By Dr. Mercola
The Nordic Cochrane Center has put out a leaflet that every woman should read, explaining the potential benefits and potential harms of mammographyi.
They point out that recent studies suggest mammography screening is not effective in reducing your risk of dying from breast cancer.
And in fact, screening creates breast cancer patients out of healthy women who would never have developed symptoms.
Treatment of these healthy women increases their risk of dying from heart disease and, yes, cancer itself.
According to the Nordic Cochrane Center:
"It therefore no longer seems reasonable to attend for breast cancer screening.
In fact, by avoiding going to screening, a woman will lower her risk of getting a breast cancer diagnosis."
I highly recommend reading the report in its entiretyii, as it contains a number of enlightening tidbits that may help you make a more informed decision.
For example, after systematically reviewing the randomized trials of mammography, the authors concluded that:
"If 2,000 women are screened regularly for 10 years, one will benefit from screening, as she will avoid dying from breast cancer because the screening detected the cancer earlier.
Since these trials were undertaken, treatment of breast cancer has improved considerably.
Women today also seek medical advice much earlier than previously, if they have noted anything unusual in their breasts...
Because of these improvements, screening is less effective today and newer studies suggest that mammography screening is no longer effective in reducing the risk of dying from breast cancer."
... Since it is not possible to tell the difference between the dangerous and the harmless cell changes and cancers, all of them are treated.
Therefore, screening results in treatment of many women for a cancer disease they do not have, and that they will not get. Based on the randomized trials, it appears that:
If 2,000 women are screened regularly for 10 years, 10 healthy women will be turned into cancer patients and will be treated unnecessarily. These women will have either a part of their breast or the whole breast removed, and they will often receive radiotherapy, and sometimes chemotherapy. Treatment of these healthy women increases their risk of dying, e.g. from heart disease and cancer."
So, to recap, in order for mammographic breast screening to save ONE woman's life:
- 2,000 women must be screened for 10 years
- 200 women will get false positives, and
- 10 will receive surgery and/or chemotherapy even though they do not actually have cancer
Cochrane Conclusions Confirmed...
A couple of researchers at the University of Southampton set out to "assess the claim in a Cochrane review that mammographic breast cancer screening could be doing more harm than good."
Their findings were published in the British Medical Journal in December last yeariii. By combining life years gained from screening with losses of quality of life from false positive diagnoses and surgery, the authors agreed with the Cochrane assessment, concluding that mammograms may indeed have "caused net harm for up to 10 years after the start of screening."
ABC News reported on this findingiv:
"The default is to assume that screening must be good; catching something early must be good," said James Raftery, professor of health technology assessment at the University of Southampton, U.K., and lead author of the review. "But if a woman has an unnecessary mastectomy, or chemotherapy or radiation, that's a tragedy.
... "It's difficult to balance the gain of one life against 200 false positives and 10 unnecessary surgeries," said Raftery... The alternative is watchful waiting: delaying treatment until it's clear whether a lump is truly a life-threatening tumor. But for woman faced with the words, "breast cancer," watchful waiting is easier said than done..."
Have Dangerous Cancer Screening Devices Been Approved?
Based on information straight from the horse's mouth, as it were, the answer to that question appears to be yes. Doctors and scientists at the U.S. Food and Drug Administration (FDA) Office of Device Evaluation have in fact warned Congress that the agency was approving medical devices that posed unacceptable risks to patients. As early as 2007, concerned employees in this department began making internal complaints about a dozen different radiological devices about to be approved despite lack of proof of effectiveness.
They stated they were concerned that millions of patients' lives would be put at risk from these devices.
This included three devices that risked missing signs of breast cancer, and several colon cancer screening devices that employed such heavy doses of radiation they risked causing cancer in otherwise healthy people. In the case of a computer-aided imaging device for breast cancer screening, the scientists recommended against approval no less than three times, but after the third rejection, a senior manager, Donna-Bea Tillman, suddenly approved the device.
