Wednesday 12 February 2014 – 12am PST
Copyright: Medical News Today
According to a study conducted by researchers in Canada and published in the BMJ, annual screening for breast cancer does not reduce likelihood of dying from cancer any more than physical examination or usual care do in women aged 40-59.
Cancers of the breast detected in screening (or “mammography”) are, on average, smaller than breast cancers that can be detected through physical examination. And experts know that women with small breast cancers have a better chance of long-term survival than women with large breast cancers.
But experts cannot be sure that this better chance of survival is because of screening, or if this increased survival is influenced by other factors.
These include factors called “lead time bias” and “over-diagnosis.” Lead time bias is when testing increases perceived survival time without affecting the course of the disease. Over-diagnosis is the clinical term for the detection of harmless cancers that will not result in symptoms during a patient’s lifetime or cause them to die.
As breast cancer screening occurs annually for some women as part of an effort to lower breast cancer mortality rates, the researchers behind this new study wanted to measure how effective annual screening is in preventing death from breast cancer.
“It is true that if you find cancer early it could be at a more treatable stage,” study author Prof. Anthony B. Miller told Medical News Today. “But there is no evidence that early detection affects the inherent biology of the cancer. Indeed it is possible that finding the cancer at an earlier stage will result in undertreatment. There is some evidence that is so.”
“In our study, and in some other screening studies, those whose cancers were detected by mammography seemed to have more rapidly progressive disease. In addition, the mere fact that a cancer is detected by screening does not guarantee a benefit from detecting that cancer.”
This was a large, long-term study across six Canadian provinces that followed 89,835 women between the ages of 40 and 59 over a period of 25 years. These women were randomly divided into two groups. The mammography group received one screening every year for 5 years, whereas women in the control group were screened only once.
Over the entire 25-year study period, a total of 3,250 women in the mammography group and 3,133 in the control group were diagnosed with cancer. In the mammography group, 500 women died, compared with 505 women in the control group. So the mortality rates in both groups were similar.
The authors say that an excess of 142 cancers were recorded in the mammography group during the 5 years of the screening period, with 106 excess cancers recorded after a period of 15 years. From this, the authors deduce that 22% of the cancers in the mammography group were over-diagnosed.
“These cancers – comprising half of those found by mammography alone – could not have affected the woman’s lifetime,” said Prof. Miller, “instead there were adverse consequences that she had to endure, living with the knowledge that she had had breast cancer, though in fact that detection did not benefit her at all.”
“So stopping mammography screening will not result in lives lost, but lives lived with greater quality of that life,” he added.
What did other studies find?
In 2013, Medical News Today reported on a UK-based study that also found breast cancer screening does not reduce deaths from the disease.
But the findings of this study do contradict findings from some other similar studies. A Swedish study attributed a 31% reduction in mortality to mammography. But the authors of the Canadian study think that the Swedish trial was flawed and the difference is down to “an initial imbalance of the compared groups, not a benefit of screening mammography.”
A large systematic review of data from 1976 to 2008 also had different findings to the Canadian study, estimating that 31% of all breast cancers were over-diagnosed. The Canadian researchers think this difference was due to that review taking a wider age range into account than their study, which looked at women between the ages of 40 and 59 only. They think that over-diagnosis is more common in people older than this, as there are more potential causes of death as individuals age.
The researchers also admit that the result of the Canadian study may not be generalizable to all countries.
Rationale for mammography should be ‘reassessed’
Although Prof. Miller and his team assert that education, early diagnosis and clinical care remain priorities in treating breast cancer, they say that mammography does not result in a reduction in breast cancer-specific mortality for women aged 40-59 beyond that of physical examination alone or usual care in the community.
The authors say that annual breast cancer screening should be urgently reassessed by policy makers, but they anticipate resistance from medical groups with “vested interests.”
Prof. Miller told Medical News Today:
“The greatest resistance will come from radiologists, who are convinced that finding cancers results in benefit, and who also benefit financially from that belief. We have demonstrated that is not so. Others whose advice resulted in the establishment of breast screening programs will also feel threatened.
It is unfortunate that although we maintain we should practice evidence-based medicine, when that evidence is produced, there will be many who will seek the means to discredit that evidence because it is against their vested interests.”
