RENO — Brigette Stovall went to the doctor last year after feeling some unusual sensitivity in her breast. She found a lump that wasn’t there a few months earlier and despite being two years shy of 30 years old, she thought she ought to have it checked.

A few physicians advised her to wait and remain vigilant, saying it was most likely a harmless cyst. When she finally was tested, the mammogram didn’t show anything. At just 28, her breast tissue was more dense, making it difficult to detect unusual cells in the screening. An ultrasound showed an unusual mass, and when she finally had a biopsy in September 2008, the diagnosis was cancer.

Stovall said she was “pretty devastated,” and felt similar to others upon hearing the news.

“A lot of times, people equate cancer with death,” she said.

The lump since has been removed and Stovall, now 30, is in the midst of five years of hormone therapy.

Stovall’s case is a local example of questions about breast cancer screening raised this week by the U.S. Preventive Services Task Force, a panel of experts in prevention and primary care appointed by the U.S. Department of Health and Human Services. The panel's recommendation went against a long-established and generally accepted guideline of receiving mammograms as early as age 35, and annually thereafter.

The task force’s new recommendation of beginning the screenings at age 50 and having them done every two years has stirred a lot of discussion and debate.

Although the Surgeon General has not yet released a statement about the task force’s recommendation, according to television station WAFF news in Alabama, Congressman Parker Griffith, D-Ala., plans to meet with America’s new Surgeon General over what he calls reckless recommendations about mammograms.

Griffith condemned a report by the Department of Health and Human Services which recommended women delay their first mammogram until age 50 with regular checkups every two years instead of annually.

Several Reno-area physicians said they are reluctant about the new advice and say they will adhere to guidelines currently in place. Some of these doctors and radiologists, in fact, are still researching the new ideas.

Dr. Alvaro Devia, a private practice surgeon with Reno-based Premiere Surgical Specialists, is experienced in dealing with breast cancer and has performed lumpectomies and biopsies.

“(The task force recommendation) is a marked change from what we have been recommending for years now,” Devia, 44, said. “I am not sure I will just adopt those recommendations at this point.”

Devia said much research would be required to fully understand the implications.

“I’ve learned from experience that someone makes a recommendation and six months later, they recommend something else,” he said. “Things can change. Something that is recommended on Monday, I’m not going to incorporate into my practice on Tuesday.”

The intent of the task force’s new analysis is to prevent women from harm in the event of over screening with mammograms being conducted too frequently, and discredits the need for self-exams.

Dr. Robert Leckie, a radiologist at Northern Nevada Medical Center (NNMC), called the findings “counterintuitive.”

“We don’t all get to the doctor every six months or every year or so like we should,” he said. “If someone feels a lump, they can go to a doctor, get assessed. … Again, in my own experience, a lot of women have come in because they found a lump on their own.”

But he added that mammograms aren’t perfect and they still might not find everything the first time.

“When we do screenings, 10 percent of the time I bring people back for additional images because we see a little spot and don’t know if it’s dangerous,” he said.

According to Leckie, between 1 and 8 million, or 12 percent, of all women will get breast cancer. It’s the second leading number of cancer deaths in women and the second most common cause of cancer behind skin cancer.

Leckie said NNMC performs a couple thousand mammograms per year and some of those have led to biopsy procedures. Two women whom he has biopsied this year were both in their 40s and had lesions in their breasts. He was optimistic that they caught the cancer early enough that they will survive.

“My concern is if we don’t do mammograms for ladies between 40 and 49, that would be tragic,” Leckie said. “Cancers will be missed.”

Leckie said it would not be unreasonable to change the guidelines to getting screened every other year, but if the age group between 40 and 50 is not screened until 50, some cancers could be missed.

“Clearly, between 40 and 49 we have some breast cancer survivors we wouldn’t have otherwise,” he said. “On average, we’ll catch a breast cancer two years before you feel it. That’s a long time and it makes a difference between a small, early cancer and a cancer that’s gone too far and we can’t cure it.”

Devia said current practices are based on years of research and many of his colleagues are in agreement with him.

“The recommendations we (currently) use didn’t just come out of thin air,” Devia said. “We have to be cautious not to jump on board because of one task force.”

Devia said he’s been out of the office for a week and has not heard questions from patients yet, but is sure he will.

Leckie said if the American College of Radiology (ACR) decides to accept the task force’s recommendations, he’ll follow it. For now, he will keep an eye on the issue.

“I’m anxious to hear what the ACR says and what surgeons groups come out with,” he said. “At this time, my inclination is to stick with the recommendations by the ACR and we’ll see what reports come out. I’m anxious to have this report scrutinized by others.”

Stovall said she realizes the task force’s recommendation is largely based on number crunching and that individuals must make their own decisions about screenings, just as she did. She said she worries that the recommendation might make some people think they don’t have to worry about breast cancer until they are in their 50s or that it might prompt insurance companies to not cover screenings before that age.  

“Cancer, unfortunately, does not discriminate against age,” she said.