By Dr. Mercola
Mammograms are widely promoted as a "life-saving" tool for helping women detect breast cancer in its earliest stages.
The message has so thoroughly saturated the public mind that nearly 68 percent of women over the age of 40 have had a mammogram in the past two years -- and most of these women believe doing so will help them avoid dying from breast cancer.
Unfortunately, women have largely been sold a false bill of goods, as the science tells a very different story about the ability of mammograms to save lives.
In Most Cases, Mammograms Don't Save Lives
Considering that mammograms are regarded as the "gold standard" for breast cancer prevention in the conventional medical establishment, you may have assumed they save lives.
Well, researchers from Dartmouth College had a novel idea -- they decided to determine how often lives were actually saved by mammography screening vs. breast cancer industry generated statistics and their marketing propaganda.
And what they found should make even the staunchest mammography proponent give pause.
Using breast cancer data from The National Cancer Institute and The Centers for Disease Control and Prevention, researchers calculated a 50-year-old woman's likelihood of developing breast cancer in the next 10 years, the odds the cancer would be detected by mammography, and her risk of dying from the cancer over 20 years.
They found that a mammogram has, at best, only a 13 percent probability of saving her life, and that the probability may actually be as low as 3 percent. No matter what analyses they used, including considering women of different ages, the probability of a mammogram saving a life remained below 25 percent.
"Most women with screen-detected breast cancer have not had their life saved by screening. They are instead either diagnosed early (with no effect on their mortality) or overdiagnosed."
This bears repeating:
Mammograms often diagnose tumors that may never threaten a woman's life. They also often result in false positives that lead to over-treatment, i.e. misdiagnosed women often undergo unnecessary mastectomies, lumpectomies, radiation treatments and chemotherapy, which can have a devastating effect on both the quality and length of their lives.
Up to 50 Percent of Breast Cancer "Diagnoses" are Not Actually Cancer
As Sayer Ji, founder of GreenMedInfo.com, explained in a recent article, between 30-50% of new breast cancer diagnoses obtained through mammography screenings are classified as Ductal Carcinoma In Situ (DCIS), which may not be cancer at all.
DCIS refers to the abnormal growth of cells within the milk ducts of the breast forming a calcified lesion commonly between 1-1.5 cm in diameter, and is considered non-invasive or "stage zero breast cancer" -- with some experts arguing for its complete re-classification as a non-cancerous condition.
Many conventional physicians view DCIS as "pre-cancerous" and argue that, because it could cause harm if left untreated it should be treated in the same aggressive manner as invasive cancer; however the rate at which DCIS progresses to invasive cancer is still largely unknown, with the weight of evidence suggesting it is significantly less than 50% -- perhaps as low as 2-4%.
Amazingly, there are no diagnostic standards for DCIS, and there are no requirements that the pathologists doing the readings have specialized expertise.
Dr. Shahla Masood, the head of pathology at The University of Florida College of Medicine in Jacksonville, told the New York Times:
"There are studies that show that diagnosing these borderline breast lesions occasionally comes down to the flip of a coin."
The New York Times also reported on several other concerning findings about the frequency of misdiagnosis of DCIS:
- A 2006 study funded by Susan G. Komen for the Cure estimated that in 90,000 cases where women were diagnosed with DCIS or invasive breast cancer, they either did not have the disease or they received an unnecessary treatment due to a pathologist's error.
- A 2002 study at Northwestern University Medical Center found that nearly 8 percent of 340 breast cancer cases "had errors serious enough to change plans for surgery."
- Dr. Lagios, a pathologist at St. Mary's Medical Center in San Francisco, reviewed nearly 600 breast cases in 2007 and 2008 and found discrepancies in 141 of them.
The Times stated, "Dr. Lagios says that based on his experience, microscopic core needle biopsies of low-grade D.C.I.S. and benign lesions, called atypical ductal hyperplasia, or A.D.H., may be misread 20 percent of the time."
So, if you are a woman considering going in for a mammogram, you need to be aware of the fact that mammograms often detect breast abnormalities (lesions) that -- while being diagnosed as "early cancer" and treated as if aggressive, invasive cancers -- will often never progress to actual cancer if left to run their natural course.
