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Nightly News   |  November 17, 2009

Many docs disregarding new mammogram guidelines

Nov. 17: Despite new recommendations reversing breast cancer screening advice, some doctors at major U.S. cancer treatment centers say that, for now, they plan to stick with existing guidelines and screen their 40-something patients every year. NBC Chief Medical Editor Dr. Nancy Snyderman reports.

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>>> field. "nightly news" begins now.

>>> good evening tonight from phoenix. a generation of american women has grown up believing that turning 40 means getting your first mammogram. suddenly yesterday we all learned that recommendation jumps ahead ten years to the age of 50. and a change that big, that sudden, isn't being taken lightly. women are surprised, they're angry, their skeptical. some are scared they're going to miss something. it's serious business having to do with the number two cancer killer of women in this country. and because no two women are alike, because no two stories are alike, and because so many of us have lost someone in our lives to breast cancer , this has started a huge debate understandably. we'll begin our coverage here tonight with our chief medical editor, dr. nancy snyderman .

>> reporter: across the country today, women of all ages were talking about breast cancer .

>> i have a mammogram every year, and i don't knowly should now or not.

>> reporter: in particular a new set of guidelines issued yesterday by an independent panel of experts, which changes the recommendations regarding who should get mammograms and when.

>> turn in a little more.

>> reporter: i'm in my 40s and i have had mind and it gives me a peace of mind everything is okay when you get it.

>> reporter: new guidelines now recommend women ages 40 to 49 should not be routinely screened unless they're at risk for breast cancer . and women ages 50 to 74 should be screened but only two years. many women are saying it's a mixed message.

>> there's a lot of confusion within the medical community as far as i understand, so --

>> reporter: despite the recommendation, some doctors from the u.s. cancer center are saying for now they are sticking with the consistent guidelines, screening their 40-something patients every year as they always have.

>> we strongly believe the begins in their 40s and continue throughout the 50s and 0s.

>> reporter: cindy pearson is with the national women 's health network, who is in favor of the new guidelines.

>> because they help us to move forward that help us find something that could possibly save many more lives than mammography has ever been able to do.

>> reporter: another concern is that this change of recommendations will be an opportunity for insurance companies to stop paying for some breast cancer screening . so far, the industry is staying the course.

>> women who have discussions with their physicians about the potential benefits and harms and want to go ahead at a younger age with a mammogram, that, thatcovered.

>> reporter: it's important to remember that these new recommendations from that independent task force are just that, there's recommendations. they don't mandate any changes in who should get mammograms and when. and so far, from what we've heard all from women across the country, there is still a lot of confusion.

>> and, nancy, let's try to clear some of that up. in our own editorial meeting this afternoon, a woman in our staff said in my 40s, i have an appointment for a mammogram next week. should i keep that appointment?

>> brian , she's the ideal person to sort of pause and think, these guidelines are really written to me. no risk factors , no family history. she's one of those people who could really question whether she should wait until 50 and have that conversation with her physician.

>> and with people currently so suspicious about insurance companies and for that matter a lot of doctors, how quick do you think the pace of change will be? will this -- will this washington through the medical community slowly or quickly?

>> i think this is a seismic shift for the message. i don't, however, think it's going to be a seismic shift in how doctors prescribe. slowly, we'll see the younger doctors take this on. the doctors who are entrenched and believe that they're working on anecdotes and what they see in their offices, how they want to practice medicine. i suspect those doctors will be a little slower to pick up on those recommendations.

>> as i mentioned, we all have our own anecdotal personal stories. my e-mail file today -- and i imagine yours as well -- filled up with e-mails from so many women between the age of 40 and 50 saying, i am a survivor. i wouldn't be a survivor today had my tumor not been caught by a mammogram when i was in my 40s. how do you address that? what do you say to all of those women ?

>> brian , that's where we have to be really careful to remember that anecdotes in this big body of science don't necessarily jive. the anecdotes are important but they're individual studies, and this big piece of new information, in fact, looks at all of the numbers and takes a lot of the emotion out of it. i think that's one of the hardest messages for today. whether or not this was a false safety net for most of us, the experts on this panel are saying that the data speaks for itself, in fact, that it's very strong. brian ?

>> and, again, bears repeating, this was a recommendation after all. dr. nancy snyderman , our chief medical editor with us from our new york studios tonight. thanks.

>> you bet.

>>> as we said, we received hundreds of your questions and comments on these guidelines all throughout this day. dr. snyderman has answered more of them on our website and will continue to. that's nightly.msnbc.com.

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