I also want to thank the members of our community who joined us, asked tough questions, challenged conventional wisdom and spoke on behalf of women who have no voice.

Barbara Brenner explained the science supporting the U.S. Prevention Services Task Force mammography screening recommendations released in November that advise against routine annual mammograms for women age 40 to 49, encourage screening every two years for post-menopausal women and no longer promote self breast exam. These recommendations are for women who are asymptomatic and who are not at elevated risk of breast cancer.

Some have interpreted the guidelines as a recommendation against mammography for women age 40 to 49. In fact, the task force actually intended to encourage women to talk with their providers and assess their personal risk factors in deciding whether to have a mammogram. The guidelines also don't say that no one under 50 should have screening mammograms and that screening mammograms should not be covered by insurance.

Barbara stressed that no detection method is perfect and that none prevent breast cancer.

Dr. Tice described studies that illustrate the delicate balance in weighing the benefits (reduction in death from breast cancer) against the harms (overdiagnosis, false positives and radiation exposure) of mammograms and self-breast exams.

WCRC staff members Dolores Moorehead and Alicia Riley voiced the frustration of many about the irrelevance of these recommendations to women who lack basic living resources - food, housing and access to medical care and don't know their family history and risk factors.

Barbara Clifford discussed the December closure of Every Woman Counts to women age 40 to 49 and to all new enrollees for women age 50 and older until July 2010. EWC provides breast and cervical cancer screening and diagnostic services to low-income, uninsured and underinsured women in California who do not qualify for Medi-Cal. Even more severe cuts are anticipated. Although these cuts result from lack of funding and are not related to the USPSTF guidelines, there is considerable concern that the guidelines will be used as cover for further cuts.

All speakers encouraged women to know their own bodies, be aware of their risk factors and family history and to advocate to their elected representatives for funding for breast cancer screening, diagnostic and treatment services.

WCRC's mission commits us to empower women to be active and informed consumers of health care services. We will keep you posted about ongoing education programs and Community Dialogues.