By Dr. Mercola
The "C" word; probably the most feared word there is in healthcare. Just the mere mention of cancer conjures up images of death and despair. Cancer screening like annual mammograms is the conventional go-to "prevention" strategy. But researchers increasingly agree that mammography is ineffective at best, and harmful at worst...
In November of 2009, the U.S. Preventive Services Task Force, a federal advisory board, revised their cancer screening recommendations, saying annual mammograms weren't necessary for women under age 50 and that screenings were recommended only every two years after that1.
The panel based the new guidelines on data indicating that mammography does more harm than good when used on younger women.
Besides the fact that the ionizing radiation delivered during mammography can cause cancer in and of itself, overdiagnosis of cancer, as well as misdiagnosis, has been shown to be a significant problem plaguing this form of cancer screening.
According to a Norwegian study, published in April of this year2, as many as 1 in 4 women are consistently overdiagnosed with breast cancer that, if left alone, would never have caused them any harm.
Whistleblowers Claim FDA Approved Dangerous Mammography Equipment
On July 15, the New York Times revealed that the FDA has engaged in an intense spying campaign against five whistleblowers within the organization3, as well as "FDA opponents" deemed to be in collaboration with the whistleblowers.
According to the NYT:
"What began as a narrow investigation into the possible leaking of confidential agency information by five scientists quickly grew in mid-2010 into a much broader campaign to counter outside critics of the agency's medical review process, according to the cache of more than 80,000 pages of computer documents generated by the surveillance effort.
Moving to quell what one memorandum called the "collaboration" of the F.D.A.'s opponents, the surveillance operation identified 21 agency employees, Congressional officials, outside medical researchers and journalists thought to be working together to put out negative and "defamatory" information about the agency.
... The extraordinary surveillance effort grew out of a bitter dispute lasting years between the scientists and their bosses at the FDA over the scientists' claims that faulty review procedures at the agency had led to the approval of medical imaging devices for mammograms and colonoscopies that exposed patients to dangerous levels of radiation."
As a longtime critic of mammograms, I'm familiar with the kind of harassment the FDA can dish out, so it does not surprise me the agency would stoop so low as to spy on their critics.
How can the FDA justify spying on and harassing their own scientists—professionals hired to assess the safety of devices such as mammograms—just because these employees found serious health threats that the agency would rather continue to ignore in order to protect their industry clients? It's completely unconscionable and there's no good defense.
Good News: Fewer Younger Women are Getting Mammograms
While U.S. Preventive Services Task Force's new guidelines initially ignited fierce protests from cancer advocacy groups, mammography rates for women in their 40s are declining4.
According to recent findings by the Mayo Clinic5:
"Presented last week at an annual research meeting, the study analyzed data from 100 health plans across the U.S. Looking specifically at the number of mammograms performed from January 2006 to December of 2010, researchers found a drop of nearly 6 percent among women ages 40 to 49.
Meanwhile, the number of mammograms among women ages 50 to 64 remained steady, despite the same panel's recommendation that women need only be screened every two years.
"We applaud this news," says ACSH's Dr. Elizabeth Whelan. She notes that, while too many people still believe there's no harm in getting a mammogram, the task force study demonstrated that this is clearly not the case. "We now have reason to hope that the influence of the USPSTF guidelines will only increase, meaning that we'll see a decrease in the number of women who unnecessarily undergo procedures such as radiation, mastectomy, or lumpectomy."
Cancer Overdiagnosis, Still a Serious Concern
According to Dr. Otis Webb Brawley, chief medical officer of the American Cancer Society, the term "overdiagnosis" in cancer medicine refers to6:
"... a tumor that fulfills all laboratory criteria to be called cancer but, if left alone, would never cause harm. This is a tumor that will not continue to grow, spread and kill. It is a tumor that can be cured with treatment but does not need to be treated and/or cured."