Subsequently, over the course of two years, the FDA secretly monitored the personal e-mail of nine whistleblowers within the department of device evaluations, and tried to launch an investigation against them, accusing them of "undermining the integrity and mission of the FDA" and illegal disclosure of trade secrets. Six of the monitored scientists and doctors recently filed a lawsuit against the FDA, charging that the agency violated their constitutional rights to privacy by monitoring lawful activity in personal email accounts, and using that information to harass and ultimately relieve some of them of their positions.
One of the key players in this ongoing drama is Jeffrey Shuren, director of the FDA's Center for Devices and Radiological Health, who has repeatedly requested action be taken against the employees in question. Shuren is also the official who oversees mercury dental fillings, which they have been fraudulently referring to as 'silver fillings.' Shuren promised to make an announcement about dental amalgam by the end of 2011, but with just minutes left in the work year, the FDA conceded that no announcement was forthcoming, and maybe never will...
The FDA's own doctors and scientists have called for a complete overhaul of the agency due to "deep-rooted systemic corruption at the highest levels." There's no doubt they know what they're talking about. And there's a lot of damning information out there that can, and eventually will, be used to call for a congressional hearing on the mammography cover-up.
Mammograms Often Lead to Unnecessary Treatments
In 1974, the National Cancer Institute (NCI) was warned by professor Malcolm C. Pike at the University of Southern California School of Medicine that a number of specialists had concluded that "giving a women under age 50 a mammogram on a routine basis is close to unethical."
The warning fell on deaf ears, and the long-held conventional medical advice has been for women to get an annual mammogram once they hit 40. A couple of years ago, the U.S. Preventive Services Task Force decided to alter their mammogram recommendation, advising women under the age of 50 to avoid mammograms, and limit them to every other year after the age of 50. The revision caused outrage among many cancer organizations. What was overlooked, however, was the reasoning behind the Task Force's decision to change their recommendation.
The prior advice was given in 2002, before a host of new research came out showing the problems of over diagnosis, including false positives. And as discussed above, it's really hard to justify harming 10 women with surgery and toxic chemotherapy treatment, just to save the life of one woman...
Part of the problem is that cancer diagnosing is not really a cut and dry process. If a mammogram detects an abnormal spot in a woman's breast, the next step is typically a biopsy. This involves removing 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. However, 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 actually NO diagnostic standards for D.C.I.S., and there are no requirements that the pathologists doing the readings have specialized expertise...
Increase in Breast Cancer Actually Found to be Due to Over-Diagnosis!
In other recent news, a Norwegian follow-up study that looked at 14 years of mammography screening in Norway concluded that the increased incidence of breast cancer observed in that period was, again, simply due to over-diagnosis.v According to the authors:
"In 2004 we wrote in Tidsskriftet that mammography screening resulted in massive over-diagnosis and over-treatment of breast cancer. Our study was criticized because we had only five years of follow-up time and did not take account of the fact that increased use of hormone replacement therapy could lead to more breast cancer.
We have now been screening women for 14 years, and during a period when the use of hormones has fallen by 70 percent.
... The number of new cases of breast cancer in the period increased from around 2,000 to 2,750. About 300 cases of ductal carcinoma in situ (DCIS) were also diagnosed. Today a total of some 1,050 more women have been diagnosed than before screening started. Our calculations indicate that in the absence of screening, around 800 of these women would never have become breast cancer patients. The figures from 14 years of mammography screening indicate that all increase in the incidence of breast cancer is due to over-diagnosis: findings of tumors that in the absence of screening would never have given rise to clinical illness."
When it Comes to Cancer, Getting Second and Third Opinions is Advisable...
Once you delve into the research, you find that the issue of mammography is not as clear-cut as conventional medical wisdom would have you believe. There are many risks, and according to some studies, these risks will outweigh the potential benefits for many women. And, it appears very clear that more women are harmed by it than are saved...
In the event you do receive a mammogram and a biopsy and are diagnosed with D.C.I.S. or another form of early stage breast cancer, I recommend getting a second, and possibly third and even fourth, opinion. I cannot stress this enough, as the false positive rates are so high, and the diagnostic criteria so subjective. Before you make any decision on treatment, and definitely before you decide to have surgery or chemotherapy, make sure your biopsy results have been reviewed by a breast specialist who is knowledgeable and experienced in the field.
