GENEVA — Dr. Amitabh Goel proudly wears pink T-shirts.
His tie-tack is a pink awareness ribbon, the notes on his desk are a speech he will give to groups of women encouraging them to get their mammograms and do monthly breast self-exams.
Many women who come and go from Goel’s office wear brightly colored head scarves or nervously smooth tufts of new hair growing helter-skelter after rounds of radiation and chemotherapy. Sometimes they leave in tears — tears of sadness, tears of relief, tears of determination.
Goel, a breast surgeon at UH-Geneva Medical Center, said he does not support the recent recommendation by a government panel that women under 50 should not get mammograms to detect breast cancer.
“I speak on behalf of University Hospitals Cancer Center when I say that we do not support these new guidelines and we will not change our current practice of mammograms for early detection of breast cancer,” Goel said.
The new guidelines, announced last week by the United States Preventive Services Task Force, contradict the long-held advice of organizations including the American Cancer Society and the American College of Obstetrics and Gynecology, which recommend women begin getting annual mammograms at 40.
Goel, who speaks publicly on the topic of mammograms and early cancer detection many times a year, notes that awareness of breast cancer, family medical history and mammography are at an all-time high with efforts including the Susan G. Komen Foundation’s Walk for the Cure held nationwide in September and other events.
“Right now we will give the patient the choice. We do recommend women have a mammogram before age 50,” Goel said. “I am saying that if a patient comes in to see a University Hospitals doctor because she has a family history of breast cancer, is at high risk for breast cancer or has any abnormality in the breast, she will get a mammogram, regardless of her age.”
The USPSTF is a panel of individual medical experts employed by the U.S. Department of Health and Human Services. The panel also recommends women the 50 to 74 have mammograms every other year, rather than an annual exam. The panel is also argues against teaching women to perform self breast examinations, calling them “ineffective,” the Associated Press reports.
Goel said a woman waiting to turn 50 before getting a mammogram can be a deadly mistake.
“In Europe, they don’t screen for breast cancer until a woman is 50,” Goel said, “But the problem is when you look at the data across the board, it doesn’t necessarily support what the USPSTF is saying. Many studies say this study is wrong.”
“If you miss a cancer between the ages of 40 to 49, the patient will have a much, much lower survival rate and cost of treatment will be much, much higher,” he said.
Goel said he isn’t concerned about fellow doctors supporting early cancer detection for women at age 40.
“It is the insurance companies I am worried about,” Goel said. “I am concerned insurance companies will take this study and turn it into an opportunity to decline to cover mammograms. That is the concern.”
Goel, who has seen the best saves and the worst cases of breast cancer, said women ages 40 to 49 should have digital mammograms, which are better at detecting abnormalities in the breast, because younger women have more fibrous breast tissue.
“It is very important for women to understand that these are just guidelines and are nothing definitive,” he said. “We are under no obligation to follow these guidelines, so we will continue to offer best practices for our patients at any age.”
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