Rather than annual breast screenings, the authors of the study would like to see funding diverted into better public education programs to convince women to seek skilled advice if they detect an abnormality in their breast, and professional education programs that ensure doctors are familiar with the latest advances in research.
by Carol Ko , Staff Writer
A new study shows that slow-growing breast lesions classified as “probably benign” commonly found with ultrasound screenings can be safely re-evaluated in 12 months instead of being immediately followed up with unnecessary biopsies and exams.
Current guidelines suggest that such lesions should be followed up either with a biopsy or with a short-term follow-up, but some doctors now say this might be unnecessary.
A growing body of evidence suggests that ultrasound is an effective supplemental tool to find cancers that mammography can’t.
“We’re finding additional lesions on ultrasound that we wouldn’t find on mammo, and vice versa. The numbers somewhat overlap,” Dr. Richard Barr, lead study researcher and professor of radiology at the Northeast Ohio Medical University, told DOTmed News.
However, ultrasound screenings have a downside: a high number of cancers detected by the modality are lesions at low-risk for turning into cancer — what doctors classify as BI-RADS 3.
Study researchers analyzed the screening of ultrasound exams and follow-up data of 2,662 women recruited between 2004 and 2006 in the American College of Radiology Imaging Network (ACRIN) trial.
Of all the trial participants, 745 low-risk lesions were detected by the screening, representing 25 percent of all ultrasound-detected lesions in the study.
However, of those 745 cases, only six were considered malignant — averaging a 0.8 percent malignancy rate overall.
Furthermore, of those six cases, suspicious changes in the cancer detected at the 12-month mark had not spread beyond the breast, meaning that the odds of these already-rare cases developing suspicious changes at the half-year mark were very low.
“Even though we waited a year to follow up, it didn’t change the prognosis,” said Barr.
Barr also cautions that because these lesions have always been automatically removed in the past, researchers still have incomplete data on these lesions and their long-term likelihood of developing into cancer.
“Though this study involved 2662 participants, we ended up with a very small number of cancers. We need larger studies that try this technique instead of short term follow-up to see if this is true,” he said.
In recent years, cancer screening programs such as mammography have come under fire from critics who say that their high rate of false positives, unnecessary biopsies and over-treatment do more harm than good.
The conversation around over-diagnosis applies to more than just screenings: earlier this month a panel affiliated with the National Cancer Institute also came out with a recommendation to redefine cancer to rein in over-treatment and over-diagnosis for certain low-risk lesions — acknowledged by a growing chorus of doctors to be a real medical problem.
And with health care cost reduction dominating the conversation within the industry, ideas around curbing over-treatment are becoming more popular. “We can also make a significant impact on the cost of follow-up,” said Barr.
July 19, 2013
by Carol Ko , Staff Writer
This first appeared in the July 2013 issue of DOTmed Business News
It’s no secret that getting a mammogram is a nerve-wracking experience for many women. Although some studies suggest women at higher risk for breast cancer are more likely to get regular screens, others show that the most fearful women are the least likely to be screened.
To that end, many imaging centers are working to try to put women at ease by making their mammography screening more than just a test. “We want to make sure they’re the most important person at that given moment,” explains Barbara Marshall of Battlefield Imaging.
The facility, based in Ringgold Georgia, is designed to convey a spa-like feeling, complete with oversized furniture, flat screen TVs and a nutrition café. Even the center’s mammography machines supplied by Siemens contribute to the atmosphere, coming in different colors like pink and green, and equipped with mood lighting designed to soothe the patient. “It’s been the talk of the community,” says Marshall. “The patients are surprised when they see it, they say, this is beautiful.”
But even as doctors are trying to encourage more of the population to get screened regularly, others are questioning whether routine annual screenings for certain women are necessary at all. [Read More…]
Article Date: 11 Jun 2013 – 9:00 PDT
Posted at: MedicalNewsToday.com
A new UK study suggests screening for breast cancer does not reduce deaths from the disease. The study, which looked at nearly 40 years of breast screening, adds to the controversy surrounding whether it is screening or improvement in treatment that accounts for the fall in rates of death from breast cancer.
The researchers from the Department of Public Health at the University of Oxford, report their findings online in the June issue of the Journal of the Royal Society of Medicine.
For their study, lead author Toqir Mukhtar and colleagues analyzed mortality statistics recorded before and after 1988, the year that the National Health Service Breast Screening Programme began.
