21 Oct When it comes to mammograms – breast you be informed
In almost perfect timing for Breast Cancer Awareness Month, the Swiss medical board once again condemns mammography. In addition, more studies continue to surface, showing that the massive increase in mammography in the past decade has mixed results. Although survival rates for breast cancer have gone up in recent decades, screening options remain a very controversial issue. When you dig a little deeper it becomes apparent that mammography has both benefit and risk, and so it pays, like always, to have the full view. This way you are more empowered to apply genuine discernment when you make your decision to screen or not to screen.
Firstly, the facts about mammography risks: (references below)
- Mammography screenings induce a lot of unnecessary procedures, anxiety, and costs
A large-scale Swedish study found that 726 women of 60,000 who underwent mammograms were referred to oncologists for treatment. But roughly 70% of those women were actually cancer-free! The proportion of false positive results was particularly high in women under 50 years old. A whopping 86% of the women under 50 who were referred for further treatment wound up being found to be cancer-free.
- Regular early screening in younger women show no reduction in breast cancer mortality
Another analysis done by the Nordic Cochrane Center involving 800,000 women found no statistically significant reduction in breast cancer mortality in the first nine years of a mammogram screening program.
- Mammograms have been shown to be inaccurate in younger women
The Lancet reports that mammograms are very inaccurate in younger women. Of the 5% of referrals to oncologists, after mammograms are performed, studies show that between 20–93% of cases are believed to be “false positives.” How could the number of inaccurate diagnoses be so high? The belief is that in a very high percentage of those who receive false positive diagnoses, the inaccurate diagnoses is made due to unclear readings as a result of high breast density.
- High rate of false positives
Another study, conducted by members of the Radiological Society of North America found that a woman who has yearly mammograms between ages 40 and 49 has about a 30% chance of having a false-positive mammogram at some point in that decade. Research also shows that a whopping 62% of women don’t even want to take false-positive results into account when deciding about screening options.
- Mammograms don’t decrease advancement of breast cancer compared to physical examination
A Canadian study spanning 13 years involving 39, 405 women concluded that mammography screening does not result in a decrease in the absolute rate of advanced breast cancer and does not reduce mortality when compared to physical examination only. The researchers concluded that women aged 50–59 years consider the option of an annual physical examination plus regular self-examination as an alternative to annual mammograms.
- Treatment not mammograms could be the cause of breast cancer death rates
There has been about a 25 percent drop in breast-cancer death rates since 1990, and some researchers argue that treatment — not mammograms — may be chiefly responsible for that decline.
So what does this all mean?
The issue of safe and effective early detection of cancer is a complicated one. The mammogram procedure comes with physical risks and results from these particular screenings are not as robust as we have been led to believe.
1. Radiation is a cancer risk-factor
First of all, it’s important to realize that the ionizing radiation used to find possible breast tumours is ironically a risk factor for the development of breast cancer.
- Radiation intensity: Mammograms expose your body to very high levels of radiation — some even speculate radiation that is 1,000 times greater than that of a chest x-ray.
- Breast compression: Additionally, if you do have a malignant tumor, the crushing compression of your breast could potentially cause it to spread.
This is particularly true of the breast tissue of women under 40 (pre-menopausal women) which is highly sensitive to radiation. The Breast Cancer Organization points out that “diagnostic radiation from mammography in women under 40, or possibly in women before menopause in general, may well carry an increased risk of cancer associated with radiation alone.” They also state that radiation is very dangerous for pregnant women − even more so than chemotherapy.
2. Over-Diagnosis and over-treating and all its effects
Although The American Cancer Society supports mammograms, they also state the following on their website: “Mammograms miss some cancers. And sometimes more tests will be needed to find out if something found on a mammogram is or is not cancer. There’s also a small possibility of being diagnosed with a cancer that never would have caused any problems had it not been found during screening.”
This is the thing – if screening’s benefits have been widely advertised, its potential harms are pushed under the rug and that’s where we want you to be informed. According to a survey of randomised clinical trials involving 600 000 women around the world, for every 2 000 women screened annually over 10 years, one life is prolonged but 10 healthy women are given diagnoses of breast cancer and unnecessarily treated, often with therapies that themselves have life-threatening side effects. How does this happen you may wonder?
