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New Research Suggests Benefits of Mammography May Be Overstated While Risks Are Underestimated

Story at-a-glance -

  • Two new studies cast further doubt about the effectiveness and safety of routine screening mammograms for preventing lethal breast cancer
  • One study finds mammogram screening has significantly increased rates of breast cancer, both early-stage (lower lethality) and later-stage (higher lethality)
  • The decline in breast cancer mortality has resulted from more effective treatments, not earlier detection
  • Using mammography as a screening tool has failed miserably, increasing “overdiagnosis harm” from unnecessary treatments, surgeries and emotional stress
  • Even the National Cancer Institute has suggested narrowing the definition of “cancer” due to the inherent risks associated with overtreatment

By Dr. Mercola

Mammograms are in the news again. Former "Good Morning America" host Joan Lunden recently announced she was diagnosed with a particularly aggressive form of breast cancer – two weeks after a mammogram gave her a clean bill of health.1 The diagnosis was made via ultrasound, which revealed a lump the mammogram had missed.

Two studies about the effectiveness of mammogram screening, released just weeks apart, also cast further doubt on the wisdom of subjecting yourself to the risk of routine mammography.

The first study, featured in the above news report, relates to an extensive review of research conducted by Harvard Medical School and Brigham and Women's Hospital and published in the April 2014 issue of Journal of the American Medical Association.2

The analysis covered more than five decades of data and examined mortality benefits and harms of mammography screening, with results that were far from glowing.

The study found that while mammograms decreased a woman's risk of dying from breast cancer by an average of 19 percent, the same amount—19 percent—of the cancers found and treated are actually not life-threatening and do not need to be treated.

The study did not take into account whether mammograms reduced (or increased) a woman's risk of dying from other causes, such as from heart muscle damage related to the use of chemotherapy drugs and other cancer treatments.

There's No One-Size-Fits-All Breast Cancer Screening Recommendation

The researchers wisely suggest that what we really need is a more personalized approach3 to breast cancer screening. Younger women get the least benefit, and therefore need to think more carefully about their choice. As reported by USA Today:4

"They estimate that for every 10,000 women in their 40s who undergo annual mammograms for 10 years, 190 will be diagnosed with breast cancer. But only five of those women would avoid dying of breast cancer as a result of the screening. Of the remainder, about 25 would die despite being treated, and 36 would be treated unnecessarily because the cancer wouldn't have become life-threatening.

For women in their 50s, 10 breast-cancer deaths would be averted for every 10,000 women screened annually for 10 years. For women in their 60s, 42 breast-cancer deaths would be averted. But as many as 137 women in their 50s, and 194 in their 60s would be diagnosed and treated unnecessarily."

With routine mammogram screenings, cancer is frequently overdiagnosed and therefore overtreated and/or mistreated, significantly increasing women's health risk. In fact, researchers concluded that when it comes to mammography screening, the harm might outweigh the benefit, stating, "Better breast cancer screening tests are needed."5 There is also the fact that mammography misses 20 to 40 percent of cancers.

And if you aren't confused enough about whether or not you should get a mammogram, the findings of yet another new study—curiously absent from mainstream media coverage—are even more disturbing.

Mammogram Screening Raises 'Lethal' Breast Cancer Incidence

The second new study involved 1.8 million Norwegian women diagnosed with breast cancer between 1987 and 2010, and was published in the March 2014 issue of The European Journal of Public Health.6

Researchers found that among women 50 to 69 years of age, breast cancer screening is associated with a significantly higher incidence of early stage, lower lethality cancer (221 percent) and HIGHER rates of late-stage, more advanced breast cancer (35 percent) when compared with women who did not receive mammogram screenings.

This is exactly the opposite of what you would expect to see if mammograms were actually catching malignant tumors earlier—late stage cancers would be lower and not higher. Sayer Ji of GreenMedInfo explains the risks of increased early-stage breast cancer diagnoses in light of what we now know about DCIS (Ductal Carcinoma in Situ):7

"One of the most dramatic revelations of our time occurred last year when a National Cancer Institute commissioned expert panel concluded that so-called 'early stage cancers' such as DCIS are not cancer at all, but benign or indolent growths.8 This implies that millions of women were wrongly diagnosed with 'breast cancer' over the past 30 years, who would have been better off left undiagnosed and untreated."

All of this comes on the heels of a Canadian study that concluded annual mammography does not reduce your risk of dying from breast cancer if you're a woman between the ages of 40 and 59. That study was published in the February 2014 issue of the British Journal of Medicine and caused quite a media stir.9

But this is not the only research to suggest mammography screening has been oversold. A 2013 British report from the University of Oxford came to the same conclusion, based on an analysis of 40 years of data.10, 11

All of this spells bad news for the cancer industry, for which mammograms are a major profit center. Breast cancer is big business. The lion's share of mammography profits come from routine annual screenings—effective or not. You can count on hefty pushback from the medical industry if public skepticism begins to threaten the bottom line.