From The Daily Health. 12th June 2013
We’ve been saying this for a while now: Mammograms simply don’t crack it when it comes to saving lives.
In fact, studies have shown that for every 2,000 women over the age of 50 who are screened every year for a decade with this archaic and painful screening method, approximately one breast cancer death is avoided.
Call me crazy, but that hardly sounds like an effective method of breast cancer detection… despite what the mainstream may try to claim to the contrary.
Dividing the camp [Read More…]
By PEGGY ORENSTEIN
Published: April 25, 2013
So when the radiologist found an odd, bicycle-spoke-like pattern on the film — not even a lump — and sent me for a biopsy, I wasn’t worried. After all, who got breast cancer at 35?
It turns out I did. Recalling the fear, confusion, anger and grief of that time is still painful. My only solace was that the system worked precisely as it should: the mammogram caught my tumor early, and I was treated with a lumpectomy and six weeks of radiation; I was going to survive.
By coincidence, just a week after my diagnosis, a panel convened by the National Institutes of Health made headlines when it declined to recommend universal screening for women in their 40s; evidence simply didn’t show it significantly decreased breast-cancer deaths in that age group. What’s more, because of their denser breast tissue, younger women were subject to disproportionate false positives — leading to unnecessary biopsies and worry — as well as false negatives, in which cancer was missed entirely.
Those conclusions hit me like a sucker punch. “I am the person whose life is officially not worth saving,” I wrote angrily. When the American Cancer Society as well as the newer Susan G. Komen foundation rejected the panel’s findings, saying mammography was still the best tool to decrease breast-cancer mortality, friends across the country called to congratulate me as if I’d scored a personal victory. I considered myself a loud-and-proud example of the benefits of early detection.
Sixteen years later, my thinking has changed. As study after study revealed the limits of screening — and the dangers of overtreatment — a thought niggled at my consciousness. How much had my mammogram really mattered? Would the outcome have been the same had I bumped into the cancer on my own years later? It’s hard to argue with a good result. After all, I am alive and grateful to be here. But I’ve watched friends whose breast cancers were detected “early” die anyway. I’ve sweated out what blessedly turned out to be false alarms with many others.
Recently, a survey of three decades of screening published in November in The New England Journal of Medicine found that mammography’s impact is decidedly mixed: it does reduce, by a small percentage, the number of women who are told they have late-stage cancer, but it is far more likely to result in overdiagnosis and unnecessary treatment, including surgery, weeks of radiation and potentially toxic drugs. And yet, mammography remains an unquestioned pillar of the pink-ribbon awareness movement. Just about everywhere I go — the supermarket, the dry cleaner, the gym, the gas pump, the movie theater, the airport, the florist, the bank, the mall — I see posters proclaiming that “early detection is the best protection” and “mammograms save lives.” But how many lives, exactly, are being “saved,” under what circumstances and at what cost? Raising the public profile of breast cancer, a disease once spoken of only in whispers, was at one time critically important, as was emphasizing the benefits of screening. But there are unintended consequences to ever-greater “awareness” — and they, too, affect women’s health.
Breast cancer in your breast doesn’t kill you; the disease becomes deadly when it metastasizes, spreading to other organs or the bones. Early detection is based on the theory, dating back to the late 19th century, that the disease progresses consistently, beginning with a single rogue cell, growing sequentially and at some invariable point making a lethal leap. Curing it, then, was assumed to be a matter of finding and cutting out a tumor before that metastasis happens.
The New York Times Articles
By: H. Gilbert Welch
Written: November 21, 2012
FOR decades women have been told that one of the most important things they can do to protect their health is to have regular mammograms. But over the past few years, it’s become increasingly clear that these screenings are not all they’re cracked up to be. The latest piece of evidence appears in a study in Wednesday’s New England Journal of Medicine, conducted by the oncologist Archie Bleyer and me.
The study looks at the big picture, the effect of three decades of mammography screening in the United States. After correcting for underlying trends and the use of hormone replacement therapy, we found that the introduction of screening has been associated with about 1.5 million additional women receiving a diagnosis of early stage breast cancer.
That would be a good thing if it meant that 1.5 million fewer women had gotten a diagnosis of late-stage breast cancer. Then we could say that screening had advanced the time of diagnosis and provided the opportunity of reduced mortality for 1.5 million women.
