Should Mammograms be Phased Out?

By: Dr. Christine Horner

For over 40 years, women have been told the best way to lower their risk of dying of breast cancer is by getting a yearly mammogram. But recently, several well-designed studies have found this recommendation may not be true. Researchers conclude the value of mammograms has been overrated and the harm they can cause severely underrated. So much so, that in truth, their detriment may outweigh their benefits.

In 2013, a landmark study was published in the Cochrane Database System Review which combined the data from 10 of the best mammography studies. This meta-analysis was considered highly significant because it included an exceptionally large number of women: 600,000! After pooling and analyzing all of the data, the researchers concluded that there is ?no evidence that mammography screening reduces overall mortality.?

In addition, they found an extremely significant problem with this screening tool. Thirty percent of the ?early breast cancers? detected by mammograms in reality were not breast cancers at all and would never have become a problem! In other words, for every 2,000 women invited for screening for 10 years, the researchers stated that only one will avoid dying of cancer while 10 healthy women will be unnecessarily treated with surgery, radiation, and chemotherapy.

Another major study published in 2012 in the prestigious New England Journal of Medicine entitled, ?Effect of Three Decades of Screening Mammography on Breast-Cancer Incidence,? came to a similar conclusion.

The researchers said, ?Despite substantial increases in the number of detected cases of ?early-stage breast cancer,? mammography screening has only marginally reduced the rate at which women present with advanced cancer. Although it is not certain which women have been affected, the imbalance suggests that there is substantial over-diagnoses, accounting for nearly a third of all newly diagnosed breast cancers; and that screening is having, at best, ?only a small effect on the rate of death from breast cancer.? The researchers added, ?We estimated that breast cancer was over-diagnosed in 1.3 million U.S. women in the past 30 years. In 2008, breast cancer was over-diagnosed in more than 70,000 women; this accounted for 31% of all breast cancers diagnosed.?

This past February, another landmark study was published in The British Medical Journal which reported the results of a randomized screening trial which analyzed breast cancer incidence and mortality over 25 years.

At the beginning of the study, women were randomly assigned into two groups in which half the women were to receive an annual mammogram; and the other half were to receive only an annual physical examination. The reason this study is so significant is because of the way it was designed and the length of follow-up. A prospective, randomized trial is considered the ?gold standard? as a study design because it gives the most accurate scientific data. When it comes to breast cancer mortality statistics, a minimum of 20 years of follow-up is required.

This study followed women for 25 years-the longest of any mammography study to date. The results of this study were the same as other studies: There was ?no evidence that mammography screening reduces overall mortality.?

Mammograms: The Problems Outweigh the Promise

There are many problems with mammograms that have been under-reported leading to a false sense that mammograms are a much better test than they actually are. Mammograms are not infallible, and therefore should never have been recommended as a stand-alone test. Their accuracy rate is not reliable.

Mammograms:

  • Fail to produce useful results for large groups of women, including those who are young (less than 40 years old) or have breasts that are:
    • Dense
    • Small
    • Large
    • Reconstructed
    • Augmented with implants
  • Deploy ionizing radiation which can cause breast cancer
  • Miss 20-30% of breast cancers
  • Produce high false positive rates-80% of what mammograms call ?suspicious? and need to be biopsied are actually benign
  • Over-diagnose in 21% to 30%, leading to unnecessary treatment with potentially serious complications
  • Fail to prevent. They only detect already established tumors.

Swiss Medical Board Takes the Lead

Because of all the shortcomings of mammograms, the Swiss Medical Board published a statement in the February 2014 issue of The New England Journal of Medicine recommending that mammography screening programs be phased out. They said, ?From an ethical perspective: a public health program that does not clearly produce more benefits than harm is hard to justify.?

Safe and Effective Alternative Tests

If mammography has now been shown to be ineffective and risky, what can you do for breast cancer screening instead? Fortunately, there are several excellent alternative tests. First, one caveat: No test is perfect. However, research shows the best results come from doing a combination of at least three examinations. My recommendation is to get annual evaluations using thermography, ultrasound, and physical exam.

Thermography

Before a tumor starts to grow, new blood vessels grow into the area. But, these blood vessels are not normal. They grow in abnormal patterns and produce excessive heat. Thermography is a completely safe infra-red picture that can ?see? these physiological changes years before they become cancerous. Infra-red technology uses a camera to take a picture that does not use radiation. Thermography does not have any of the limitations of mammography. It is effective for all ages, breast sizes and densities, and is not hindered with the presence of implants, or reconstruction.

Ultrasound

Ultrasound technology uses harmless sound waves to evaluate the physical properties of the breasts. More sophisticated ultrasounds include ?elastography ultrasound? (EU) and 3-D ultrasound. EU uses a color mode to show the difference between stiffer cell membranes associated with cancer, and normal flexible cell membranes. A 3-D ultrasound is particularly useful for women with dense breasts.

Compared to mammography, 3-D ultrasounds are three times more sensitive than mammograms in detecting cancers in dense breast tissue. In other words, 3-D ultrasounds find many cancers that mammograms fail to discover-in fact, 300% more!

What should you do?

Research shows beyond any doubt that the value of mammograms has been greatly overestimated, and the harm underestimated. Mammograms do not improve mortality from breast cancer over simple physical exam, and are fraught with serious problems. I agree with the Swiss Board-mammography screening should no longer be recommended from an ethical standpoint. Instead, a combination of ultrasound, thermography and physical examination is a much better choice. For certain women, an MRI scan which uses a magnet rather than radiation may also be appropriate.

In addition to regular alternative screening and self-examination, you should place even more attention on breast cancer prevention. Why? Because research shows that over 95% of breast cancers could be prevented through simple but profound diet and lifestyle techniques, along with some key nutritional supplements. If you are interested in learning more about all the research-proven natural ways to minimize your risk of breast cancer, you can read about them in my book, Waking the Warrior Goddess: Dr. Christine Horner?s Program to Protect Against and Fight Breast Cancer.?

References:

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  • Gotzsche PC, Jorgensen KJ. ?Screening for Breast Cancer with Mammography.? Cochrane Database Syst Rev. 2013 Jun 4;6:CD001877. doi: 10.1002/14651858.CD001877.pub5.
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  • ?Zhi, H. et al ?Comparison of Ultrasound Elastography, Mammography, and Sonography in the Diagnosis of Solid Breast Lesions.? J Ultrasound Med. 2007 Jun;26(6):807-15.
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