For Every Life Saved by Mammograms, 3-10 Women are Overdiagnosed and Unnecessarily Treated
November 15, 2012
By Dr. Mercola
A new study published in The Lancet1 shows that for every life saved by mammography screening, three women will be overdiagnosed and treated for a cancer that might never have given them trouble in their lifetimes.
This cost to women's well-being is worth considering, the study panel said, because:
- 99 percent of patients diagnosed with a screen-detected breast cancer will undergo surgery
- About 70 percent will receive radiotherapy
- 70 percent will receive adjuvant endocrine therapy, and
- 25 percent will undergo toxic chemotherapy
For Every Life Saved, Three are Overdiagnosed and Treated Unnecessarily
The featured analysis was done by an independent panel in the UK, convened "to reach conclusions about the benefits and harms of breast screening on the basis of a review of published work and oral and written evidence presented by experts in the subject."
The review included both randomized trials and observational studies. The focus was on the British setting, where women between the ages of 50 and 70 are screened every three years.
In the US, the typical recommendation calls for women over the age of 40 to be screened annually, even though the U.S. Preventive Services Task Force updated their recommendation in 2009, advising women should wait until the age of 50 to get screened, and only get a mammogram every other year thereafter.
The recommendation was widely criticized and outright rejected by some American cancer organizations and doctors, so while mammograms among women in their 40's have declined slightly since 2009,2 many are still sticking with the old guidelines.
What this means is that the findings from the featured review are actually an underestimation when applied to American women, as screening in the US has, and still tends to begin a decade earlier, and the frequency is three times as great (annually instead of every three years).
According to the authors:
"Since the estimates provided are from studies with many limitations and whose relevance to present-day screening programs can be questioned, they have substantial uncertainty and should be regarded only as an approximate guide.
If these figures are used directly, for every 10,000 UK women aged 50 years invited to screening for the next 20 years, 43 deaths from breast cancer would be prevented and 129 cases of breast cancer, invasive and non-invasive, would be overdiagnosed; that is one breast cancer death prevented for about every three overdiagnosed cases identified and treated.
...Evidence from a focus group organized by Cancer Research UK and attended by some members of the Panel showed that many women feel that accepting the offer of breast screening is worthwhile, which agrees with the results of previous similar studies. Information should be made available in a transparent and objective way to women invited to screening so that they can make informed decisions."
I couldn't agree more.
Having the facts with which to make decisions about your health is key. And when it comes to annual mammograms, it's important to know that you're FAR more likely to be harmed by the procedure than having your life saved by it. Many women will undoubtedly still be willing to take that risk, but having this information will probably make some women think twice, and propel them to start looking for safer, more effective alternatives to an annual dose of radiation...
Maybe that person is you, or your wife, mother, or daughter. I would encourage you to share this information with the women in your life, to help them make a more educated decision. As Karsten Jorgensen, a researcher at the Nordic Cochrane Centre in Copenhagen told NBC News:3
"Cancer charities and public health authorities have been misleading women for the past two decades by giving too rosy a picture of the benefits. It's important they have at least acknowledged screening causes substantial harms."
Gold Standard Medical Review Found 10 Women Harmed for Every Life Saved by Mammography
In the past few years, a number of studies have tried to ascertain the true value of mammography, and so far, the results have been dismal. Last year, a review by the Cochrane Database of Systemic Reviews4 found that mammography breast cancer screening led to 30 percent overdiagnosis and overtreatment, or an absolute risk increase of 0.5 percent. Meanwhile, the absolute risk reduction for dying from breast cancer was 0.05 percent.
Seriously, if I tried to sell you a product that had a 0.05 percent chance of saving your life, would you buy it? Especially if I told you your chances of undergoing unnecessary surgery or toxic treatment was ten times higher than the possibility of it saving your life? According to the authors:
"This means that for every 2,000 women invited for screening throughout 10 years, one will have her life prolonged and 10 healthy women, who would not have been diagnosed if there had not been screening, will be treated unnecessarily. Furthermore, more than 200 women will experience important psychological distress for many months because of false positive findings. It is thus not clear whether screening does more good than harm."
False positives from mammograms – a diagnosis of cancer when it turns not to be cancer – are notorious in the industry, causing women needless anxiety, pain and, often, invasive and disfiguring surgical procedures. If a mammogram detects an abnormal spot in a woman's breast, the next step is typically a biopsy. This involves taking a small amount of tissue from the breast, which is then looked at by a pathologist under a microscope to determine if cancer is present. The problem is that early stage cancer like ductal carcinoma in situ, or D.C.I.S., can be very hard to diagnose, and pathologists have a wide range of experience and expertise.
