Mammograms Worth The Risk???
There have been a variety of estimates of the benefits and harms of mammographic screening for breast cancer. A study aimed to assess the effect of screening for breast cancer on mortality and morbidity.
The researchers found that, while screening was likely to reduce breast cancer mortality, screening also led to a 30 percent rate of overdiagnosis and overtreatment -- which meant that all in all it actually increased the absolute risk by 0.5 percent.
According to the study, as reported by Green Med Info:
“This means that for every 2000 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.”
Dr. Mercola's Comments:
If you're a U.S. woman over 40, there's a good chance your physician has advised you to get a mammogram, the breast x-ray that's regarded as the "gold standard" of breast cancer screening in the conventional medical establishment.
And if you were advised to get a mammogram, chances are you didn't even question this advice, believing mammograms to be a safe and effective way to proactively care for your health. Most U.S. women are well aware of mammograms, and many have gotten the tests already in the past, as they are very heavily promoted by public health agencies like the American Cancer Society (ACS), which, by the way, has numerous ties to the mammography industry itself.
The ACS commonly runs advertisements urging women to get mammograms, even going so far in one ad as to promise that early detection leads to a cure "nearly 100 percent of the time." But what the American Cancer Society and most physicians are not making clear in their heavy mammography marketing material and advice is the risk involved, such as what was revealed by the Cochrane Database of Systemic Reviews study noted above.
"It is Not Clear Whether Screening Does More Good than Harm"
When many women go in to have a mammogram, they are completely unaware that the science backing them up is sketchy at best. As was revealed by a study in the Cochrane Database of Systemic Reviews, mammography breast cancer screening led to 30 percent overdiagnosis and overtreatment, or an absolute risk increase of 0.5 percent.
"This means that for every 2000 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.
Dr. Shahla Masood, the head of pathology at the University of Florida College of Medicine in Jacksonville, told the New York Times:
"There are studies that show that diagnosing these borderline breast lesions occasionally comes down to the flip of a coin."
The New York Times reported several concerning findings about the frequency of misdiagnosis:
- A 2006 study by Susan G. Komen for the Cure estimated that in 90,000 cases when women were diagnosed with D.C.I.S. or invasive breast cancer, they either did not have the disease or they got incorrect treatment due to a pathologist error.
- A 2002 study at Northwestern University Medical Center found that nearly 8 percent of 340 breast cancer cases " had errors serious enough to change plans for surgery."
- Dr. Lagios, a pathologist at St. Mary's Medical Center in San Francisco, reviewed nearly 600 breast cases in 2007 and 2008 and found discrepancies in 141 of them.
False positives are not only emotionally trying, they can also lead to expensive repeat screenings, exposing you to more potentially toxic radiation, and, as discussed earlier, can sometimes result in unnecessary invasive procedures including biopsies, and even unnecessary surgery, radiation, chemotherapy and more.
U.S. Preventive Services Task Force Alters Mammogram Guidelines
Updated guidelines set forth by the U.S. Preventive Services Task Force (USPSTF) state that women in their 40s should NOT get routine mammograms for early detection of breast cancer -- a far cry from the previous recommendation of routine screenings every year or two for women age 40 and older.
The agency undoubtedly had to know that there is reason to question whether mammograms are all they are made out to be, and that is why they labeled them a "C recommendation" for women in this age group, which means:
"The USPSTF recommends against routinely providing the service. There may be considerations that support providing the service in an individual patient. There is at least moderate certainty that the net benefit is small."
As for older women, the task force also altered their recommendations, stating screenings were advised only every two years at age 50 and beyond. Perhaps they updated their advice after seeing this study in the New England Journal of Medicine, which found a close to zero percent benefit from mammography.
Researchers analyzed data from over 40,000 Norwegian women with breast cancer and found that those who had mammograms and were treated by special breast cancer medical teams had a 10 percent lower breast cancer death rate than women who had neither.
However, they also found that women over the age of 70 who were treated by the special teams had an 8 percent lower death risk from breast cancer, even though they had not received mammograms.
What this suggests, and what Dr. H. Gilbert Welch wrote in an accompanying editorial, is that mammograms may have only reduced the cancer death rate by 2 percent -- an amount so small it may as well be zero. Unfortunately, other public health agencies appear to be ignoring the evidence and the USPSTF guidelines, as both the National Cancer Institute and the American Cancer Society continue to recommend mammograms every year or two for women 40 years of age and older.
What are the Risks of Mammography?
What the imaging industry doesn't want you to know, but what the U.S. Preventive Task Force evidently saw, is that mammography not only is sadly lacking in accuracy, but it can be dangerous as well. Perhaps most notably, the radiation risks from routine mammography pose significant cumulative risks; mammograms expose your body to radiation that can be 1,000 times greater than that from a chest x-ray, which may pose a cancer risk over time. Even the National Cancer Institute (NCI) states:
"The risk of harm from this [mammography] radiation exposure is low, but repeated x-rays have the potential to cause cancer."
They also point out several other mammogram risks on their government site, including:
- False negative results: “Overall, screening mammograms miss up to 20 percent of breast cancers that are present at the time of screening.”
- Overdiagnosis and overtreatment: “ … they [mammograms] can also find cancers and cases of DCIS that will never cause symptoms or threaten a woman’s life, leading to “overdiagnosis” of breast cancer. Treatment of these latter cancers and cases of DCIS is not needed, leading to “overtreatment.”
So it is important that you weigh these potential risks against the benefits of the procedure, which, again, studies have shown to be questionable at best.
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 watch my one-hour free lecture on vitamin D to find out what your optimal vitamin D levels should be and how to optimize them.
- Get plenty of natural vitamin A. There is evidence that vitamin A also plays a roll 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 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).
- 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.
- Improve Your Insulin Receptor Sensitivity. The best way to do this is by avoiding sugar and grains and making sure you areexercising, especially with Peak 8.
- 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 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 here.
- 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. Even electric blankets can increase your cancer risk.