DATE: Monday, April 14, 1997                TAG: 9704120003

SECTION: LOCAL                   PAGE: B10  EDITION: FINAL 

TYPE: Editorial 

                                            LENGTH:   48 lines

A PERPLEXING PARADOX WOMEN IN THEIR 40S NEED TO KNOW WHETHER MAMMOGRAMS ARE REALLY NECESSARY.

The American Cancer society says you should.

The National Cancer Institute has been saying you shouldn't.

This difference of opinion might be amusing if it weren't for the lives at stake.

Annual mammography for women in their 40s is a hotly debated topic among medical experts. Even health-care specialists who have studied cancer trends and survival rates can't seem to agree on the value of mammography for relatively younger women.

All concur that annual mammograms are worthwhile for women over 50 and of little value for women under 40.

It's those in-between years that are causing the debate and a great deal of anxiety in 40-something women. The fact is, few women between the ages of 40 and 49 contract breast cancer each year. Yet the disease is the leading cause of death for women in that age group.

Mammograms for these women are problematical because their breast tissue is still dense and tends to give many false positive readings. Suspicious mammograms result in additional mammography, ultrasound or biopsies to rule out cancer - not to mention high levels of anxiety in women who are suspected of having cancer.

For those correctly diagnosed with breast cancer in their 40s, however, mammography can be a life saver.

In January, the National Cancer Institute made headlines when it issued a statement saying it could not make sweeping recommendations for annual mammograms for women under 50. It suggested that women consult with their doctors and make an informed personal decision.

The announcement caused a furor in the health-care community. It reflects an underlying concern that insurance companies might use the institute's announcement as an excuse to cease paying for the screenings.

As a result of the pressure, the institute has been backpedaling from its position in recent weeks.

Health care is an imprecise science. But we would hope that medical experts would carefully weigh the risks and benefits of mammography for women in their 40s and try to make a unified recommendation.

Beyond that, we hope health insurance companies will continue to pay for mammograms for women in their 40s until or unless they are found to be totally without merit. KEYWORDS: MAMMOGRAM BREAST CANCER

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