But instead, we found that there were only around 0.1 million fewer women with a diagnosis of late-stage breast cancer. This discrepancy means there was a lot of overdiagnosis: more than a million women who were told they had early stage cancer — most of whom underwent surgery, chemotherapy or radiation — for a “cancer” that was never going to make them sick. Although it’s impossible to know which women these are, that’s some pretty serious harm.
But even more damaging is what these data suggest about the benefit of screening. If it does not advance the time of diagnosis of late-stage cancer, it won’t reduce mortality. In fact, we found no change in the number of women with life-threatening metastatic breast cancer.
The harm of overdiagnosis shouldn’t come as a surprise. Six years ago, a long-term follow-up of a randomized trial showed that about one-quarter of cancers detected by screening were overdiagnosed. And this study reflected mammograms as used in the 1980s. Newer digital mammograms detect a lot more abnormalities, and the estimates of overdiagnosis have risen commensurately: now somewhere between a third and half of screen-detected cancers.
The news on the benefits of screening isn’t any better. Some of the original trials from back in the ’80s suggested that mammography reduced breast cancer mortality by as much as 25 percent. This figure became the conventional wisdom. In the last two years, however, three investigations in Europe came to a radically different conclusion: mammography has either a limited impact on breast cancer mortality (reducing it by less than 10 percent) or none at all.
Feeling depressed? Don’t be. There’s good news here, too: breast cancer mortality has fallen substantially in the United States and Europe. But it’s not about screening. It’s about treatment. Our therapies for breast cancer are simply better than they were 30 years ago.
As treatment improves, the benefit of screening diminishes. Think about it: because we can treat most patients who develop pneumonia, there’s little benefit to trying to detect pneumonia early. That’s why we don’t screen for pneumonia.
So here is what we now know: the mortality benefit of mammography is much smaller, and the harm of overdiagnosis much larger, than has been previously recognized.
But to be honest, that general message has been around for more than a decade. Why isn’t it getting more traction?
The reason is that no other medical test has been as aggressively promoted as mammograms — efforts that have gone beyond persuasion to guilt and even coercion (“I can’t be your doctor if you don’t get one”). And proponents have used the most misleading screening statistic there is: survival rates. A recent Komen foundation campaign typifies the approach: “Early detection saves lives. The five-year survival rate for breast cancer when caught early is 98 percent. When it’s not? It decreases to 23 percent.”
Survival rates always go up with early diagnosis: people who get a diagnosis earlier in life will live longer with their diagnosis, even if it doesn’t change their time of death by one iota. And diagnosing cancer in people whose “cancer” was never destined to kill them will inflate survival rates — even if the number of deaths stays exactly the same. In short, tell everyone they have cancer, and survival will skyrocket.
Screening proponents have also encouraged the public to believe two things that are patently untrue. First, that every woman who has a cancer diagnosed by mammography has had her life saved (consider those “Mammograms save lives. I’m the proof” T-shirts for breast cancer survivors). The truth is, those survivors are much more likely to have been victims of overdiagnosis. Second, that a woman who died from breast cancer “could have been saved” had her cancer been detected early. The truth is, a few breast cancers are destined to kill no matter what we do.
What motivates proponents to use these tactics? Largely, it’s sincere faith in the virtue of early diagnosis, the belief that screening must be good for women. And 30 years ago, when we started down this road, they may have been right. In light of what we know now, it is wrong to continue down it. Let’s offer the proponents amnesty and move forward.
What should be done? First and foremost, tell the truth: woman really do have a choice. While no one can dismiss the possibility that screening may help a tiny number of women, there’s no doubt that it leads many, many more to be treated for breast cancer unnecessarily. Women have to decide for themselves about the benefit and harms.
But health care providers can also do better. They can look less hard for tiny cancers and precancers and put more effort into differentiating between consequential and inconsequential cancers. We must redesign screening protocols to reduce overdiagnosis or stop population-wide screening completely. Screening could be targeted instead to those at the highest risk of dying from breast cancer — women with strong family histories or genetic predispositions to the disease. These are the women who are most likely to benefit and least likely to be overdiagnosed.
One final plea: Can we please stop using screening mammography as measure of how well our health care system is performing? That’s beginning to look like a cruel joke: cruel because it leads doctors to harass women into compliance; a joke because no one can argue this is either a public health imperative or a valid measure of the quality of care.
