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ByLindseyTanner TheAssociatedPress CHICAGO The American Cancer Society now says women should start mam- mograms later in life and get fewer of them, a stance that puts the trusted group closer to an influential gov- ernment task force's advice. In new guidelines out Tuesday, the cancer soci- ety recommends that most women should begin annual screening for breast cancer at age 45 instead of 40, and switch to every other year at 55. The task force advises screening every other year starting at age 50. It's not a one-size-fits- all recommendation; both groups say women's pref- erences for when to be scanned should be consid- ered. The advice is for women at average risk for breast cancer. Doctors generally recommend more inten- sive screening for higher- risk women, including those with specific genetic mutations. "The most important message of all is that a mammogram is the most ef- fective thing that a woman can do to reduce her chance of dying from breast can- cer," said Dr. Richard Wender, the cancer society's cancer control chief. "It's not that mammo- grams are ineffective in younger women," he said, but at age 40, breast can- cer is uncommon and false alarms are more likely. "Therefore, you'd have to do a lot more mammograms to prevent one death," com- pared to older women, Wender said. Concern about false alarms contributed to the cancer society's new guid- ance. These lead to worry and more testing — they mean an initial result was suspicious but that can- cer was ruled out by ad- ditional scans and some- times biopsies. The latest guidelines acknowledge that some younger women are will- ing to accept that, and that for them starting annual ex- ams at age 40 is fine, as long as they know the risks. The guidelines were de- veloped by experts who re- viewed dozens of studies in- cluding research published since 1997 — the year the cancer group recommended yearly mammograms start- ing at age 40, and since 2003, when it stopped rec- ommending monthly breast self-exams. The update recommends that women continue get- ting screened as long as they are in good health and have a life expectancy of at least 10 years. The old guidelines did not include an age limit. The cancer group also dropped a recommenda- tion for routine physical breast exams by doctors, saying there's no evidence that these save lives. The Rev. Jennifer Mun- roe-Nathans, 46, a pastor in Millis, Massachusetts, said she hasn't paid attention to guidelines and started get- ting annual scans around age 40 on her doctor's ad- vice. Her mother had breast cancer, so have some of her congregants and Mun- roe-Nathans said she has no plans to change course when she gets older. "For my own peace of mind I intend to continue yearly mammograms," she said. "I've seen the impact of breast cancer — perhaps that makes me a little more hyper-vigilant." The society's updated guidelines say switching to every other year at age 55 makes sense because tu- mors in women after meno- pause tend to grow more slowly. Also, older wom- en's breasts are usually less dense so cancer is more vis- ible on mammograms, said Dr. Kevin Oeffinger, chair- man of the society's breast cancer guideline panel and director of the cancer sur- vivorship center at Memo- rial Sloan Kettering Cancer Center in New York. The guidelines were pub- lished Tuesday in the Jour- nal of the American Medi- cal Association. More than 200,000 women in the U.S. each year are diagnosed with breast cancer and about 40,000 die from the disease. Over- all, 1 in 8 women will be di- agnosed with the disease at some point and chances in- crease with age. Oeffinger said women need to be familiar with their breasts and aware of any changes, which should be evaluated by their doc- tors. The U.S. Preventive Ser- vices Task Force, whose guidelines have histori- cally influenced Medicare coverage, made waves in 2009 when it recommended mammograms every other year starting at age 50, to age 74. In draft recommen- dations released earlier this year, the group said mam- mograms for women in their 40s should be an in- dividual decision based on preferences and health history, and that more re- search is needed to deter- mine potential benefits or harms for scans for women aged 75 and older. That panel also ques- tioned the value of breast exams by doctors, citing a lack of evidence for any ben- efit or harm. It will exam- ine the cancer society's ev- idence review in finalizing its update, said Dr. Kirsten Bibbins-Domingo, the task force's vice chair and a pro- fessor at the University of California, San Francisco. Most health plans are required to cover screen- ing mammograms free of charge as part of preventive care mandated by the Af- fordable Care Act, and many insurers cover the screen- ings starting at age 40. Several doctor groups still recommend mammo- grams starting at age 40, including those represent- ing radiologists and gyne- cologists, but the American Cancer Society's breast can- cer guidelines are the most widely followed, said Dr. Kenneth Lin, a family med- icine physician at George- town University School of Medicine. HEALTH Ca nc er g ro up' s ma mm og ra m advice: Start later and get fewer WENDYMAEDA—THEBOSTONGLOBE Michael McCarthy attends a hearing in Dorchester District Court on Tuesday in Boston. McCarthy is charged with murder in the death of Bella Bond, 2, the girl dubbed Baby Doe. The Associated Press BOSTON A mother and boyfriend charged in the death of a 2-year-old girl whose body washed up on a Boston Harbor beach can have their own autopsy conducted on her remains, a judge ruled Tuesday. Rachelle Bond and Mi- chael McCarthy were charged last month. Bond's daughter,Bella,wasknown