Mary L. Gemignani, MD, MPH, Perlmutter Cancer Center鈥檚 new chief of breast surgery
好色tv Langone Staff
In April, the U.S. Preventive Services Task Force, an independent national panel of experts in evidence-based medicine, changed its long-standing guidelines for breast cancer screening. The influential group now recommends that women at average risk should begin mammography screening every two years at age 40 instead of age 50. Driving the change is an alarming trend: breast cancer among women in their 40s is increasing by 2 percent annually. By initiating screening earlier, an approach long embraced by Perlmutter Cancer Center, the task force estimates that more than 8,000 lives can be saved each year.
Mary L. Gemignani, MD, MPH, an internationally renowned surgeon who joined Perlmutter Cancer Center in May from Memorial Sloan Kettering Cancer Center, has devoted her career to treating this disease. Chief of the center鈥檚 breast surgery division and a member of the at 好色tv Grossman School of Medicine, she offers her insights and perspectives on the new screening guidelines.
Do you agree with the task force鈥檚 new recommendations?
I鈥檓 happy to see that their guidelines now fall in line with other major professional organizations so that screening recommendations are more consistent. We鈥檙e seeing more younger women, particularly those in their 40s, developing breast cancer. It鈥檚 a vexing and poorly understood trend. Diet, obesity, lifestyle, and environmental toxins are all likely contributing factors, but we may also be detecting breast cancer at younger ages because we have better diagnostic tools, including genetic testing for those with a family history of the disease.
Is there anything about the guidelines that concerns you?
I鈥檓 not pleased that the task force still recommends imaging every other year rather than annually. Radiation exposure from mammography is relatively low, so starting yearly screenings at age 40 doesn鈥檛 significantly increase risk. We want to find cancers earlier to provide more and better treatment options. For instance, an aggressive type of cancer, known as triple-negative breast cancer, is more prevalent in younger women. It鈥檚 fast-growing, so if you skip a year of screening, you could miss the window of opportunity for early diagnosis. I鈥檓 also disappointed that the new guidelines put women with a family history of breast cancer in the 鈥渁verage鈥 risk category. Research has shown that these women are at higher risk and should discuss genetic testing with their doctor to determine whether they have a mutation that increases their risk, and if they should start screening younger.
How will these recommendations affect Perlmutter Cancer Center?
We don鈥檛 plan to change our own screening guidelines at all, just as we didn鈥檛 alter them when the task force previously recommended screening at age 50. We continue to advise annual mammograms for all women, starting at age 40, because it鈥檚 a simple fact: early diagnosis saves lives.