In fact, groundbreaking new research published in The Lancet Oncology shows that many actually invasive breast cancers spontaneously regress when left underdiagnosed and untreated. The authors of the study concluded:
We believe that many invasive breast cancers detected by repeated mammography screening do not persist to be detected by screening at the end of 6 years, suggesting that the natural course of many of the screen-detected invasive breast cancers is to spontaneously regress.
When you consider that mammography screenings often result in the diagnosis of what may be an inherently benign breast lesion, DCIS, and that the diagnosis itself may come down to a "coin's flip" worth of certainty – and then, you add in the fact that even so-called 'invasive breast cancer' may "spontaneously regress," the entire justification for mammography screening seems to fall apart.
After all, is exposing the breast to carcinogenic radiation once a year really a wise decision, given that the screening process itself is so obviously inaccurate and misleading? Also, considering that self-examination, examination by a trained professional and screening with radiation-free thermography provide sound alternatives, it is important that women at least be provided with an informed choice.
Annual Mammograms Increase Your Risk of False Positives, Unnecessary Biopsies
Research funded by the National Cancer Institute and published in the Annals of Internal Medicine revealed that getting an annual mammogram leads to an increased risk of false-positive results and unnecessary biopsies compared to getting a mammogram every other year.
After analyzing more than 386,000 mammograms from close to 170,000 women over a 10-year period, the study found 61 percent of those who received annual mammograms would be called back in for a follow-up, at least once, when in fact they did not have cancer. An additional 7-9 percent would receive an unnecessary biopsy. This is compared to 42 percent and 5-6 percent of the women, respectively, who had a mammogram every other year.
Furthermore, the research showed that annual mammograms were not more effective at identifying late-stage cancers compared to the every-other-year group. The overall results led lead researcher Rebecca Hubbard to say that false positives are simply "part of the process of screening mammography."
Unfortunately, this also means many women are exposed to increased stress as well as potentially invasive and potentially harmful treatments for absolutely no reason.
Even still, The American Cancer Society (ACS) advises women age 40 and older to undergo a mammogram screening every year, and continue to do so for as long as they are in good health, despite updated guidelines set forth by The U.S. Preventive Services Task Force, which state that women in their 40s should NOT get routine mammograms for early detection of breast cancer.
ACS' role in the promotion of mammography is far from altruistic, of course, as they have numerous ties to the mammography industry itself.
Mammograms Expose You to Serious Cancer-Causing Radiation
False positives, lack of life-saving results and overdiagnosis aside, there's yet another reason why you may want to carefully analyze your decision to receive a mammogram, and that is the serious health risks associated with diagnostic radiation exposure.
A mammogram uses ionizing radiation which, in and of itself, can contribute to the development of breast cancer. In fact, mammograms expose your body to doses of radiation that can be 1,000 times greater than that from a chest x-ray, which we know poses a cancer risk.
What is so confusing is that the type of X-rays used in mammography are called "low-energy," radiating at around 30 Peak kilovoltage (kVp) vs. 200 kVp and above for "high-energy" radiation.
Commonsense would seem to dictate that "low-energy" means lower harm. Indeed, It has become conventional wisdom within radiobiology and radiology that the "lower energy" rays used in x-ray mammography are far less dangerous to DNA than those associated with the spectrum of radiation released by atomic bombs at Hiroshima and Nagasaki – so-called "high energy" X-rays. Unfortunately, nothing could be further from the truth.
An accumulating body of clinical evidence indicates that the 30 kVp range of "low-energy" radiation used in breast screenings is up to 400% more damaging to the DNA – and therefore 400% more carcinogenic – than the "high energy" radiation it is often compared to.
Making Sense of All the Radiation Numbers
What this means is a potential sea change for the breast screening industry, which will no longer be able to justify its already horrible track record of "early detection" and "saving lives," nor its industry-friendly and highly skewed risk-benefit analyses -- based as they are on a completely inaccurate radiation risk model which minimizes the risk at the expense of women's health.
Keep in mind that The Cochrane Database Review determined in 2009 that for every woman whose life is prolonged through mammography screening diagnosis 10 women are "unnecessarily treated," i.e. their life is shortened.
What is so tragic is that this does not take into account the fact that the "low-energy" radiation being used in x-ray mammography, is planting the genetic seed for invasive breast cancer in countless women who would not have otherwise developed cancer, had they not been exposed to the radiation through screening in the first place.