The problem, according to a report by CNN published back in April, is related to advances in technology7. As mammograms are able to detect tinier and tinier spots in the diagnostic films, the possibility overtreatment increases exponentially when overzealous clinicians insist that more tests, including invasive MRIs with dye and painful biopsies, be done on women who have the misfortune of having a tiny spot in their X-ray.
Concerns about overdiagnosis of both breast- and prostate cancer have increased over the years. (According to Dr. Webb Brawley, an estimated 60 percent of prostate cancers are also harmless tumors that do not need treatment.)
The findings from Norway support several previous studies, such as the Cochrane Database review from 20098, which found that breast cancer screening led to a 30 percent rate of overdiagnosis and overtreatment, which actually increased the absolute risk of developing cancer by 0.5 percent. The review concluded that for every 2,000 women invited for screening throughout a 10 year period, the life of just ONE woman was prolonged, while 10 healthy women were treated unnecessarily. Another 200 women undergo psychological stress and trauma for several months due to false positives.
Mammograms are especially inaccurate for women with dense breasts. New York and Virginia recently passed laws requiring women with dense breasts to be informed they may need to seek alternative screening methods.
Mammography Not Linked to Reduction in Mortality...
Another Norwegian study, published in 2010, concluded that the reduction in mortality as a result of mammographic screening was so small as to be nonexistent—a mere 2.4 deaths per 100,000 person-years were spared as a result of the screening9.
Yet another study published in The Lancet Oncology late last year10, described the natural history of breast cancers detected in the Swedish mammography screening program between 1986 to 1990, involving 650,000 women. Since breast lesions and tumors are aggressively treated and/or removed before they can be determined with any certainty to be a clear and present threat to health, there has been little to no research on what happens when they are left alone.
This study however, demonstrated for the first time that women who received the most breast screenings had a higher cumulative incidence of invasive breast cancer over the following six years than the control group who received far less screenings! The study concluded that:
"Because the cumulative incidence among controls did not reach that of the screened group, 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."
These findings were considered near blasphemous by many, but should we really be so surprised to discover that cancer can regress spontaneously? As stated by Sayer Ji from GreenMedInfo.com in a previous article:
"Given that breast cancer is not caused by a lack of breast screenings, surgery, radiation, and chemotherapy, it should not be so difficult to understand that if the body is given an opportunity to heal itself, it will often do so. And what better way is there to promote healing than to AVOID unnecessary diagnostic and surgical procedures and chemical and radiation exposures?"
False Positives Deter Women from Mammogram Follow-Ups
Hopefully, the reduced number of women in their 40's getting mammograms is due to increased awareness of the inherent dangers of the procedure. However, a recent Australian study hints at the possibility that the reduction in mammograms could be related to the high rate of false-positive mammograms, as false-positives seem to deter women from getting rescreened. In Western Australia, the false-positive rate is about 44 in 1,000 women screened.
The study, published in the Medical Journal of Australia11 found that 67.6 percent of women who received a false-positive mammogram result were less likely to return for a rescreen in subsequent years. According to the Australian Science Network12:
"UWA Epidemiology Professor Lin Fritschi, who oversaw the statistical analysis of the study, says women who have a false-positive mammogram are put through several tests which could result in future deterrence from screening. "It is possible that [further invasive testing] upsets people and they go, 'I don't want that to happen again', and so they don't return," Professor Fritschi says.
"I think it is really important when women come in to have their further assessment... It's very important we keep looking because they can develop cancer in the future, so it's very important [the patient] continues to do their screening."
Professor Fritschi says any test may have false-positive and false-negative results and the mammogram screening process was not always definitive... "There's no point in just taking out lots of pieces of biopsy or something from somebody's breast just to see if they've got cancer. That's why we have a test that at least pulls out people who are more likely to have cancer and then further tests only them."