3. The complications around ductal carcinoma
Ductal carcinoma in situ (DCIS) is a type of cancerous cell present in 10% of all women, and in 15–60% of women in their 40s. DCIS means that abnormal cells have been found in the lining of the breast milk duct, but that they have not spread outside of the ducts into the surrounding breast tissue. DCIS itself is not life-threatening, but having DCIS can increase the risk of developing an invasive breast cancer later on. The problem is that doctors can’t tell the difference between DCIS cells that will spread and those which won’t.
How this discrepancy causes undue problems
- Initial uncertainty: This creates a big problem for doctors, because if a mammogram picks up DCIS cells in a woman’s breast, there’s no way to know how to respond with and manage their condition appropriately. A host of invasive and dangerous steps might be taken as part of a treatment plan for cancer in response to DCIS cell abnormalities, even before they ever have the chance to progress.
- Invasive treatment: Often the recommendation after DCIS has been found is for the patient to start treatment with surgery, radiation, hormone therapy or chemotherapy.
- Trauma: This has the potential for deep psychological trauma of anyone with cancer that may never think of themselves as fully healthy again. Even worse to consider is how many of these women may develop “true” cancers from the overprescribed radiation (and chemo)?
Could mammograms be the cause for DCIS increase?
Since mammography screening was first introduced in the 1970s, DCIS detection has risen dramatically. The National Cancer Institute (NCI) reported the incidence of DCIS in 2004 to be 32.5 per 100 000 women, higher than the 5.8 per 100 000 estimated in 1975. More and more naysayers of mammograms feel that the radiation and pressure to which women are subjected during mammograms is responsible for a high percentage of the increase in DCIS, but even if it isn’t, there’s a real concern for over treating DCIS and causing negative side effects.
Laura Esserman, director of the Carol Franc Buck Breast Care Center at the University of California, San Francisco says, “for many D.C.I.S. lesions, there is only a 5% chance of invasive cancer developing over 10 years. That’s like the average risk of a 62-year-old. We don’t do heart surgery when someone comes in with high cholesterol. What are we doing to these people?” The British government has come to the table by recently revising brochures on mammography to include a more thorough discussion on overdiagnosis – something the brochures previously only dealt with in one sentence.
Consider these things before deciding on a mammogram
- Which risk are you willing to take?
You could be in the percentage of woman who are diagnosed early because of a mammogram, however, you could fall into the portion of women who go through inordinate amounts of stress over nothing, or even worse, get sick because of the misdiagnosis.
- Does your age even warrant screening?
It’s also worth noting that while some health organisations suggest women from as early as 40 get a mammogram each year, (without any scientific evidence that screenings have a positive effect on mortality or correct diagnosis) healthy breast tissue at this age is more likely to show up as cancer on mammograms because it is still naturally more dense.
So, are there any alternatives?
Self-examination obviously comes with no negative side effects so it’s worth learning how to do this properly.
This is a new, non-invasive technology that does not use radiation or compression to screen for breast cancer. It measures infrared heat from your body and interprets the information in images that can be tracked over time to look for changes. Here’s what you should know about this option:
- Breast density does not affect its results
- Likely to be more accurate in younger women
- It’s painless
- Easy to perform
- Can be performed on pregnant women
- Lower in cost than mammograms
- Can be just as effective and accurate (if not more).
Obviously, prevention is key. Screening and detection do not eradicate cancer. Avoiding toxic exposures is one of the rational approaches to successful breast cancer prevention, along with healthy lifestyle strategies such as eating real food, exercising, and optimising your vitamin D levels.
If you are still reading and are interested in learning more, we gained so much benefit from this article in the NY times on breast cancer , and quote the author, herself a cancer survivor:
“The idea that there could be one solution to breast cancer — screening, early detection, some universal cure — is certainly appealing. All of us — those who fear the disease, those who live with it, our friends and families, the corporations who swathe themselves in pink — wish it were true. Wearing a bracelet, sporting a ribbon, running a race or buying a pink blender expresses our hopes, and that feels good, even virtuous. But making a difference is more complicated than that.
It has been four decades since the former first lady Betty Ford went public with her breast-cancer diagnosis, shattering the stigma of the disease. It has been three decades since the founding of Komen. Two decades since the introduction of the pink ribbon. Yet all that well-meaning awareness has ultimately made women less conscious of the facts: obscuring the limits of screening, conflating risk with disease, compromising our decisions about health care, celebrating “cancer survivors” who may have never required treating. And ultimately, it has come at the expense of those whose lives are most at risk.”
We’ve put together a selection of products on natural breast cancer prevention and support to help you in living your healthiest, most natural life possible.