It is already commonly accepted by the medical establishment that x-ray mammography screenings do cause breast cancer – they just do not realize, or are not willing to admit, how severe the problem is.
For example, research published in The Journal Radiology showed that annual mammography screening of 100,000 women from age 40-55, and biennial screening after that to age 74, would cause 86 radiation-induced cancers, including 11 fatalities and 136 life years lost. If we adjust for the new radiation risk model, required by acknowledging the difference between "low" and "high" energy radiation, we must multiply the harms caused by a factor of four to get a more realistic estimate of the iatrogenic damage: namely, 344 radiation-induced cancers, including 44 fatalities and 544 life years lost.
And remember, research has already been performed clearly showing that adding an annual mammogram to a careful physical examination of the breasts does not improve breast cancer survival rates over getting the examination alone.
So it comes down to an assessment of risk versus benefit, and even the mainstream press is beginning to report researchers' sentiments that:
"It's generally a really close call."
As Dr. H. Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice, told TIME:
"Women need to understand their trade-offs here. The reason to be screened isn't because you've heard a lot of survivor stories. Some of those women have not benefited [from screening]."
And, as was revealed by a study in the Cochrane Database of Systemic Reviews, breast cancer screening using x-ray mammography led to 30 percent overdiagnosis and overtreatment, or an absolute risk increase of 0.5 percent!
What Really Will Reduce Your Risk of Dying from Breast Cancer?
Breast cancer is the most common cancer among U.S. women, and one in eight will be diagnosed with it during their lifetime. Unfortunately, the aggressive push for mammography has many women equating actual preventive measures (e.g. lifestyle, diet and nutrition changes, as well as avoiding chemical exposures) with annual breast screenings, which do nothing to prevent cancer, and may actually contribute to it.
Unfortunately, medical organizations like The American Cancer Society do very little to spread the word about the many ways women can help prevent breast cancer in the first place.
A healthy diet, regular physical exercise, and an effective way to manage your emotional health are the cornerstones of just about any cancer prevention program, including breast cancer.
The following lifestyle strategies will also help to further lower your risk:
- Radically reduce your sugar/fructose intake. Normalizing your insulin levels by avoiding sugar and fructose is one of the most powerful physical actions you can take to lower your risk of cancer. Unfortunately, very few oncologists appreciate or apply this knowledge today. The Cancer Centers of America is one of the few exceptions, where strict dietary measures are included in their cancer treatment program. Fructose is especially dangerous, as research shows it actually speeds up cancer growth.
- Optimize your vitamin D level. Ideally it should be over 50 ng/ml, but levels from 60-80 ng/ml will radically reduce your cancer risk. Safe sun exposure is the most effective way to increase your levels, followed by safe tanning beds and then oral vitamin D3 supplementation as a last resort if no other option is available.
- Maintain a healthy body weight. This will come naturally when you begin eating right for your nutritional type and exercising using high-intensity burst-type activities like Peak Fitness. It's important to lose excess weight because estrogen, a hormone produced excessively in fat tissue, may trigger and/or feed breast cancer.
- Get plenty of high quality animal-based omega-3 fats, such as those from krill oil. Omega-3 deficiency is a common underlying factor for cancer.
- Avoid drinking alcohol, or limit your drinks to one a day for women.
- Breastfeed exclusively for at least six months. Research shows this will reduce your breast cancer risk.
- Watch out for excessive iron levels. This is actually very common once women stop menstruating. The extra iron actually works as a powerful oxidant, increasing free radicals and raising your risk of cancer. So if you are a post-menopausal woman or have breast cancer you will certainly want to have your Ferritin levels drawn. Ferritin is the iron transport protein and should not be above 80. If it is elevated you can simply donate your blood to reduce it.
- Avoid charring your meats. Charcoal or flame broiled meat is linked with increased breast cancer risk. Acrylamide—a carcinogen created when starchy foods are baked, roasted or fried—has been found to increase breast cancer risk as well.
- Avoid unfermented soy products. Unfermented soy is high in plant estrogens, or phytoestrogens, also known as isoflavones. In some studies, soy appears to work in concert with human estrogen to increase breast cell proliferation.