While the number of deaths caused by breast cancer has decreased, the incidence of breast cancer is still rising. According to most health experts, catching a breast tumor in its early stages increases a woman’s chances of survival by at least 17 percent. But is mammography the best way to do it?
Women that go through a mammogram are not given some very compelling information about the procedure that might actually affect their ability to give an informed consent. There are a lot of things you should know about mammograms before you decide to go through one.
General Facts
- Mammograms do not prevent breast cancer. They detect cancer that already exists. Most breast cancers have been present for six to eight years by the time they appear on mammograms.
- Mammography is a form of ionizing radiation. Radiation is a known cause of cancer, and the effects of small amounts may accumulate in the body. The risk of harm from radiation is highest in tissue where cells are rapidly changing, such as the growing breast tissue of adolescent females.
- Mammography is an imperfect test. It misses 10% of all tumors, and 25% of tumors in women younger than 50. Premenopausal women are more likely to have dense breast tissue, which appears white on an x-ray, as does cancer. So the false positive rate—the frequency of unnecessary biopsies—is twelve times higher among women under 50 than women over 50.
- The risk of radiation on women younger than 50, combined with the high incidence of both false negatives and false positives, means that routine mammography for this group may do more harm than good. For women under 50, the most powerful detection method may very well be their own two hands.
Risks and Dangers
The American Cancer Society (ACS) and the National Cancer Institute (NCI) began promoting mammograms in the early 1970s as a tool in the war against breast cancer. Mammography is the process of using low-dose X-rays to examine the human breast. The goal of mammography is the early detection of breast cancer, typically through detection of characteristic masses and/or microcalcifications. The X-ray picture of your breast can supposedly reveal tumor growths otherwise undetectable in a physical exam. Mammography is the most common method for early detection of breast cancer, the leading cause of death among American women between the ages of 44 and 55, but it has garnered a sizable opposition in the medical community because of an error rate that is still high and the amount of harmful radiation used in the procedure.
- Radiologists at the University of Guttingen say that women with an inherited, increased breast cancer risk should avoid frequent and early mammogram screening. The German researchers suggest that the low-dose X-rays used in mammograms are nearly three times as effective at mutating genes in human cells as conventional X-rays. They advise high-risk women to insist on other screening tests.
- A meta-analysis of randomized trials published in 1997 showed that screening women aged 40 to 49 resulted in an increase in deaths from breast cancer for the first ten years after beginning screening. A significant two-fold increase in breast cancer deaths after three years of screening was found.
- Another study, by Dr. Anthony Miller including approximately 40,000 women in Canada aged 50 to 59 with a 13-year follow-up, showed breast cancer mortality to be equal between one group receiving annual mammograms and another group doing physical examinations only.
- A new report by the National Academy of Sciences reiterates what even low doses of ionizing radiation pose an increased cancer risk.
- In 1976 mammographic technology delivered five to ten rads (radiation-absorbed doses) per screening, as compared to 1 rad in current screening methods. In women between the ages of 35 and 50, each rad of exposure increased the risk of breast cancer by one percent, according to Dr. Frank Rauscher, then director of the NCI.
- Annual radiological breast exams today increase the risk of breast cancer by an average of two percent a year. So over 10 years the risk of developing breast cancer will have increased 20 percent.
- Dr. John W. Gofman estimates that 75 percent of breast cancer could be prevented by avoiding or minimizing exposure to the ionizing radiation. This includes mammography, x-rays, and other medical and dental sources.
- A significant percentage of women in the United States have a gene called oncogene AC that is extremely sensitive to even small doses of radiation, which could increase their risk of mammography-induced cancer. An average of 10,000 oncogene AC carriers will die of breast cancer this year due to mammography.
- Dr. Michael P. Sherman, M.D., Ph.D. wants women to understand that, “Mammograms do not prevent cancer, they can only find an existing cancer.” The cumulative radiation damage to DNA from yearly mammograms over a woman’s lifetime increases the risk of developing breast cancer in later years.
- Mammograms have a 50% to 75% accuracy rate with many false positives leading to anxiety, stress, unnecessary medical costs, and over-treatment. More frustrating is that many tumors are missed. Not all equipment produce high quality results, and interpretation is subjective.
- The painful compression of breast tissue during the procedure itself can increase the possibility of metastasis by as much as 80%.
- Between 10 and 17% of a non-life-threatening form of cancer called ductal carcinoma in situ can be made active by the compressive force of routine mammography.
- Since mammographic screening was introduced, the incidence of ductal carcinoma in situ (DCIS) has in fact increased by 328 percent.
- Researchers Drs. Wright and Mueller of the University of British Columbia recommended the withdrawal of public funding for mammography screening, because the “benefit achieved is marginal, and the harm caused is substantial.” (Lancet, 1 Jul 1995).