How to Dramatically Cut Your Breast Cancer Risk
There are a number of lifestyle changes that can help prevent breast cancer from ever becoming a reality for you. For starters, we cannot discuss breast cancer without mentioning the importance of vitamin D. Vitamin D, a steroid hormone that influences virtually every cell in your body, is easily one of nature's most potent cancer fighters. Receptors that respond to vitamin D have been found in nearly every type of human cell, from your bones to your brain. Your liver, kidney and other tissues can convert the vitamin D in your bloodstream into calcitriol, which is the hormonal or activated version of vitamin D.
Your organs then use it to repair damage, including that from cancer cells.
Vitamin D is actually able to enter cancer cells and trigger apoptosis or cancer cell death. When JoEllen Welsh, a researcher with the State University of New York at Albany, injected a potent form of vitamin D into human breast cancer cells, half of them shriveled up and died within days! vi
The vitamin D worked as well at killing cancer cells as the toxic breast cancer drug Tamoxifen, without any of the detrimental side effects and at a tiny fraction of the cost.
It is my impression that it is criminal malpractice not to recommend vitamin D and aggressively monitor a breast cancer patient's vitamin D level to get it between 70 and 100 ng/ml. Vitamin D works synergistically with every cancer treatment I am aware of and has no adverse effects. According to one landmark study, some 600,000 cases of breast and colorectal cancers could be prevented each year if vitamin D levels among populations worldwide were increased. And that's just counting the death toll for two types of cancer (it actually works against at least 16 different types)!
So please do watch my one-hour free lecture on vitamin D to find out what your optimal vitamin D levels should be … and how to get them there. This is one of the most important steps you can take to protect yourself from cancer.
Other Breast Cancer Prevention Musts
A healthy diet, regular physical exercise, appropriate sun exposure and an effective way to manage your emotional health are the cornerstones of just about any cancer prevention program, including breast cancer. But for breast cancer, specifically, you can take it a step further by also watching out for excessive iron levels. This is very common once women stop menstruating, and the extra iron 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 level drawn. Ferritin is the iron transport protein and should not be above 80. So if it is elevated you can simply donate your blood to reduce it.
Further, the following lifestyle strategies will help to further lower your risk:
- Improve Your Insulin Receptor Sensitivity. The best way to do this is to cut as much sugar, fructose and grains as possible from your diet, and make sure you have an optimized exercise program. Please don't make the mistake of focusing on cardio to the exclusion of everything else. You can get some ideas from reviewing my video on exercise. (Although I did not mention stretching and flexibility work, such as yoga, in the video, it is a very important part of your exercise program. It will not affect insulin receptors but it will help prevent you from getting injured and stopping your other exercise.)
- Maintain a healthy body weight. This will come naturally when you begin eating properly and exercising. It's important to lose excess weight because estrogen, a hormone produced in fat tissue, may trigger breast cancer.
- Get plenty of high quality animal-based omega-3 fats, such as 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 up to six months. Research shows this will reduce your breast cancer risk.
- Avoid synthetic hormone replacement therapy. 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 breast cancer. Dr. David Brownsteinvii, 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. I hope to publish some articles on this later this year with my recommendations.
- i SCREENING FOR BREAST CANCER WITH MAMMOGRAPHY (PDF), The Nordic Cochrane Center 2012
- ii WITH MAMMOGRAPHY (PDF), The Nordic Cochrane Center 2012, SCREENING FOR BREAST CANCER
- iii Possible net harms of breast cancer screening: updated modelling of Forrest report, BMJ. 2011 ;343:d7627
- iv ABC News December 8, 2011
- v Tidsskrift for den Norske Laegeforening. 2012 Feb 21;132(4):414-417
- vi Is This the New Silver Bullet for Cancer?
- vii Dr. Brownstein - Holostic Familt Medicine