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  • By eliminating out-of-pocket expenses for certain cancer screening procedures, the Affordable Care Act has helped more women get mammograms
  • A 17-year-long study shows mammograms have no impact on advanced breast cancer incidence, and leads to significant overdiagnosis and unnecessary treatment of harmless tumors
  • The U.S. spends $4 billion each year on false-positive mammograms and breast cancer overdiagnosis. Mammograms are not a wise use of funds considering they have no impact on mortality rates and harm more women than they help
 

How the Affordable Care Act Wastes Billions and Harms Tens of Thousands of Women Each Year

January 25, 2017 | 158,657 views

By Dr. Mercola

On January 10, 2017, the Huffington Post reported the Affordable Care Act (ACA), colloquially known as "Obamacare," has helped many poor women get mammograms, as it eliminates out-of-pocket costs for certain cancer screening procedures.1

Among female Medicare patients over the age of 70 who were due for a mammogram, screening rates increased by 2 percent after the implementation of the ACA, from 5 to 7 percent each month.

Screening rates also rose among other age groups, and the rate differences between the wealthiest and the poorest shrunk after the ACA went into effect. According to the featured article, if the ACA were to be repealed, fewer women would get screened for breast cancer. The question is, would that actually be a bad thing?

Conventional wisdom states cancer screening is the best "prevention," as catching cancer early increases your chances of successful treatment. However, studies have repeatedly negated the idea that mammograms lower death rates, noting more women are harmed in the process than are actually saved.

Long-Term Study Questions Value and Effectiveness of Mammograms

Ironically, the very next day, on January 11, a 17-year-long study2,3,4,5,6 again concluded that mammograms have no impact on advanced breast cancer incidence, and lead to significant overdiagnosis and unnecessary treatment of harmless tumors. As reported by The New York Times:7

"In Denmark, screening was implemented in different regions at different times, so researchers there were able to compare groups of women who were screened with those who were not.

If screening were effective, a reduction in the incidence of advanced tumors would be expected — tumors would be caught and treated when small. Instead, the researchers found no difference in incidence between screened and unscreened groups.

But in screened groups, they found substantial overdiagnosis — that is, detection of tumors that would not become cancers needing treatment."

Overall, one-fifth to one-third of all breast cancer tumors detected by mammograms were overdiagnosed, leading to biopsies, surgery, radiation and/or chemotherapy — all of which can cause serious harm.

Meanwhile, the screening had no impact on reducing the rate of advanced breast cancer and breast cancer mortality, which are key selling points of cancer screening.

Conventional thinking tells you that regular screenings will allow you to catch the tumor well before it reaches an advanced stage, thereby saving your life through early detection, but that's just not happening.

Mammograms Do More Harm Than Good

According to lead author Dr. Karsten Juhl Jorgensen, deputy director of the Nordic Cochrane Center:

"Some types of screening are a good idea … But breast cancer has a biology that doesn't lend itself to screening.

Healthy women get a breast cancer diagnosis, and this has serious psychological consequences and well-known physical harms from unnecessary treatment. We're really doing more harm than good."

Dr. Otis Brawley, chief medical officer of the American Cancer Society (ACS), wrote an editorial8,9 for the study, noting that "researchers increasingly recognize that not all breast cancers pose the same risk, even if they look the same under a microscope."

"There's a tendency in the United States to think that screening is better than it actually is," he writes, adding that "Assuming that all small breast lesions have the potential to turn deadly is akin to 'racial profiling.'"

As Fran Visco, president of the National Breast Cancer Coalition (NBCC), told Newsweek; getting treated for a harmless tumor can jeopardize your health, but women are rarely informed of this other side of the equation.

"Radiation can damage the heart or even cause new cancers," Newsweek writes.10 "Visco notes that breast cancer activist Carolina Hinestrosa, a vice president at the coalition, died at age 50 from soft-tissue sarcoma, a tumor caused by radiation used to treat an early breast cancer.

Women should understand these risks, Visco said. Instead, women often hear only about mammograms' benefits. 'Women have been inundated with the early-detection message for decades,' she said."

Drawbacks and Risks of Mammography

I've written many articles on the hazards and drawbacks of mammograms, which include:

The risk of false positives. Besides leading to unnecessary mental anguish and medical treatment, a false cancer diagnosis may also interfere with your eligibility for medical insurance, which can have serious financial ramifications.

The risk of false negatives, which is of particular concern for dense-breasted women.