- 70 to 80 percent of all positive mammograms do not, upon biopsy, show any presence of cancer.
- In a Swedish study of 60,000 women, 70 percent of the mammographically detected tumors weren’t tumors at all, they were false positives.
- Mammograms also have a high rate of missed tumors, or “false negatives.” Dr. Samuel S. Epstein, in his book, The Politics Of Cancer, claims that in women ages 40 to 49, one in four instances of cancer is missed at each mammography. The National Cancer Institute (NCI) puts the false negative rate even higher at 40 percent among women ages 40-49. National Institutes of Health spokespeople also admit that mammograms miss 10 percent of malignant tumors in women over 50.
- NCI released evidence that, among women under 35, mammography could cause 75 cases of breast cancer for every 15 it identifies.
- A Canadian study found a 52 percent increase in breast cancer mortality in young women given annual mammograms.
- Dr. Samuel Epstein also claims that pregnant women exposed to radiation could endanger their fetus. He advises against mammography during pregnancy because “the future risks of leukemia to your unborn child, not to mention birth defects, are just not worth it.” Similarly, studies reveal that children exposed to radiation are more likely to develop breast cancer as adults.
As early as 1976, John C. Bailar III, then editor of the NCI Journal, questioned the procedure by writing, “mammography may eventually cause more deaths from breast cancer than it prevents.” Since then, it is no surprise that little, if any, research has followed up this concern expressed by other medical experts including John Gofman, MD, PhD, author of Preventing Breast Cancer: The Story of a Major, Proven, Preventable Cause of This Disease, and founder of the Committee for Nuclear Responsibility (CNR); Janette D. Sherman, MD, author of Life’s Delicate Balance, Causes and Prevention of Breast Cancer, and Samuel S. Epstein, MD, author of The Politics of Cancer.
As early as September 2008, Dr. Eric P. Winer of the Dana-Farber Cancer Institute in Boston said “We all know that mammography is, in and of itself, an imperfect tool, and we clearly need to do better in the future. It is fair to say that M.R.I. will not solve all problems either.”
Screening Alternatives
Screening is an important step in fighting breast cancer, there is no doubt about it. The good news is that today there are better alternatives to mammography.
Breast Thermography is based on the principle that metabolic activity and vascular circulation in both pre-cancerous tissue and the area surrounding a developing breast cancer is almost always higher than in normal breast tissue. Cancerous tumors require and ever-increasing supply of nutrients and therefore increase circulation to their cells by holding open existing blood vessels, opening dormant vessels, and creating new ones (neoangiogenesis). This process frequently results in an increase in regional surface temperatures of the breast. Digital Infrared Imaging uses extremely sensitive medical infrared cameras and sophisticated computers to detect, analyze, and produce high-resolution diagnostic images of these temperature variations. These temperature variations may be among the earliest signs of breast cancer and/or a pre-cancerous state of the breast. Breast Thermography is able to detect cancers at a minute physical stage of development, thermography does not use x-rays, nor is there any compression of the breast. Also important, new thermography technologies do not lose effectiveness with dense breast tissue, decreasing the chances of false-negative results. It is the safest screening available today.
Some doctors are now offering digital mammograms. Digital mammography is a mammography system in which x-ray film is replaced by solid-state detectors that convert x-rays into electric signals. Though radiation is still used, digital mammography requires a much smaller dose. The electrical signals are used to produce images that can be electronically manipulated; a physician can zoom in, magnify and optimize different parts of breast tissue without having to take an additional image. Some earlier studies had suggested that digital mammography would result in fewer false positives than film mammography, but the rates of false positives for digital mammography and traditional mammography were the same. Although digital mammograms are better than traditional ones, take them with a grain of salt.
How About Molecular Breast Imaging?
M.B.I. is an experimental new technology in which small breast cancers absorb a type of radioactive molecule that can then be detected by a special camera. In other words, a radioactive mole will “light up” cancer cells inside women’s breasts and a special camera will take the money shot. How “safe” is this radioactive bug? M.B.I uses about 8 to 10 times the radiation of mammograms! You go figure. So far, whatever happens next with the radioactive tracer is non of women’s business, apparently. Doctors working with molecular breast imaging also have reported that the technique occasionally may miss a tumor that would have been picked up on routine mammography.
To make matters worse, M.B.I. would not replace mammograms for women at average risk for cancer, but it might become an additional tool for higher-risk women with a lot of dense tissue that makes tumors hard to spot on mammograms, which includes women under 50. What a great idea! The group that is more sensitive to radiation-induced cancer is being experimentally exposed to an incredible and dangerous amount of radioactive load. Once again, women’s health is being sacrificed for yet again another dangerous and aggressive screening method, all in the name of modern oncology tumor-obssesed pursuit of finding cancer rather than curing it.
So don’t believe the hype. M.B.I might be even worst than the outdated, innefective, and dangerous mammography.
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