The authors concluded "mammographic population screening services should keep their false-positive result rates low, to prevent women from being deterred from screening." That's easier said than done, however. Besides, the wisdom of continually radiating your breasts with ionizing radiation, which we know causes cancer, in an effort to detect cancer early enough to treat it is questionable at best...
While the medical community certainly needs to focus on reducing false positives to avoid overtreatment, there are other alternatives that can help you monitor your breast health and give you an indication of cancer risk without resorting to ionizing radiation. And while Professor Fritschi was referring to mammography as the test to use to identify those at increased risk and "further test only them," the high rates of false positives tells us mammography is ineffective for this job.
False Negatives—Another Hazard of Mammography
Besides false positives that lead to unnecessary treatments, there's also the risk of getting a false negative, meaning that a life-threatening cancer is missed. It's important to realize that a negative mammogram cannot be equated with a clean bill of health. All a negative mammogram can tell you is that IF you do have cancer, it hasn't grown large enough yet to be detected. According to the National Cancer Institute (NCI):
"Overall, screening mammograms miss up to 20 percent of breast cancers that are present at the time of screening."
This is particularly true for women with dense breast tissue. Forty-nine percent of women have high breast tissue density13, and mammography's sensitivity for dense breasts is as low as 27 percent14—meaning about 75 percent of dense-breasted women are at risk for a cancer being missed if they rely solely on mammography. Even with digital mammography, the sensitivity is still less than 60 percent.
Thermography—A Physiological Test to Help Monitor Breast Health
I recently interviewed Gaea Powell about the use of thermography as a safe way to monitor your risk of breast cancer over the long term. Thermographic breast screening is brilliantly simple and completely harmless. It's as safe as having your photograph taken. It measures the infrared heat emitted by your body and translates this information into thermal images. Thermography does not require mechanical compression or ionizing radiation, and can detect signs of physiological changes due to inflammation and/or increased tumor related blood flow approximately 8-10 years before mammography or a physical exam can detect a mass.
As explained by Gaea:
"Thermography is a physiological test, so it allows you to look for physiological changes at an early stage. As we know, when you go to the doctor's office, the first thing they want you to do is be weighed, have your blood pressure taken and have your temperature taken. Those are physiological tests that can be monitored for stability over time. It's the same type of process. Every single person has their own unique thermal vascular roadmap, and thermography allows us to watch that roadmap over time."
It's important to understand that, just like mammography, thermography does not diagnose cancer. It allows you to track your unique temperature data over time, and changes in temperature and symmetry can alert you that changes are taking place, for better or worse. Higher temperature readings indicate higher levels of inflammation, which can lead to cancer.
So, if your Thermogram shows areas of high inflammation, it doesn't mean you have cancer, but it lets you know you need to address that inflammation to avoid deterioration, and in some cases that the area needs further evaluation. One of the main things your evaluating doctor will look for is stability and symmetry over time, which is why Gaea recommends getting Thermograms at regular intervals. That way, you're collecting data that can be analyzed and evaluated over the years. To learn more, please listen to the interview above, or read through the transcript.
New Yorkers Banned from Filing Medical Malpractice Suits for Botched Mammograms
As dangerous and inaccurate as mammograms can be, it's worth knowing that the law in some states shields radiologists against medical malpractice suits for misdiagnosed mammograms. According to David Perecman, a New York personal injury lawyer15:
"According to the law in New York, the statute of limitations for medical malpractice is two and half years from the date the malpractice occurs. This statute of limitations period is only postponed if a foreign object is found in a body after surgery or an individual has been receiving continuous treatment from the physical who commits the malpractice. So consider this hypothetical.
A 40 year-old woman has a mammogram performed. When the radiologist reads the mammogram film, he or she does not notice a potential tumor. For whatever reason, the woman does not get another mammogram until three years later when she finds a large lump in her breast. A new mammogram discovers the tumor in her breast and an oncologist determines the tumor is cancerous.