Breast cancer is arguably the most important cancer for a nonsmoking woman to care about. Diagnostic mammography — when a woman with a breast lump gets a mammogram to learn if it’s something to worry about — is an important tool. No one argues about this. Pre-emptive mammography screening, on the other hand, is, at best, is a very mixed bag — it most likely causes more health problems than it solves.
H. Gilbert Welch is a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice and an author of “Overdiagnosed: Making People Sick in the Pursuit of Health.”
By Johnnie Ham, MD, MBA
Original Article at Mercola.com
Many women are completely unaware that the science backing the use of mammograms is sketchy at best. As was revealed in a 2011 meta-analysis by the Cochrane Database of Systemic Reviews, mammography breast cancer screening led to 30 percent overdiagnosis and overtreatment, which equates to an absolute risk increase of 0.5 percent.
There’s also the risk of getting a false negative, meaning that a life-threatening cancer is missed.
Unfortunately, even though some high-profile people agree that mammography has limitations as well as dangers, others prefer to ignore the science and continue to campaign for annual screenings without so much as a hint at the risks involved.
Now, they’ve unrolled “new and improved” 3D TOMOSYNTHESIS mammogram, which still requiring mechanical compression, and delivers 30 percent more radiation!
In order to make better informed decisions, I provide my patients with all of their screening options, their strengths and weaknesses, and I reinforce that they have a right to utilize those options. Some of the options may include; self and clinical breast exams, thermography, ultrasound and/or MRI. My role as a doctor is to diagnose and treat, but I am also an educator. I want my patients’ focus to be on prevention to improve their health and well-being.
The Industry of Cancer
Breast cancer has become big business, starting with the multi-billion dollar goliath, mammography. No other medical screening has been as aggressively promoted. My passion is providing integrative primary care as an MD for hundreds of patients. I also have over 23 combined years of military experience as an OB/GYN, trauma surgeon, experimental test pilot, and master army aviator.
My training prepared me to navigate through challenging, and sometimes life threatening situations. Unfortunately, most women do not have the training I received, yet they could certainly use some of it to help navigate through the fear based methods of the breast cancer industry.
The tide of thought on mammography’s benefits is rapidly changing as evidenced by recently published studies in the Archives of Internal Medicine,1 the Lancet Review,2 the British Medical Journal3 and the Nordic Cochrane Center;4 and the fact that the US Preventative Services Task Force5 and the Canadian Task Force on Preventative Health Care.6
Why are Nearly All Health Care Professionals Not Following Current Mammogram Recommendations?
Nearly every woman age 40 and older continues to be told by their primary care physician, their gynecologist, the media, self-proclaimed advocacy groups, and even their medical insurance carrier, “get your annual mammogram!” despite the fact that nearly every recent authoritative study concludes that women should know all of the facts before agreeing to a mammogram screening. Yet nearly all health care professionals insist on mammograms. If a woman dare refuse, she may be chastised or worse, threatened. These efforts have gone beyond persuasion to guilt and even coercion, “I can’t be your doctor if you don’t get a mammogram.” Women need to stop this runaway train, not only for their sake, but for the sake of their daughters.
In November 2012, the New England Journal of Medicine published a study by Dr Archie Bleyer, MD from The Oregon Health Sciences Center, and his co-author, Dr H. Gilbert Welch, M.D., M.P.H., from Dartmouth, challenging the validity of mammogram screenings and concluded that mammograms have little to no influence in the reduction of the number of women who ultimately die of breast cancer.7
Thirty years of US government data studied found that as many as 1/3 of cancers detected by mammography may not have been life threatening, and that over 1 million women have been over-diagnosed; leading to unnecessary treatments involving disfiguring surgeries; radiation and chemotherapy. They also showed that mammogram screenings have increased from about 30 percent of women 40 and older in 1985, to about 70 percent of women screened, proving how effective we have been at convincing women they need to get a mammogram.
I have witnessed this strategy for decades and I have seen the profound psychological effect it has had on many of my patients. This paradigm has seriously misled women regarding the actual effectiveness, and the benefits vs. potential dangers of mammograms. They also have women confused about the erroneous belief that mammography is their only tool. Some women actually believe mammograms can prevent cancer, or do not realize they have the right to say, no!
