About one in 1,900 women screened for breast cancer between ages 40 and 49 has the disease.

The number is one in 1,300 for women ages 50 to 59.

Yet a federal advisory panel believes the second group should be screened while the first group shouldn't.

"They're apparently saying the lives of the second group is more valuable than the first group," said Cheryl Baker, an obstetrician/gynecologist in Missoula. "I wouldn't imagine that decision makes much sense to the women under 50."

Put it this way: The new breast-screening recommendations issued this week by the U.S. Preventive Services Task Force aren't going down well in Missoula.

"For some people, this would eliminate 30 to 40 years of their lives," said oncologist Bill Nichols. "The way we do things now is saving lives. It's hard to believe that's not a good thing."

The decision, which said women in their 40s shouldn't get mammograms, hasn't been well received nationally, either. The American Cancer Society, American Medical Association, American College of Obstetrics and Gynecology and the American College of Radiology have also voiced opposition.

Doctors aren't saying mammograms and self-examination - which the task force dismissed out of hand as useless - are perfect. But they're better than doing nothing, doctors said.

"This is really like saying that we're going to take medicine back 30 years," said Missoula surgeon Elizabeth Suh. "This is a drastic change."

The handful of doctors who spoke Wednesday at Community Medical Center said the task force's move smacks of a cost-cutting measure.

"This is designed to save money, mainly for insurance companies," said Baker, who is a breast cancer survivor.

"I can't think of any other reason that makes sense," said Suh.

Jonathan Weisul, chief medical officer at Community, said the particular equation that pits cost versus life is untenable.

"We're talking about young people at risk here," he said. "Saving those lives is worth the cost."

The breast cancer statistics must have given the task force some cause for pause.

Simply put, screening women 40 to 49 saves the lives of 6,800.

"How can you say the cost of doing mammograms isn't worth those lives?" said surgeon Kristin Janczewski.

The task force said that while mammography does identify women in their 40s with breast cancer, testing overall does more harm than good. The task force identified as harms primarily the anxiety associated with tests, including both false negative and false positive reports, and the stress caused by follow-up biopsies.

For every life saved, 470 false alarms are triggered. That life, the Missoula docs said, is worth the stress of false alarms.

"I think most people are more comfortable with a little anxiety than they are with cancer," said Nichols.

In fact, Baker pointed out that anxiety could just as easily be created by not being tested.

"Even though more women die of cardiac problems, breast cancer is the thing that women worry about," she said.

Said Suh: "This is something where we've spent years trying to teach women to be proactive, and now we're telling them, ‘Oh, it's not that big a deal.' "

What strikes the doctors as particularly galling about the task force's message is the fact that breast cancer mortality has been declining steadily since mammograms become more commonplace.

The overall mortality rate has declined by 2.3 percent since 1990, and the rate for women in their 40s has declined by 3.3 percent.

"This is something where we're doing a good job," said Janczewski.

The most unfortunate aspect of the task force's decision is yet to happen, but seems inevitable.

"You can bet that insurance companies will be denying coverage for this in the next few years," said Suh. "And when women have to pay out of their pockets, they'll be less likely to go for a checkup."

And that decision, for at least some women, could prove deadly.

"What we want women to do is continue seeing their doctors," said Weisul. "This is something to talk about, for sure, but we're going to continue to recommend that women get mammograms."

Reporter Michael Moore can be reached at 523-5252 or at mmoore@missoulian.com.