ARE MAMMOGRAMS GOOD, SAFE, NECESSARY?


We all know what a mammogram is, but should we be getting them? This is Part 1 of a 2 part Blog, about good advice for maintaining healthy breast.

Everybody has heard of mammograms, especially if your between the age of 40 and 75, where your Doctor will recommend a yearly mammogram, followed by an ultrasound. When I had my last mammogram and experienced the complete violation of my breast and the resulting pain, then followed by the much gentler ultrasound, supposedly to confirm in more specific detail, any discrepancy the mammogram may have detected. It occurred to me that if the mammogram by itself was not conclusive in its findings which needed to be confirmed by the ultrasound, then why do we need to do the painful and sadistic mammogram anyway?

So I made up my mind that the next time I did a breast screening, that I would only have the ultrasound, having already carried out regular breast checks myself at home. Having come to that conclusion, I was pleasantly surprised and vindicated when I read an article written by Dr Mercola in realfarmacy.com , “Why mammography Screening is being abolished in Switzerland.” This article was written about an independent health technology assessment initiative, undertaken by the Swiss Medical Board.

It was conducted over a year, reviewing the available evidence, by a team of experts including a Medical Ethicist, a Clinical Epidemiologist, a Pharmacologist, an Oncologic Surgeon, a Nurse Scientist, a Lawyer, and a Health Economist.They became ‘increasingly concerned’, that

“the ‘evidence’ simply did not back up the global consensus of other experts in the field, suggesting that mammograms were safe and capable of saving lives.”

They found that mammography appeared to only prevent 1 death for every 1,000 women screened, while causing harm to many more. As a result of their findings, which were made public in February 2014, they recommended that no new mammography programs should be introduced and put a time limit on the existing programs. They also advised that women should be told about the benefits and harms of screening, in asymptomatic populations; a sentiment echoed around the globe.

Two members of the Swiss Medical Board of experts, later published in the The New England Journal of Medicine, the three main factors that helped the board to come to their conclusion.

  1. Outdated Clinical Trials - They questioned

“ Could the modest benefits of mammography screening, in terms of breast cancer mortality that was shown in trials initiated between 1963 & 1991, still be detected in a trial conducted today?” This when taking into account, that modern breast cancer treatment has a much higher prognosis today, than from even two decades ago.

2. They were very concerned about how the benefits did not clearly outweigh the potential harms. They cited two studies first from the British Medical Journal (BMJ 2014, Feb. 11; 348 g366) which carried out one of the largest and longest studies of mammograms so far, involving 90,000 women over 25 years!

They concluded that “mammograms have absolutely NO impact on breast cancer mortality.”

Death rates were shown to be almost identical between those who got annual mammograms and those who did not.

However, 22% of screen detected invasive breast cancers were over-diagnosed; leading to unnecessary treatment!

“This means that 10% of the 44,925 healthy women in the screening group, were diagnosed with a treatment for breast cancer unnecessarily, which resulted in needless surgical interventions, radiotherapy, chemotherapy or some combination of these therapies.”

They then concluded if screening reduces breast cancer mortality by 15%, and over diagnosis over treats 30%, that for every 2,000 women screened over 10 years, 1 will avoid dying and 10 healthy women, who without a mammogram would not have been diagnosed, would be treated unnecessarily. To back this conclusion up, a “Cochrane Collaboration” also found no evidence that mammography screening had an effect on overall mortality. (Cochrane Database Syst. Rev. 2013, June 4:6:CD001877)

The Swiss group also noted the serious mental distress and anxiety, that more than 200 women will have, as a result of false positive findings!

3. That women surveyed believed that mammography decreases the risk of death from breast cancer by 80 deaths per 1,000 women tested; while in reality it only prevented 1 death in 10,000 women!

They seriously questioned how women can make an informed choice, if they overestimated the benefits of having a mammogram so much. Obviously they cannot!

Rather than informing women that the science baking the benefits of having mammograms is lacking, we instead are told that missing a yearly mammogram is the most irresponsible thing you can do, which it clearly is not.

It leaves us questioning how much of this entire procedure is based on a profit agenda, rather than on a preventative health maintenance agenda. Especially considering that these studies have shown that more women are harmed as a result of regular mammograms than are saved by them. This is especially true for those women that would have experienced cancer causing radiation as part of their treatment, or the chemical chemotherapy cocktails, for no apparent reason.

This does not even take into consideration, that for women with dense breast tissue, that mammograms are all but useless as it is akin to trying to find a snowflake in a snowstorm! To this end, California, Connecticut, New York, Virginia & Texas have all passed Laws making it mandatory for Radiologists to tell patients with dense breast tissue, that mammograms are basically useless. My own sister was stressed, thinking that she had breast cancer, which she did not, for this very reason; because the Radiologist chose a profitable practice, over the ethical need to share this information.

Another group of women at risk are those with BRCA 1/2 mutation, which can increase the risk of breast cancer. These women are often recommended to have a mammogram every year, starting as young as aged 25. This is even though a 2012 study published in BMT, showed that women with this mutation who were exposed to diagnostic radiation before age 30, were twice as likely to develop breast cancer! They also found that this kind of radiation-induced cancer, was dose related, meaning that the higher the dose, the greater the chance of getting cancer. Despite this, these same ladies are told by some experts, to still do regular mammograms???

Next weeks blog will discuss the alternatives to mammograms, which are effective, harmless and cheap, which women can choose in order to help prevent and detect breast cancer early.

Please comment below as I would love to know what you think about this topic?

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