Most women comply with the current “gold standard” in fear of the ravages of breast cancer, convinced their annual mammogram will save their life through early detection. It is nearly impossible for them to negate decades of slick marketing, annual reminders from radiology imaging centers and the exploitation of October’s Breast Cancer Awareness month blitz. All of these efforts beautifully packaged, tied up with a pretty pink ribbon.
I take my oath to do no harm very seriously. After many years of research, clinical practice; and due to my wife’s personal experience with mammography, I cannot in good conscience recommend mammograms. I inform my patients that mammograms are considered the current “gold standard”, but I also make certain they know the facts about the screening and that there are other screen tools available.
Facts and Persisting Concerns: Mammograms
More women are refusing mammograms. This is reflected in the dramatic decline of 4.3 percent in 2010. Previously, mammography use had increased annually by 1 percent between 2005 and 2009. Mammograms:
- Are incorrect 80 percent of the time (providing a false negative or false positive)
- Require repeated ionized radiation that can cause cancer
- Use compression, which can damage breast tissue or potentially spread cancer
- Are not effective for up to 50 percent of women (women with dense breasts or implants)
- Can lead to over-diagnosis and over-treatment of non-invasive cancers
- Can lead to the disturbing practice of “preventative” double mastectomies
What is Mammography Industries Solution?
The “new and improved” 3D TOMOSYNTHESIS mammogram, still requiring mechanical compression, and 30 percent more radiation! We know all levels of ionizing radiation can cause cancer but, astonishingly, radiologists still want you to have your traditional mammogram screening first, followed by tomosynthesis mammogram for those with dense breasts or an area of suspicion. When my local Radiology Community approached me in an effort to disprove my concerns, I posed one simple question: Can you show me, one well-designed study that proves screening mammography has improved ultimate survival rates? I am still waiting for their answer.
We cannot prove that screening mammography improves the ultimate survival rate. A quick look at the SEER data would suggest treatment has improved, by a decline in the death rate since 1998 of 1.9 percent.8 For every 1,000 women in this country, today 125 will ultimately be diagnosed with breast cancer. Of those 125, over 40 will be over-diagnosed, and receive treatment they never needed, and suffer the potential psychological consequences of a cancer diagnosis. That leaves about 80, of which 28 will die of breast cancer. The decline since 1998 in the death rate means that for our 28 women who would have otherwise died from breast cancer, 2 more out of 1000 women diagnosed with breast cancer survived due to over a decade of treatment advances.
But, we really don’t know what actually saved those 2 women, of the 125 diagnosed with breast cancer for every 1,000 women in our group. If we attribute anything to lifestyle changes we have emphasized recently (which has been shown repeatedly to work), then either we wipe out any improved survival rate from decades of treatment advances, or worse, we cause death to some of those 40 women who were over-diagnosed!
If You Have Dense Breasts it is Even Worse
Breast density laws have now been passed in California,9 Connecticut, New York, Virginia and Texas making it mandatory for radiologists to inform their patients, who have dense breast tissue (40 to 50 percent of women) that mammograms are basically useless for them. Dense breast tissue and cancer both appear white on an X-ray, making it nearly impossible for a radiologist to detect cancer in these women. It’s like trying to find a snowflake in a blizzard. A law is now being considered at a Federal level as well.
Some radiologists already provide density information to their patients, and encourage them to utilize other options like thermography, ultrasound and/or MRI. I believe it reasonable for a woman to trust that her radiologist is not withholding vital density information. Unfortunately, many have kept this potentially lifesaving data from women for decades, and our government agencies have failed to protect them from this unethical practice.
I know it is extremely difficult to navigate through all of the contradicting information and study findings. It would better serve women if efforts, money and resources were utilized on educating women on cancer prevention, being that 95 percent of disease is lifestyle related. Yet 40,000 women continue to die of breast cancer each year. The only way to reduce this number is through utilizing preventative therapies.
Basic Cancer Prevention Strategies
As mentioned above, many women are completely unaware that the science backing the use of mammograms is sorely lacking, and that more women are being harmed by regular mammograms than are saved by them. Many also do not realize that the “new and improved” 3D tomosynthesis mammogram actually delivers even MORE ionizing radiation than the older version. This is not a step forward…
Please understand that there are other screening options, each with their own strengths and weaknesses, and you have a right to utilize those options. Also remember that in order to truly avoid breast cancer, you need to focus your attention on prevention.
