Stop Lying To Women About Mammography
14 Nov 2007
What’s a "sacred cow"? One is a medical belief that’s been etched in stone for years. For instance, to question the value of cholesterol lowering drugs is like damning motherhood. Or to challenge the belief that mammography does not save many lives may condemn you to hell. But everyone should be asking probing questions about the sacred cow of mammography.
Dr. Peter Gotzsche, a leading Danish researcher, claims there is no convincing evidence that annual mammograms decrease the risk of death from breast cancer.To reach this conclusion Gotzsche and his colleagues analyzed international studies on half a million women. Dr. Michael Baum, professor of surgery at University College, London, England says, "The latest evidence shifts the balance towards harm and away from benefits".
Today, women, health care professionals and the media all focus on the benefits of regular mammograms. Mentioning their negatives is considered unethical. But there is bad news and it’s unethical not to publish it.
Many women are unaware that mammograms may do more harm than good. For example, if women between the ages of 40 and 49 have regular screening, three years later these patients have 2X the death rate from breast cancer than unscreened women!
The cruel truth is that whatever way you slice the cake the decrease in cancer deaths by mammography is modest. Experts say that you have to screen 2,000 women for 10 years for one benefit. That’s why some authorities argue women should not be exposed to radiation for such poor results. Or expose them to worry. I’ve seen first-hand the profound anxiety of the patient whose report states more x-rays must be taken because of a questionable first result. Then real fear sets in when the second report can’t separate a cancerous lump from a benign one. More sleepless nights follow while waiting to have a breast biopsy and further delay for the result. Even if the final report is good, many worry that doctors might still have missed the cancer.
This is not a minor happening. Women who have regular mammograms for 10 years have a 49 percent chance of being recalled at some time for a biopsy. These terrible odds are much worse than Las Vegas.
Mammograms can, on the other hand, also provide a false sense of security. Studies show that they miss 30 percent of cancers in women 40-to 49 years of age.
Another concern is that squeezing breasts during mammography causes more than pain. Some authorities say this pressure may also rupture blood vessels in or around a tumour causing the cancer to spread.
I think the larger question is whether breast cancer screening should be continued since the benefits are so small. Or only used when manual breast examination detects a questionable area.
Unfortunately women die of breast cancer for one prime reason. There is no way to diagnose it early.
The Cancer Society and others have lead women to believe mammography results in early diagnosis. This is a lie. It takes eight years before a lump is large enough to detect which provides time for cancer cells to spread to other areas. This is not early diagnosis. One critic said it well, "Finding a cancer this way is damage control, not prevention".
The debate about mammography will continue as economics plays a role. To deny its benefits means a huge economic loss to everyone involved in the procedure. And who wants to admit they’ve been wrong about the benefits of mammography after stressing its need for so many years?
What is rarely mentioned by anyone is the risk of radiation. In the U.S. women are advised to have a mammogram starting at age 40 as breast tissue is dense at this age which makes breast lumps less visible. In Canada the generally accepted age is 50. This involves a considerable number of x-rays by 70 years of age. And since women are often called back for additional mammogram studies, more radiation is needed.
Next week, why some experts believe women are developing breast cancer due to previous exposure to radiation. And some shocking findings about how little most people know about radiation dosage.