The fact that ionizing radiation actually causes cancer and may contribute to breast cancer when done over a lifetime.

Results published in the British Medical Journal (BMJ) show that women carrying the BRCA1/2 gene mutation are particularly vulnerable to radiation-induced cancer.11

The fact that studies repeatedly find that mammograms have no impact on mortality rates.

As so expertly demonstrated in the video at the top of this article, created by Dr. Andrew Lazris and environmental scientist, Erik Rifkin, Ph.D., it's very easy to misunderstand the stated benefits of mammograms.

Mammograms are said to reduce your risk of dying from breast cancer by 20 percent, but unless you understand where this number comes from, you'll be vastly overestimating the potential benefit of regular mammogram screening. Most doctors also fail to inform patients about the other side of the equation, which is that far MORE women are actually harmed by the procedure than benefit from it.

1 in 1,000 Women Are Saved by Regular Mammogram Screening While 10 Undergo Cancer Treatment for No Reason

Incredible as it may sound, the 20 percent mortality risk reduction touted by conventional medicine actually amounts to just 1 woman per 1,000 who get regular mammograms. How can that be? As explained in the video, for every 1,000 women who do not get mammograms, five of them will die of breast cancer. For every 1,000 women who do get mammograms, four will die anyway.

The difference between the two groups is 20 percent (the difference of that one person in the mammogram group whose life is saved). On the other side of the equation, out of every 1,000 women who get regular mammograms over a lifetime:

HALF will receive a false positive. So while they do NOT have cancer, about 500 out of every 1,000 women getting mammograms will face the terror associated with a breast cancer diagnosis.

64 will get biopsies, which can be painful and carry risks of adverse effects.

10 will go on to receive cancer treatment for what is in actuality NOT cancer, including disfiguring surgery and toxic drugs or radiation. Surgery, chemo and radiation are all risky, and dying from the treatment for a cancer you do not have is doubly tragic.

Billions Wasted on Ineffective and Harmful Breast Cancer Screening

Last year, just in time for Breast Cancer Awareness Month, researchers published an analysis of U.S. cancer statistics collected by the government in order to estimate the effectiveness of mammography.12,13,14,15,16,17

Comparing records of breast cancers diagnosed in women over the age of 40 between 1975 and 1979 — a time before mammograms came into routine use — and between 2000 and 2002, they discovered that the incidence of large tumors (2 centimeters or larger) has declined, from 68 percent to 32 percent.

While this may sound significant, in absolute numbers, the decrease in large tumors was actually rather small — a mere 30 tumors less per 100,000 women. Meanwhile, the number of women diagnosed with small tumors (81 percent of which did not actually need treatment) increased from 36 to 64 percent, and the incidence of metastatic cancer, which is the most lethal, remained stable.

It should be quite clear by now that findings such as these are no fluke. At least a dozen studies18,19,20,21,22,23,24,25,26,27,28,29,30 have now reached the conclusion that mammograms harm more women than they help and, in the end, have no impact on overall mortality rates.

According to a study published in Health Affairs in 2015, the U.S. spends a whopping $4 billion each year on false-positive mammograms and breast cancer overdiagnosis among women aged 40 to 59.31 All things considered, is it really a wise use of health care funds to continue pushing for routine mammograms? I would argue that the answer is no. I believe that money can be spent in FAR better ways.

Many Early Stage Cancers Are Harmless

Up to 33 percent of new breast cancer diagnoses obtained through X-ray mammography screenings are classified as Ductal Carcinoma in Situ (DCIS). DCIS refers to the abnormal growth of cells within the milk ducts of the breast forming a lesion commonly between 1 to 1.5 centimeters (cm) in diameter. While the cells appear malignant under a microscope, they have not invaded surrounding tissue.

Hence DCIS is considered non-invasive or "stage zero breast cancer," with some experts arguing for its complete re-classification as a non-cancerous condition. Since DCIS is almost invariably asymptomatic and has no palpable lesions, it would not even be known as a clinically relevant entity were it not for the use of x-ray diagnostic technology.

Indeed, it was not until the development and widespread application of mammography in the early 1980s as the central push behind National Breast Cancer Awareness campaigns that rates of DCIS diagnosis began to expand to their present day epidemic proportions.32

The DCIS Treatment Dilemma

According to the ACS, an estimated 253,000 new breast cancer cases will be diagnosed in the U.S. this year, and an estimated 41,000 women will die from breast cancer. An additional 63,000 women will be diagnosed with DCIS, and most of these will undergo the same treatment as those with invasive breast cancer.