With all of these studies intersecting at the same general point, it can no longer be argued that mammograms are a safe and effective screening tool, or that these contradictory findings are due to research anomalies or "poor study design," which is a favorite criticism by mammography proponents.

How Mammography Screening Has Failed

The short presentation in the video above provides an excellent visual illustration of what has happened in terms of breast cancer detection, overdiagnosis, and overtreatment since the advent of screening mammography. Dr. Gilbert Welch, co-author of Effect of Three Decades of Screening Mammography on Breast-Cancer Incidence,12 explains how screening mammography has failed. This study was published in the most prestigious medical journal in the world, the New England Journal of Medicine. According to Dr. Welch, since the advent of screening, we have witnessed the following:

  • The number of women diagnosed with early breast cancer has approximately doubled. These diagnoses are roughly equally divided between two types of early stage breast cancer: DCIS and "localized invasive." Prior to mammography, DCIS was never seen.
  • There has been little compensatory decrease in the number of women presenting with late-stage breast cancer, which is much more lethal. There has been less than a 10 percent decline in breast cancer mortality. However, overdiagnosis harm is substantial—half of all screen-detected breast cancers now represent overdiagnosis and false-positives.
  • There has been very little change in breast cancer rates among younger women (under age 40), suggesting there has NOT been a dramatic change in the underlying amount of breast cancer. Therefore, the logical conclusion is that the extra cancers we see today result from the screening itself.

Other important facts have emerged from this data, according to Dr. Welch. Mammograms are detecting "cancers" that are never going to appear, and these are all being treated as if they are lethal forms of cancer.13 Even the National Cancer Institute itself has suggested narrowing the definition of "cancer," as mounting research shows that many harmless tumors are being overtreated, causing more harm than good.

The rate of metastatic breast cancer has not changed at all—mammograms are not finding these dangerous cancers earlier. The decline in breast cancer mortality is a result of improved treatments, not earlier detection of the more lethal types of breast cancer, and survival rates are improving regardless of whether or not the cancer was found by mammogram screenings.

Mammography May Harm 10 Times More Women Than It Helps

The risks of mammography screening are significant and should not be ignored, including those associated with radiation, chemotherapy, and surgeries such as lumpectomies and mastectomies, as well as the stress of receiving a cancer diagnosis and having to undergo invasive medical procedures.14 The Nordic Cochrane Center determined that only ONE out of 2,000 women screened regularly for 10 years will benefit from early cancer detection. Meanwhile, out of the same 2,000 women, 10 healthy women will be misdiagnosed, turned into cancer patients and unnecessarily treated.

All in all, mammography screening results in 30 percent overdiagnosis and overtreatment, which equates to an absolute risk increase of 0.5 percent. What these statistics clearly tell us is that just because you were treated for cancer does not mean you're a cancer survivor. If you really didn't have cancer to begin with, then you're really just a "cancer treatment survivor."

Yet all women treated for cancer who survive become part of the official "cancer survivor" statistic that is then used to justify the effectiveness of the current system of diagnosis and treatment! GreenMedInfo has compiled a list of dozens of studies about the risks of mammography screening, as well as those documenting the lack of any measurable benefit to offset the risk.15 And screening may be even more risky if you are a woman under age 50, according to a 2007 meta-analysis published in the Annals of Internal Medicine.16

Their Solution Is to TRIPLE Your Radiation Exposure by Adding 3D Tomosynthesis

Unfortunately, instead of admitting the flaws and inherent dangers of routine mammography, in 2011 the industry unveiled a "new and improved" type of mammogram called 3D tomosynthesis, which actually exposes you to even HIGHER doses of radiation than a standard mammogram. According to surgeon Dr. Susan Love, tomosynthesis exposes you to about twice the amount of radiation of a standard mammogram.

What's worse, they also recommend you continue receiving your traditional 2D mammogram when you get tomosynthesis, thereby compounding your radiation exposure even further. According to a 2010 study, for women between the ages of 40 and 80, annual screening using standard digital or screen-film mammography is associated with—and is likely a direct cause of—20 to 25 cases of fatal cancer for every 100,000 women getting the test. Using a cancer screening method that causes the very disease it's supposed to be preventing can hardly be considered progress!

Deodorant and Underwire Bras: Possible Breast Cancer Causes?

Research published in the journal of the European Institute of Oncology17 has lent some credence to long-held concerns that chemicals in deodorant, and even underwire bras, could be contributing to breast cancer risk. The paper analyzed health records of Scottish women diagnosed with breast cancer three decades apart (between 1957-1959 and 1997-1999). Breast cancer in the upper outer quadrant (UOQ) of the breast, in particular, was found to be on the rise.

