareness about breast health issues through outreach, education and support services; we will continue to recommend annual mammography screening for women age 40 and older in conjunction with a clinical breast exam; and we will continue facilitating and providing mammograms, as we always have. DBCC will also continue teaching women the proper technique for doing monthly BSEs. We encourage women to know their bodies so that they can better recognize changes or abnormalities and seek medical advice, when and if they occur. We will continue to support the existing guidelines until a time when there is greater consensus on, or an official change to, the guidelines and/or alternate screening choices are available for women. DBCC remains the only organization in the State of Delaware focused solely on breast health issues as they affect the women and men who live here. The Delaware Breast Cancer Coalition, Inc. (DBCC) is a state-wide 501(c)(3) non-profit organization with offices in Dover, Lewes and Wilmington. For more information about DBCC's programs and services, visit or call 866-312-DBCC (3222).

Diehl joins NMH Nanticoke Health Services welcomes Thomas Diehl to the position of director of Materials Management. As director, Diehl is responsible for leading Materials Management employees, automating processes, improving quality, reducing total overall cost, increasing customer satisfaction and improving hospital operational efficiencies. Diehl has a degree in business management from Radford University and Six Sigma Green Belt Certification. He comes to Nanticoke Memorial Hospital with more than 28 years of progressive materials management experience, including supply chain and logistics, and production control and inventory management.

Stroke and Osteoporosis Screening Residents living in and around the Laurel community can be screened to reduce their risk of having a stroke or bone fracture.

The American Legion Post 19 will host Life Line Screening on Dec. 21. The site is located at 12168 Laurel Road in Laurel. Appointments will begin at 9 a.m. Four key points every person needs to know: 1. Stroke is the third leading cause of death and a leading cause of permanent disability. 2. 80 percent of stroke victims had no apparent warning signs prior to their stroke. 3. Preventive ultrasound screenings can help you avoid a stroke. 4. Screenings are fast, noninvasive, painless, affordable and convenient. Screenings identify potential cardiovascular conditions such as blocked arteries and irregular heart rhythm, abdominal aortic aneurysms, and hardening of the arteries in the legs, which is a strong predictor of heart disease. A bone density screening to assess osteoporosis risk is also offered and is appropriate for both men and women. Packages start at $139. All five screenings take 60-90 minutes to complete. For more information regarding the screenings or to schedule an appointment, call 1-877-237-1287 or visit our website at Pre-registration is required. Life Line Screening was established in 1993, and has since become the nation's leading provider of preventive screenings.

Look Good program is Dec. 14 Women undergoing chemotherapy or radiation treatment for cancer can receive free professional help to cosmetically disguise the appearance-related side effects of their treatments. LOOK GOOD...FEEL BETTER, a program developed by the Cosmetic, Toiletry and Fragrance Association Foundation, the American Cancer Society and the National Cosmetology Association, trains volunteer cosmetologists to help women with cancer, conceal loss of hair, skin problems and other side effects that can result from cancer therapy. The next program will be hosted by the Cancer Care Center at Nanticoke Memorial Hospital on Monday, Dec. 14, from 5 to 7 p.m. at the Cancer Care Center's 2nd floor conference room. The program is free to all patients in active cancer treatment. Registration is required, and space is limited. To register, contact Nanticoke Memorial Hospital's Cancer Care Center at 629-6611, ext. 2378 or 2588.

Man to Man support group Nanticoke Memorial Hospital offers a Man to Man support group meeting on the fourth Wednesday of each month. Man to Man helps men cope with prostate cancer by receiving information and peer support. Man to Man is a forum for men and their support network to learn about diagnosis and treatment options through presentations, written materials and videos. Specialists share information such as side effects and how to cope with prostate cancer and its treatment. News and information about nutrition, general health, research and treatment, as well as messages from men living with prostate cancer and other Man to Man activities, are offered to assist in the recovery process. Pre-registration is not required for this free support group. For more information, contact Larry Skala (337-3678) or Grafton Adams (628-8311).

New breast cancer support group Delaware Breast Cancer Coalition, Inc. (DBCC) has expanded its Beginning Your Pink Ribbon Journey, a program for women newly-diagnosed with breast cancer, by partnering with Nanticoke Memorial Hospital Cancer Center in Seaford. The free, monthly program is offered at the Cancer Center located at 801 Middleford Road, Seaford, the third Thursday of each month from 3 to 4 p.m. beginning Thursday, Dec. 17. The program is facilitated by Nanticoke Memorial Hospital Cancer Center professional staff - Terri A. Clifton, MS, NCC, Cancer Care coordinator; Mary Brown, RN, DSN, manager Cancer Care Center; and Wendy Polk, nutritionist - with assistance from Lois Wilkinson, DBCC special projects manager, who helps facilitate the program at Bayhealth. Together, they answer questions, help calm fears, and share information about resources that are available at Nanticoke, through DBCC, and other organizations within the local community. Of particular value to newly-diagnosed women is DBCC's Peer Mentor Program through which they are paired with a long-term survivor for one-on-one support. To learn more about Beginning Your Pink Ribbon Journey at Nanticoke Memorial Hospital Cancer Center, call Lois Wilkinson at 672-6435. Registration is required and light refreshments and small gifts are provided.

Stroke support group offered Nanticoke Memorial Hospital's next Stroke Support Group meeting is Thursday, Dec. 17, at 1:30 p.m. at Nanticoke Memorial's 2nd Floor Cancer Care Center Conference Room. The support group is designed for individuals who have survived a stroke as well as their families and caregivers. The two-hour support group meetings will consist of guest speakers and breakaway sessions, in which caregivers and stroke survivors will meet in two groups to discuss concerns, provide support and allow for networking. Refreshments will be provided. Pre-registration is not required for this free support group. For more information, contact Nanticoke Memorial Hospital at 629-6611, ext. 8626.

Monthly support group Compassionate Care Hospice, The Wellness Community-DE and Nanticoke Memorial Hospital will collaborate to present a monthly bereavement group, The Next Step. The group focuses on issues of loss that continue beyond the early stages of grief. Mary Van House, bereavement coordinator, will facilitate the group at 10 a.m. on the third Tuesday of each month, at the Nanticoke Cancer Care Center, second floor conference room. To register, call Lisa at 629-6611, ext. 2378.

Depression Support Group There is a free bimonthly Depression Support Group meeting in Laurel on the second and fourth Wednesday evenings from 7 to 8:30 p.m. Any person who has signs and symptoms of depression and is under the care of a professional counselor/MD is welcome to attend. To register, call Life Matters Counseling and Consulting at 302-465-6612.