The reason for this is because doctors typically recommend treating DCIS in order to prevent it from becoming invasive. In other words, a mentality of "when in doubt, cut it out" tends to predominate. However, when you consider the risks of serious harm — including death — from the treatment itself, is this really the wisest strategy? As noted by Newsweek:33

"Other experts note that DCIS carries such low risk that it should be considered merely a risk factor for cancer. Researchers are conducting studies to measure whether it's safe to scale back treatment of DCIS …  In the meantime, [patients] and their doctors must make difficult choices without knowing for sure whether it's the right thing to do."

2 Effective Cancer Prevention Tools

I believe there are better ways of addressing breast cancer than simply relying on a screening test that harms more women than it helps. It is my sincere hope that, in time, doctors will begin educating patients on cancer prevention and not just screening. Two strategies that have been repeatedly shown to lower the risk of cancer are:

Optimizing your vitamin D level. Research shows that optimizing your vitamin D level within a range of 40 to 60 nanograms per milliliter (ng/ml) provides impressive cancer protection. One of the most recent studies34 looking at vitamin D for breast cancer found vitamin D deficiency is associated with cancer progression and metastasis. Having higher levels of vitamin D has also been linked to increased likelihood of survival after being diagnosed with breast cancer.35

In one study, breast cancer patients who had an average of 30 ng/ml of vitamin D in their blood had a 50 percent lower mortality rate compared to those who had an average of 17 ng/ml of vitamin D. I believe testing your vitamin D level is one of the most important cancer prevention tests available. Ideally get tested twice a year.

The best way to get vitamin D is from sensible sun exposure, and if you're really interested in optimal health and healing you will do everything in your power to get it, as sunlight provides many other health benefits besides vitamin D.

For example, over 40 percent of sunlight is near-infrared rays your body requires to structure the water in your body and stimulate mitochondrial repair and regeneration. If you merely swallow vitamin D and avoid the sun, you miss out on this important benefit.

Nutritional ketosis. The traditional dogma maintains that cancer is a genetic disease, but there's a growing body of evidence suggesting that cancer is actually a metabolic disease, caused by a defect in the cellular energy metabolism of the cell (primarily related to the function of the mitochondria, which are the little power stations within each cell).

Even James Watson, who got the Nobel Prize in '54 for discovering the structure of DNA has turned his focus to the metabolic roots of cancer.

Once you understand the metabolic dysfunction that leads to cancer, new prevention and treatment strategies become more readily apparent. In a nutshell, cancer cells primarily feed on glucose, a fuel that generates far more reactive oxygen species (ROS) than fat and ketones.

In order to burn ketones, the cell must be healthy and normal. The reason ketogenic diets appear to be so effective is because cancer cells lack the ability to burn fat. They essentially starve the cancer while nourishing healthy cells.

In his book, "Cancer as a Metabolic Disease," Thomas Seyfried, Ph.D., goes into the details of this evidence, and it's quite compelling. Seyfried's work is also heavily featured in Travis Christofferson's excellent book, "Tripping Over the Truth: The Metabolic Theory of Cancer," which may be an easier read for the layperson.

In my view, this information is the game changer that not only treats cancer but virtually every single disease known to man, because at the core of most serious ailments you find mitochondrial dysfunction. To listen to my interviews with Seyfried and Christofferson, follow the hyperlinks provided.

Screening as Personal Choice

Does this mean mammography should be scrapped altogether? Not necessarily. If you feel a lump in your breast, a mammogram may be warranted, although even then there are other non-ionizing alternatives, such as ultrasound — which has been shown to be considerably superior to mammography, especially for dense-breasted women who are at much higher risk of a false negative when using mammography.

The bottom line is this: There are many strategies that are far more beneficial in terms of breast cancer prevention, and even screening, than mammography. And, if you hitch your fate on mammograms alone — or any other type of screening, without taking any preventive measures — you're really doing yourself a huge disservice. By shifting our focus to prevention, along with selective screening using less harmful screening methods, we would likely see a big change in cancer rates.

For key dietary guidelines and lifestyle strategies that can help reduce your cancer risk, please see my previous article, "Top Tips to Decrease Your Breast Cancer Risk." Another excellent resource is Dr. Christine Horner's book, "Waking the Warrior Goddess: Dr. Christine Horner's Program to Protect Against and Fight Breast Cancer," which contains scientifically validated all-natural approaches that can protect against and treat breast cancer.

[+] Sources and References

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