The upper outer quadrant is the area between your armpit and your breast. It's been suggested that the increased cancers in this area could be due to the higher amount of breast tissue found there, but this doesn't explain why incidence has changed over time. The paper suggested several other reasons that may account for the shift in the location of tumors to the upper outer quadrant. Among them:18

  • Repetitive trauma, including blocked sweat ducts from antiperspirants and deodorants, and skin damage from shaving. This could lead to blocked ducts in your breast and the formation of cysts, which is linked to an increased cancer risk.
  • Chemicals and additives in antiperspirants and deodorants, including parabens and aluminum salts, mimic the actions of the hormone estrogen, which may drive cancer
  • Wearing underwire bras, which may constrict breast tissue and the lymphatic system

The researchers explained:

"Explanations for an increase of tumors in the UOQ include the possibility that agents administered topically… might gain access to the breast and be responsible for the initiation/promotion of tumors at that site. Interestingly compounds in deodorants, such as parabens, have been reported to have the ability to penetrate the skin and have estrogenic activity… Since antiperspirants act by blocking sweat ducts, and breast cysts result from blocked breast ducts, it is possible that breast cysts could also arise from repetitive trauma to the ducts in this area… Some studies showed women with breast cysts are at an increased risk of breast cancer, especially at younger ages.

…The constant use of bras (particularly of under-wired which constricts breast tissue and lymphatics mostly in the outer quadrants by the very nature of its design) for long periods might influence lymphatic flow from the breast, this might be a cofactor with other factors in traumatizing tissues in the UOQ of the breast where the wire has the most pressure point. Axillary hair is now frequently removed by different means and is currently performed more frequently than was done four decades ago. This potentially causes repetitive trauma to the axilla and neighboring outer quadrants."

Lowering Your Cancer Risk Begins with Wise Lifestyle Choices

Mammograms are portrayed as the best form of "prevention" a woman can get. But early diagnosis is not the same as prevention. I believe the vast majority of all cancers can be prevented by applying basic, common sense lifestyle strategies, such as the following:

  • Avoid refined sugar, especially fructose, and processed foods. All forms of sugar are detrimental to health in general and promote cancer. Refined, highly processed fructose, however, is clearly one of the most harmful and should be avoided as much as possible. This means avoiding processed foods, most of which are loaded with fructose, typically in the form of high fructose corn syrup.
  • Optimize your vitamin D levels. 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 probably be between 70 and 100 ng/ml. Vitamin D works synergistically with every cancer treatment I'm aware of, with no adverse effects. Ideally, your levels should reach this point by exposure to the sun or a safe tanning bed, not oral vitamin D. For more information on this, please watch my interview with Carole Baggerly.
  • Limit your protein. Newer research has emphasized the importance of the mTOR pathways. When these are active, cancer growth is accelerated. One way to quiet this pathway is by limiting your protein, so that your body has enough protein for cellular turnover and muscle maintenance, but not more. Experts like Dr. Ron Rosedale believe an ideal amount for many would be around 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 typically about two-thirds to half of what they are currently consuming.
  • 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. Exercise is also an important factor in insulin and leptin regulation.
  • 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 and improve insulin/leptin sensitivity, which explains why exercise appears to be particularly potent against breast cancer. For more about exercise, please check out my Peak Fitness program.
  • Maintain an optimal body weight. This will come naturally when you begin eating wisely 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 a very useful adjunct in the treatment of cancer. Curcumin actually has the most evidence-based literature supporting its use against cancer of any nutrient, including vitamin D.19 For example, it has demonstrated major therapeutic potential in preventing breast cancer metastasis.20 It's important to know that curcumin is generally not absorbed that well. In a recent interview, Dr. William LaValley discusses strategies to help you get around this problem. Fortunately, newer preparations have started to emerge, offering better absorption. For best results, you'll want to use a sustained release preparation.
  • 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, 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.21
  • I have been researching iodine ever since I interviewed Dr. Brownstein and I believe that most of what he states is spot on. The caveat here—I am not convinced his dosage recommendations are correct, I believe they are much 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.

This is not an exhaustive list—there are many other strategies that can be useful as well. One 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 research-based all-natural approaches for preventing and treating breast cancer.

What to Do if You Already Have Cancer

One of the most powerful strategies I know of for treating cancer is to starve cancer cells by depriving them of their primary food source, namely sugar. Unlike normal cells that can burn either carbohydrates or fat for fuel, cancer cells have lost that metabolic flexibility, and can only burn sugar. Dr. Otto Warburg was awarded a Nobel Prize more than 75 years ago for figuring this out, but virtually no oncologist actually uses this information.

You can review my recent interview with Dr. D'Agostino for more details, but if I had a family member diagnosed with cancer, my recommendation would be to implement a ketogenic diet combined with hyperbaric oxygen therapy, which is essentially a double whammy to cut off the cancer from its fuel source. Intermittent fasting can also be invaluable here, as it helps jumpstart your body to start burning fat instead of carbs as its primary fuel. By employing these strategies, along with the guidelines already discussed, your odds of beating cancer will shift significantly in your favor.