A few simple, yet great options to assist in your efforts to avoid breast cancer are: making sure you are getting enough vitamin D, K2 and iodine; that you utilize lymphatic massage; use stress management techniques, exercise often, and balance your hormones naturally. It is also wise to eat a Mediterranean diet consisting of organic foods. Avoid processed and GMO foods; and toxic environments.
In my practice, I recommend breast thermography, even for young women to get a baseline, but also combine the imaging not only with a review of the findings, but more importantly, as a venue to educate women on breast health. It is far more effective to prevent breast cancer, than it is to wait until it is there and then treat it. We are all different so make sure you consult with your doctor and do your own research before utilizing any of these suggestions.
The advice I give all of my patients is to be your own health advocate, do your own research and always ask questions before agreeing to any therapy or treatment, screening and/or procedure.
About the Author:
Dr. Johnnie Ham, MD, former Lieutenant Colonel of the US Army Medical Corps, is the Medical Director of Coastal Prestige Medical Services, Pismo Beach, CA. Coastal Prestige Physicians offer top-notch comprehensive healthcare, with an emphasis on evidence-based primary care and preventive health for all ages.
Mammograms can detect breast cancer early, and save lives. But they can also lead to false alarms that take a heavy psychological toll, a new study found.
The Danish study of more than 1,300 women found that those who received “false positive” results on their screening mammograms reported symptoms of anxiety and depression that still lingered three years later, long after a cancer diagnosis had been ruled out. Their psychological well-being was more closely matched to that of breast cancer patients than healthy women.
“It is comparable to a life crisis, like getting divorced or the death of a close family member,” study author Dr. John Brodersen of the University of Copenhagen’s department of public health said of mammogram false positives. “People don’t trust their body anymore; they interpret their body systems differently; they go to the doctor more frequently the search for security to know they are healthy. These women are turned from healthy people to people [at] risk, to people who are close to being sick.”
Women who had false positives were also more likely to report disturbances in sleep and sexuality, according to the study, published today in the journal Annals of Family Medicine.
One in eight American women will battle breast cancer in her lifetime, according to the American Cancer Society. In 2013, roughly 232,340 women will be newly diagnosed with invasive breast cancer. Nearly 40,000 women will die from the disease.
The U.S. Preventive Services Task Force recommends biennial mammograms for women between the ages of 50 and 74. The test, an x-ray of the breast, is often the first step in diagnosing breast cancer. But it can also lead to unnecessary tests and procedures, such as biopsies and lumpectomies, not to mention stress.
“Any abnormal finding sends a woman into a tailspin,” Lillian Shockney, a breast cancer nurse at Johns Hopkins Hospital in Baltimore, told ABCNews.com. “It’s awful. But she would rather know if she has something ominous in her breast or not.”
A 2012 study of 100,000 women suggested the risks of mammogram false positives may even outweigh the benefits. It’s estimated that for one woman’s life to be saved, 2,000 women have to be screened, leading to 200 false positives and 10 unnecessary surgeries.
“The default is to assume that screening must be good; catching something early must be good,” study author James Raftery, professor of health technology assessment at the University of Southampton, U.K., told ABCNews.com at the time. But “breast cancer screening was introduced because it was assumed to benefit women’s health overall. And the side effects are pretty damn serious.”
Breast cancer screening guidelines have been a topic of ongoing of debate among researchers, with some studies supporting more frequent screening for women over 40 and others suggesting a minimal role for mammography in the reduction of breast cancer mortality overall.
In June 2012, the American Medical Association came out in support of routine mammography for women starting at age 40, bucking the USPSTF recommendation. And in Janurary 2013, a review of Medicare data found that more then $410 million was spent on screening women 75 and older — another group for whom mammography is not recommended.
But Americans appear to like their screening, according to a 2011 Gallup poll that found that 58 percent of responders were satisfied with the current level of screening and 31 percent wished there was more. A mere 7 percent thought there was too much.
Brodersen hopes his study will highlight the risks of overscreening.
“We are producing a need for health care that is unnecessary,” he said. “Please stop screening every year from age 40 to death. Trust the USPSTF recommendation.”
Dr. Samreen Hasan contributed to this story.