Under the New York statute, the statute of limitations bars the woman from bringing a medical malpractice suit against the radiologist. Furthermore, under Nykorchuck v. Henriques, toll exception to the statute of limitations does not apply to mammograms. Nykorchuck v.Henriques,78 N.Y.2d 255 (1991)."
This is not necessarily true for all states, however. For example, in 2008 a woman with terminal breast cancer won a medical malpractice suit in Tennessee, after receiving a false-negative mammogram diagnosis16, which delayed the discovery of a lethal tumor for three years.
How to Help Prevent Breast Cancer
According to the National Breast Cancer Foundation, 200,000 new cases of breast cancer will be diagnosed each year in the United States, making it three times more common than other gynecological cancers.
Preventing breast cancer is far more important and powerful than simply trying to detect it, which is why I want to share my top tips on how to help prevent this disease. In the largest review of research into lifestyle and breast cancer, the American Institute of Cancer Research estimated that about 40 percent of U.S. breast cancer cases could be prevented if people made wiser lifestyle choices. I believe these estimates are far too low, and it is more likely that 75 percent to 90 percent of breast cancers could be avoided by strictly applying the recommendations 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). 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. 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.
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.
- Get plenty of natural vitamin A. There is evidence that vitamin A also plays a role in helping prevent breast cancer. It's best to obtain it from vitamin A-rich foods, rather than a supplement. Your best sources are organic egg yolks, raw butter, raw whole milk, and beef or chicken liver. However, beware of supplementing as there's some evidence that excessive vitamin A can negate the benefits of vitamin D. Since appropriate vitamin D levels are crucial for your health in general, not to mention cancer prevention, this means that it's essential to have the proper ratio of vitamin D to vitamin A in your body.
Ideally, you'll want to provide all the vitamin A and vitamin D substrate your body needs in such a way that your body can regulate both systems naturally. This is best done by eating colorful vegetables (for vitamin A) and by exposing your skin to safe amounts sunshine every day (for vitamin D).
- Get sufficient amounts of iodine. Iodine is an essential trace element required for the synthesis of hormones, and the lack of it can also cause or contribute to the development of a number of health problems, including breast cancer. This is because your breasts absorb and use a lot of iodine, which they need for proper cellular function. Iodine deficiency or insufficiency in any of tissue will lead to dysfunction of that tissue, and tumors are one possibility.
However, there's significant controversy over the appropriate dosage, so you need to use caution here. There's evidence indicating that taking mega-doses, in the tens of milligram range may be counterproductive. One recent study suggests it might not be wise to get more than about 800 mcg of iodine per day, and supplementing with as much as 12-13 mg (12,000-13,000 mcg's) could potentially have some adverse health effects.
- Avoid xenoestrogens. Xenoestrogens are synthetic chemicals that mimic natural estrogens. They have been linked to a wide range of human health effects, including reduced sperm counts in men and increased risk of breast cancer in women. There are a large number of xenoestrogens, such as bovine growth hormones in commercial dairy, plastics like bisphenol A (BPA), phthalates and parabens in personal care products, and chemicals used in non-stick materials, just to name a few.
- Improve Your Insulin Receptor Sensitivity. The best way to do this is by avoiding sugar and grains and making sure you are exercising regularly, ideally by incorporating the principles of Peak Fitness.
- 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, which can fuel breast cancer.
- 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, which increases the chances for mutations and cancerous cells.
- Drink 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 in the treatment of breast cancer. It shows immense therapeutic potential in preventing breast cancer metastasis. It's important to know that curcumin is generally not absorbed that well, so I've provided several absorption tips in a previous article.
- Avoid drinking alcohol, or at least limit your alcoholic drinks to one per day.
- Breastfeed exclusively for up to six months. Research shows this will reduce your breast cancer risk.
- Avoid wearing underwire bras. There is a good deal of data that metal underwire bras increase your breast cancer risk.
- Avoid electromagnetic fields as much as possible. Items such as electric blankets can be particularly troublesome and increase your cancer risk.