Mary Rapose of Owl's Head is fighting breast cancer, and says a mammogram was crucial to detecting her tumor. She says women should get the screenings starting at 40 -- as some physician and advocacy groups advise. While she's 60, she's worried about her younger female relatives, like her 35-year-old daughter.
"The sooner you can have them and keep up with it the better off you are," Rapose says. "Because if you find something it may be nothing but at least you'll know, and if turns into worse, you're not going to wait 10 or 15 years before you get it done."
Politicians are taking note of the backlash. The Obama administration distanced itself from the recommendations of the federal Preventive Services Task Force just days after they were issued.
This week, Senator Olympia Snowe of Maine helped introduce legislation that would require insurers to cover preventive services such as mammograms for women 40 and older.
Democrats are using the amendment to defuse criticisms that the government -- and the task force -- is trying to interfere with patient care, even trying to ration it.
"No one on the task force is saying that women in their 40s shouldn't get a screening. They're saying it should be a woman's choice, an informed choice," says Dr. Nananda Col, who researches women's health at Maine Medical Center and sits on the Institute of Medicine's committee on the issue. She says that the federal task force is simply urging women who don't have a history of breast cancer in their families to weigh the risks of mammography.
Out of 1,900 women in their 40s screened for breast cancer, one will have her life saved because of it. The others may test positive for cancer when they are not, and end up with unnecessary tests and treatments. "There's a good chance that if something is found that what's found may be very, very, very early and may not need to be treated, and we know historically that many of these very early breast cancers are treated perhaps more aggressively than they need to be treated, and that can cause some discomfort and some long-term anxiety," Col says.
"Well, with any screening test, there's always going to be false positives, so there are always going to be extra biopsies that turn out not to be cancer. But mammographies are very good tests. It's the best thing we have," says Kip DeSerres, Vice President of Health Initiatives at the American Cancer Society of Maine.
He credits mammograms starting at age 40 for helping to catch the 900 to 1,000 new breast cancer cases in Maine each year.
"An urgent number don't get screened annually so that's really the message we want to send out is that it's an an effective test. We lose about 200 women a year in Maine due to breast cancer deaths. We know that a number of those are preventable if they had early detection. Breast cancer caught at its earlier stage has more than 90 percent survival rate."
An estimated 30 percent of women who should get mammograms under the Cancer Society's guidelines are not and DeSerres worries that the conflicting recommendations from the task force might deter some of these women further.
Dr. Kristin Jhamb says that's been the case for one of her patients. "She's 46 years old, in perfectly good health, and she does not have a family history for breast cancer, and she heard about the findings and she said, 'You know what? I'm all for it. I don't want to do a mammogram this year, I had one last year. It was normal, and I'm perfectly happy to do one next year.'"
Jhamb, an internist at Mid Coast Medical Group in Topsham, sees a lot to like about the recommendations of the federal task force.
She received a false positive test for a mammogram she had when she was 41, which led to a biopsy and a great deal of stress.
But for now, she will continue to recommend her female patients start getting tested at 40, and receive mammograms every one or two years.
"You want to know why? Because of liability issues," Jhamb says. "If we don't all embrace these and these are not acceptable guidelines for everyone, then that 46-year-old woman who waits for a mammogram and develops breast cancer in that interval is going to come looking, come looking to sue someone -- the doctor, the hospital."
Jhamb says that she will stick with her mammogram recommendations until more medical advisory boards get on the same page as the federal task force.