Women Physicians OB/GYN Blog

Many of our patients have had questions about the change in recommendations recently released by the U.S. Preventative Service Task Force (USPSTF) regarding mammograms for women in their 40’s. In 2002, the USPSTF recommended screening every 1 to 2 years for women aged 40-74. They now recommend against routine screening for women in their 40’s though they acknowledged the decision of when to start should be based on the individual patient’s characteristics, including the patient’s values about specific benefits and risks. They continue to recommend biennial screening from age 50-74. They also recommended against teaching breast self exam (BSE).

The USPSTF recommendations were based on recent studies published November 17, 2009 in the Annals of Internal Medicine. These showed that both women in their 40’s and women in their 50’s have an equal decreased risk of dying from breast cancer if they get routine screening mammograms. However, women in their 40’s may have denser breasts and so are more likely to require additional imaging studies and perhaps breast biopsies to rule out breast cancer. This could result in harm from radiation exposure, false-positive and false-negative results, overdiagnosis, pain during procedures, and anxiety. The USPSTF decided that for women in their 40’s the risk of harm was greater than for women above 50 but the likelihood of benefit was less since only about half as many women in their 40’s actually have breast cancer identified on routine screening.

The American College of Obstetricians and Gynecologists (ACOG) has also reviewed recent data on risks and benefits of mammograms. At the present time, they recommend:
• Screening mammography every 1-2 years for women aged 40-49 years
• Screening mammography every year for women age 50 or older
• BSE; BSE has the potential to detect palpable breast cancer and can be recommended.
The American Cancer Society (ACS) also continues to recommend routine screening for women 40 and above. The Department of Health and Human Services (HHS) is not changing their current funding guidelines for women 40 and above.

Your doctors here at WPMG support ACOG guidelines until there is compelling evidence to the contrary. We will also individualize recommendations for high risk women.

Unfortunately, Women Physicians Ob-Gyn has not yet received the 250 doses of H1N1 vaccine that we ordered and we are uncertain of the exact date it will arrive. We will announce our receipt on this blog as soon as it arrives. In the meantime, we want to notify all of our high risk risk patients about the clinics provided by the county.

Where to Get the H1N1 Flu Vaccine

The following clinics are for people at higher risk for getting or having complications from the H1N1 flu. Over the next weeks and months, as regular shipments of vaccine continue to arrive, there should be enough vaccine for anyone who wants it.

Public vaccination clinics for the following groups will be held on November 15, and November 21 from 9:30 a.m. to 3:30 p.m.

Pregnant women;
Children and young adults between the ages of 6 months and 24 years;
People who live with or provide care for infants under six months;
Adults between the ages of 25 and 64 years who have medical conditions that put them at higher risk for flu-related complications; and,
Healthcare and emergency medical services workers.
Because the vaccine supply is so limited at this time, it is important that persons not belonging to one of the groups above wait to be vaccinated so that those at highest risk of severe illness can get the vaccine.

Once the demand for vaccine for people at highest risk has been met, the Public Health Department and local providers will begin providing the vaccine to all others who want it. It is important to remember – this is the beginning of a long vaccination effort. We thank you for your patience and understanding.

Clinic locations, days, and hours may change based on the vaccine’s availability and public demand. Please check www.sccphd.org/h1n1flu for weekly updates to clinic schedules.

November 15th to November 21st

Times
Sunday, November 15
Saturday, November 21 9:30 a.m.
3:30 p.m.
Location
Santa Clara County Fairgrounds
EXPO HALL
334 Tully Road
San José, CA 95111

For more information about the H1N1 flu and vaccination clinics offered by the Santa Clara County Public Health Department, visit www.sccphd.org.