as "Baby Doe" for nearly three months as authorities launched a massive inves- tigation and social media campaign to find out who she was and how she died. The girl's body was found in a trash bag on Deer Island in June. State police put a compos- ite image of the brown- eyed, chubby-cheeked girl on Facebook and on bill- boards, generating hun- dreds of leads but not the identity of the girl. Finally, on Sept. 16, po- lice received a tip after Bond told a man who lived with the couple earlier this year that McCarthy killed Bella by punching her re- peatedly in the abdomen one night when she would not go to sleep. McCarthy's lawyer has said he denies killing the child and claims Bond told him her daughter had been taken away by the state's child protection agency. McCarthy, 35, is charged with murder, while Bond, 40, is charged with be- ing an accessory after the fact. Both have pleaded not guilty. A judge approved the request for a separate au- topsy during a brief hear- ing Tuesday in Dorchester District Court. McCarthy and Bond will each have an independent patholo- gist for the second autopsy, said Bond's attorney, Jan- ice Bassil. "Although my client was reluctant to do this, I felt that it was important in corroborating her state- ment as to the manner in which Michael McCar- thy killed her child," Bas- sil said after the hearing. McCarthy's lawyer, Jon- athan Shapiro, said he wanted the second au- topsy because the murder charge against McCarthy is based on Bond's state- ments to police. He said Bond is "completely not credible." Mother, boyfriend can ha ve o wn a ut op sy in 'Baby Doe' case BODY WASHED UP ON BEACH TORIN HALSEY — TIMES RECORD NEWS A radiologist compares an image from earlier 2-D technology mammogram to the new 3-D Digital Breast Tomosynthesis mammography in Wichita Falls, Texas. The Associated Press ANTHEM, ARIZ. Firefight- ers waded through knee- high floodwaters to rescue a woman stranded in her minivan Tuesday as muddy runoff gushed to the tops of her tires following storms that pelted the Phoenix area and other parts of the Southwest. Cindy Musselman of Phoenix said there was just a little water on the road when she tried to cross a desert wash outside the city. But the water rose quickly as she entered a low area, and her vehicle got stuck. Firefighters drove a pickup truck into the wash, strapped a flotation vest to Musselman and then walked her through the flowing water. They got to the truck and drove to safety, while ambulances, firetrucks and other emer- gency vehicles waited on dry land on either side of the torrent. "It went whoosh," she said of the rapidly rising water. "It caught me." The storms that pro- duced heavy rain and hail in northern Arizona and further south in Phoenix's suburbs came from a low- pressure system out of the west, said meteorologist Ken Waters with the Na- tional Weather Service in Phoenix. Weather forecast- ers said it is not directly related to a phenomenon known as El Nino that cre- ates a persistent warming of the Pacific and threatens an unusually wet winter in California and Arizona. It's too early to know if El Nino caused intense storms in California over the last few days that un- leashed flooding and mud- slides that inundated roads, homes and vehicles. Mas- sive debris flows trapped more than 100 vehicles on one highway last week, and hardened mud has kept State Route 58 closed about 80 miles north of down- town Los Angeles. Officials also suspended the search Tuesday for a 67-year-old man swept away during the California flood- ing because deep, wet mud in the area made the search too dangerous. The National Weather Service issued watches and warnings for strong winds, heavy rain and hail for large areas of Arizona and New Mexico. The area where Mussel- man was rescued Tuesday morning in Phoenix's far northern outskirts later was pelted with marble- sized hail. There were no immediate reports of dam- age or injury. ARIZONA Woman rescued from flood as storms pelt parts of Southwest ROSS D. FRANKLIN — THE ASSOCIATED PRESS A horseback rider takes a look at a car as it rests abandoned in the floodwaters of Skunk Creek a er the driver was rescued Tuesday in Desert Hills, Arizona. The Associated Press LAS VEGAS The off-Strip casino-hotel chain Station Casinos that caters to lo- cals is going public, again. The company announced last week it plans to make a public stock offering and use some of the money it raises to buy out a related management company for $460 million in cash. Brothers Frank Fertitta III and Lorenzo Fertitta own the 4-year-old manage- ment company as well as a 58 percent stake in Station Casinos. The Fertitta family doesn't expect to go any- where, noting in its pro- spectus filed with the Se- curities and Exchange Com- mission that it would retain control. Deutsche Bank Securi- ties owns 25 percent and ex- pects to make more than 5 percent of the net proceeds from the public offering. The company hasn't re- vealed how much it expects to raise from the public of- fering, when it will go pub- lic, at what share price and which stock market it will be traded on. The Fertitta's father started Station Casinos in 1976 with Palace Station off the Las Vegas Strip before the brothers assumed con- trol in 1993, taking it public. The chain went private in 2007 when the Fertitta family spent $8.7 billion in a debt-heavy buy-out that pushed it into bankruptcy in mid-2009 amid the re- cession, emerging two years later with less debt. The company says it has since cut its debt by $450 million to $2 billion and has invested $330 million in its properties. GAMBLING Off -Strip Station Casinos to go public | NEWS | REDBLUFFDAILYNEWS.COM WEDNESDAY, OCTOBER 21, 2015 8 A