There are no diagnostic standards for D.C.I.S., and there are no requirements that the pathologists doing the readings have specialized expertise. As Dr. Shahla Masood, the head of pathology at the University of Florida College of Medicine in Jacksonville, told the New York Times:5
"There are studies that show that diagnosing these borderline breast lesions occasionally comes down to the flip of a coin."
Unconscionable Marketing Tactics Arise as Science Fails: Mammogram Parties!
In related news, the cancer industry and those who profit from it have taken shrewd marketing for their American clients to a whole new level. A recent article carrying the unbelievable headline: Mammogram Parties: Overlake Makes Breast Health A Good Time,6 shows that there's apparently no level too low when it comes to keeping a profitable scheme going.
Knowing that the consequences of mammography can be harrowing, with misdiagnosis and overtreatment involving invasive surgery and/or toxic cancer treatment outnumbering lives saved by anywhere from 3-1 to 10-1, why on earth would you take it this lightly? According to the article:
"Overlake Medical Center is helping women host Mammogram Parties for their friends and family. The women meet at one of Overlake's Bellevue or Issaquah breast screening locations, and relax in robes with wine and cheese or tea and cookies, while taking turns getting examined by a radiologist. Like any party, the hostess gets a gift, according to the medical center."
The article then goes on to state that women in their 40's should have annual or bi-annual mammograms – which again is an outdated recommendation.
It's important to understand that mammograms are a major source of revenue. It's a huge part of the entire cancer industry. We're talking about something that half of the entire population is guided to buy on an annual basis for half of their entire lifetime. Even reducing the recommendation from annual mammograms to every other year means cutting the revenue that could be generated from each woman in half.
In light of the fact that your chances of being harmed by the test are three to 10 times greater than your life being saved by it, trying to lure you in with wine and cheese seems downright unconscionable, in my opinion. There are cases where a mammogram is probably warranted, but to urge women to get screened annually using a test that increases their risk of developing cancer in the future and overall harms more women than it saves, without fully informing them of these significant trade-offs, is just not good medicine.
Mammograms Raises Cancer Risk, Especially in Women with Genetic Mutation
Many have tried to stop me from warning you about the risks of mammography, despite the fact that I'm not just spouting my own opinions. Studies have repeatedly detailed these dangers, and now we can add yet another to the growing list of research blaming ionizing cancer screens for increasing cancer rates.
Results published in the British Medical Journal7 (BMJ) in September show that women carrying a specific gene mutation called BRCA1/2 are at significantly increased risk of breast cancer directly resulting from low doses of ionizing radiation, such as that from mammograms. Women carrying this mutation who were exposed to diagnostic radiation before the age of 30 were twice as likely to develop breast cancer, compared to those who did not have the mutated gene. They also found that the radiation-induced cancer was dose-responsive, meaning the greater the dose, the higher the risk of cancer developing. The authors concluded that:
"In this large European study among carriers of BRCA1/2 mutations, exposure to diagnostic radiation before age 30 was associated with an increased risk of breast cancer at dose levels considerably lower than those at which increases have been found in other cohorts exposed to radiation. The results of this study support the use of non-ionizing radiation imaging techniques (such as magnetic resonance imaging) as the main tool for surveillance in young women with BRCA1/2 mutations."
David Liu, PHD commented on the study in an article for Foodconsumer.com:8
"The study abstract did not say how radiation exposure affects the risk of breast cancer after age 30. Prior evidence has suggested that mammogram screening also has a cancer causing effect on the breast cancer risk, particularly in women with BRCA 1/2 mutations. It's just that women who are younger are at a higher risk if they are exposed to the same dose of radiation.
Ionizing radiation has been recognized as a human carcinogen by the National Toxicology Program. Ironically, such a cancer-causing agent is used to diagnose and treat many types of cancers including breast cancer. In reality, radiotherapy kills cancer cells and in the meantime cause carcinogenesis in healthy cells that can lead to future cancers.
John Gofman, Ph. D. M.D. late nuclear physician, said medical radiation is involved in 75 percent of breast cancer cases. Exposure to radiation on the chest also increases risk of ischemic heart disease, which is less publicized than the cancer-causing effect... An authoritative organization says that two most important risk factors for breast cancer are medical radiation and hormone therapy. Other risk factors such as exposure to pesticides are minor players."
