Recent news regarding delaying mammograms until age 50 does not have to deter women from undergoing testing they might otherwise consider earlier in life.

Dr. Timothy Pagana, director of Susquehanna Health's Kathryn Candor Lundy Breast Health Center, made it clear much debate remains to be had regarding the issue.

Pagana said he remains impressed by the number of women between 40 and 50 he's seen over the years, some of whom have seen cancerous breast tumors located as the result of the screenings.

He said his office has received a lot of calls since news of the U.S. Preventive Services Task Force (USPSTF) study recommended women between 50 and 74 undergo mammography every two years. The task force also concluded self breast exams do no good and women should not be taught to do them.

"These women don't know what to do, so we are trying to guide them appropriately," he said.

Pagana said breast cancer is the second leading cause of cancer among women, but widespread screening, along with treatment advances, have helped significantly reduce its mortality.

In the past 20 years most professional organizations, including the American Cancer Society, recommend yearly mammograms for women starting at age 40.

The USPSTF study considered data with respect to costs and benefits of screening tests designed to prevent cancer deaths for women at average risk of the disease who show no signs or symptoms, according to Pagana.

The task force is a 16-member panel on which vacancies are filled by appointment from the director of the Agency for Healthcare Research and Quality, according to the agency's Web site. Terms are for four years with the possibility of extension by a year to two years.

"The reason the recommendations have changed is because the costs in terms of dollars and anxiety experienced by women who undergo screening can now more accurately be calculated," Pagana wrote in a release provided to the Sun-Gazette. "Furthermore, the benefit of breast cancer screening in terms of reduced breast cancer-related deaths have been more clearly determined for various age groups."

The study would seem to conclude that mammography for women under 50 is less accurate when compared to older women. With few cancers in the younger age group, the costs in terms of biopsies that turn out to be benign compared to the lives saved through early detection is higher than what "medical economists" tell them is appropriate.

"Let's put our money somewhere else, they say. That is a reasonable approach, unless it's our mother, sister, wife," Pagana said. "I guess what I'm trying to say is, I agree you don't find as many cancers in the 40 to 49 age group. But when you do, you save a lot of years of life."

Pagana punches a number of holes in the task force's study.

For one, he said data was considered with respect to older mammography. Digital mammography of today, by contrast, is much more accurate, especially for women between 40 and 50.

He claimed that calculations used to consider costs per life saved were "based on an older method of open surgical biopsies done in hospital operating rooms" as opposed to minimally invasive needle biopsies performed the same day an abnormality is found without surgery.

In addition, he said the study indicates qualifies "anxiety" among the costs associated with yearly mammography, rather than the peace of mind a woman enjoys from having an annual exam.

Pagana said he fears insurance companies will now reconsider their coverage of mammograms for women at age 40.

"If you have insurance that pays for it, and if you are not one who gets anxious over getting a mammogram, you should get it."

Pagana said he is impressed by the number of women who identify cancers by breast self-exams.

"I think breast self-examination is worthwhile for those who are comfortable with doing it," he said.

Media reports indicate the House health care reform legislation expands the use of the task force's data in determining minimum coverage standards for all health insurance policies.

With a vote on the massive health care overhaul bill due any day in the federal Senate, and the recent release of new breast cancer recommendations by an independent panel, state Rep. Matthew E. Baker, R-Wellsboro, said he didn't think the recommendations, which push the age for a first mammogram from 40 to 50, would have much effect on how women use mammography to detect cancer.

"I doubt very much if these recommendations will have any immediate effect as they are non-binding. Time will tell if the federal or state governments will change or adopt long held medical advice that mammograms should be taken beginning at age 40 unless high risk factors are presented. In fact, this recent study and recommendations stirred up so much controversy that within 24 hours the federal Secretary of Health and Human Resources publicly issued a statement that women should adhere to the current protocols of obtaining a mammogram by age 40," he said.