Cancer Prevention Begins with Your Lifestyle Choices
Mammograms are portrayed as the best form of "prevention" a woman can get. But early diagnosis is not the same as prevention. And cancer screening that does more harm than good can hardly qualify as the best you can hope for...
I believe the vast majority of all cancers could be prevented by strictly applying basic, common-sense healthy lifestyle strategies, such as the ones below:
- Avoid sugar, especially fructose. All forms of sugar are detrimental to health in general and promote cancer. Fructose, however, is clearly one of the most harmful and should be avoided as much as possible.
- Optimize your vitamin D. Vitamin D influences virtually every cell in your body and is one of nature's most potent cancer fighters. Vitamin D is actually able to enter cancer cells and trigger apoptosis (cell death). If you have cancer, your vitamin D level should be between 70 and 100 ng/ml. Vitamin D works synergistically with every cancer treatment I'm aware of, with no adverse effects. I suggest you try watching my one-hour free lecture on vitamin D to learn more.
- Limit your protein. Newer research has emphasized the importance of the mTOR pathways. When these are active, cancer growth is accelerated. The best way to quiet this pathway is by limiting your protein to one gram of protein per kilogram of lean body mass, or roughly a bit less than half a gram of protein per every pound of lean body weight. For most people this ranges between 40 and 70 grams of protein a day, which is about 2/3 to half of what they are currently eating.
- 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, which increases the chances for mutations and cancerous cells.
- Improve your insulin and leptin receptor sensitivity. The best way to do this is by avoiding sugar and grains and restricting carbs to mostly fiber vegetables. Also making sure you are exercising, especially with Peak Fitness.
- Exercise regularly. One of the primary reasons exercise works to lower your cancer risk is because it drives your insulin levels down, and controlling your insulin levels is one of the most powerful ways to reduce your cancer risks. It's also been suggested that apoptosis is triggered by exercise, causing cancer cells to die. Studies have also found that the number of tumors decrease along with body fat, which may be an additional factor. This is because exercise helps lower your estrogen levels, which explains why exercise appears to be particularly potent against breast cancer.
- Maintain a healthy body weight. This will come naturally when you begin eating right for your nutritional type and exercising. It's important to lose excess body fat because fat produces estrogen.
- Drink a pint to a quart of organic green vegetable juice daily. Please review my juicing instructions for more detailed information.
- Get plenty of high quality animal-based omega-3 fats, such as krill oil. Omega-3 deficiency is a common underlying factor for cancer.
- Curcumin. This is the active ingredient in turmeric and in high concentrations can be very useful adjunct in the treatment of cancer. For example, it has demonstrated major therapeutic potential in preventing breast cancer metastasis.9 It's important to know that curcumin is generally not absorbed that well, so I've provided several absorption tips here.
- Avoid drinking alcohol, or at least limit your alcoholic drinks to one per day.
- Avoid electromagnetic fields as much as possible. Even electric blankets can increase your cancer risk.
- Avoid synthetic hormone replacement therapy, especially if you have risk factors for breast cancer. Breast cancer is an estrogen-related cancer, and according to a study published in the Journal of the National Cancer Institute, breast cancer rates for women dropped in tandem with decreased use of hormone replacement therapy. (There are similar risks for younger women who use oral contraceptives. Birth control pills, which are also comprised of synthetic hormones, have been linked to cervical and breast cancers.)
If you are experiencing excessive menopausal symptoms, you may want to consider bioidentical hormone replacement therapy instead, which uses hormones that are molecularly identical to the ones your body produces and do not wreak havoc on your system. This is a much safer alternative.
- Avoid BPA, phthalates and other xenoestrogens. These are estrogen-like compounds that have been linked to increased breast cancer risk
- Make sure you're not iodine deficient, as there's compelling evidence linking iodine deficiency with certain forms of cancer. Dr. David Brownstein,10 author of the book Iodine: Why You Need It, Why You Can't Live Without It, is a proponent of iodine for breast cancer. It actually has potent anticancer properties and has been shown to cause cell death in breast and thyroid cancer cells.
For more information, I recommend reading Dr. Brownstein's book. I have been researching iodine for some time ever since I interviewed Dr. Brownstein as I do believe that the bulk of what he states is spot on. However, I am not at all convinced that his dosage recommendations are correct. I believe they are too high.
- 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 cancer risk as well.