DOES MAMMOGRAPHY SAVE LIVES?
LET'S LOOK AT THE EVIDENCE
FALSE POSITIVE: Tests that that show you have a certain disease or health problem, even though you do not have said disease or problem (or the problem is so non-invasive that it would never be an issue in your natural lifetime).
FALSE NEGATIVE: A test that fails to pick up the fact that you actually do have a certain disease or problem.
OVERDIAGNOSIS: Usually based on incorrect presumptions or "False Positive" tests. You are officially diagnosed with a disease or health problem you either do not have or is not aggressive enough to ever progress to overt symptoms.
OVERTREATMENT: Based on "Overdiagnosis". You are now actually treated for a disease or health problem you do not have or will never become a problem in your natural lifetime.
DEATH: The latest studies on this topic as it pertains to Breast Cancer and Mammograms are revealing that women who get regular mammograms have no less chance (some say they increase your chances) of dying of Breast Cancer than women who get no mammograms at all.
"Even with a specificity of 90%, most abnormal mammograms are false-positives. .....most of those cancers would probably not result in illness or death. Treatment of these cancers would constitute overtreatment. The magnitude of overdiagnosis due to mammographic screening is controversial, with estimates ranging from 0% to 54%.... It may be estimated that [due to excessive amounts of radiation] up to one breast cancer may be induced per 1,000 women aged 40 to 80 years undergoing annual mammograms." - From the National Institutes of Health's (National Cancer Institute) guidelines.
"In September 2010, the New England Journal of Medicine, one of the most prestigious medical journals, published the first study in years to examine the effectiveness of mammograms. Their findings are a far cry from what most public health officials would have you believe. The bottom line is that mammograms seem to have reduced cancer death rates by only 0.4 deaths per 1,000 women --- an amount so small it might as well be zero. Put another way, 2,500 women would have to be screened over 10 years for a single breast cancer death to be avoided." -Dr. Joseph Mercola
"This latest publication is just a longer-term follow-up of a study that was completed over a decade ago, so the fact that they did not find a benefit from mammograms is not new." - Richard Wender, MD: Professor and Chair of the Department of Family and Community Medicine at Thomas Jefferson University in Philadelphia. A graduate of Princeton University and the University of Pennsylvania School of Medicine, Wender currently chairs the American Cancer Society Cancer Screening Guidelines Panel.
- OSTEOPOROSIS DRUGS PREVENT FRACTURES: The truth is, Osteoporosis Drugs cause fractures. I have been warning people of this fact for over a decade (HERE). Fortunately, the powers that be are starting to admit this on a small level.
- HIGH CHOLESTEROL IS THE CHIEF CAUSE OF HEART ATTACKS: The underlying culprit in the vast majority of Heart Disease is INFLAMMATION and not CHOLESTEROL. This is one of the reasons why you do not want to be on STATIN DRUGS.
- VACCINES ARE SAFE: Whether we are talking about FLU SHOTS or VACCINES in general, they are anything but safe. Sure they prevent acute diseases. The problem is, here in America we have been trading acute illnesses for chronic, long-term NEURO-DEGENERATIVE DISEASES, AUTISM, AUTOIMMUNITY, CANCER, and ENDOCRINE PROBLEMS, for decades.
- DOCTORS DON'T PERFORM TESTS OR PRESCRIBE DRUGS THAT YOU DON'T ACTUALLY NEED: Really? Although I could show you dozens upon dozens of examples, just look at these two topics and try and convince me otherwise (HERE & HERE).
- ANTIBIOTICS KEEP OUR NATION HEALTHY: Although ANTIBIOTICS undoubtedly have the ability to save lives, their overuse has been a major causal factor in POOR GUT HEALTH (including LEAKY GUT SYNDROME and IBS) as well as a whole host of AUTOIMMUNE DISEASES and DYSBIOSIS.
- AS LONG AS I DON'T HAVE DIABETES, MY BLOOD SUGAR IS FINE: HERE and HERE are solid proof that "Uncontrolled Blood Sugar" (even if your numbers are in the 'normal' range) is one of our nation's foundational health problems.
- ANTI-DEPRESSION DRUGS ARE SAFE AND EFFECTIVE: Because so many of you reading this post are on ANTI-DEPRESSION DRUGS, it would behoove you to click on the link and spend just a little bit of time reading before accusing me of speaking out of turn.
- ANNUAL PHYSICALS ARE A CRITICAL PART OF GOOD HEALTH: This is simply not true. Why not? Because of something you are going to learn a great deal about today ---- way too much over-treatment due to "False Positives". More on this topic to come.
- EVIDENCE-BASED MEDICINE IS A WONDERFUL WAY TO PRACTICE MEDICINE: EVIDENCE-BASED MEDICINE is the way doctors are currently forced to practice medicine by our bureaucracy-loving government. If you believe that this is improving your quality of care, you may want to click on the link.
Here's the thing folks; I could have included dozens of other examples of medical myths and sacred cows. If you want to read more about them, they're all over my site. But time is short. We need to get back to our question at hand. Is mammography a life saving diagnostic tool that leads to early detection of BREAST CANCER, and ultimately saves women's lives, or is it not? Let's cut straight to the chase.
- Routine mammograms should begin at age 50 instead of 40. They should also end at age 74.
- Women should receive a mammogram every other year instead of every year.
- Based on the most current peer-reviewed scientific literature, self-examination of the breasts (something that has been heavily promoted for decades) has little or no value.
According to a study published in this month's issue of BMJ (The British Medical Journal), Canadian researchers who started following a group of almost 90,000 women 25 years ago have come to some interesting conclusions concerning mammography and Breast Cancer. The women were divided into two groups ---- those who had annual mammography and those who had no mammography at all. Listen to the author's conclusions at the end of the 25 years. "Annual mammography in women aged 40-59 does not reduce mortality from breast cancer beyond that of physical examination or usual care when adjuvant therapy [chemo / radiation] for breast cancer is freely available. Overall, 22% (106/484) of screen detected invasive breast cancers were over-diagnosed...." The study's lead author, Dr. Anthony B. Miller (M.D.), Professor Emeritus of the University of Toronto's School of Public Health clarified what they meant by going on to say that, "At the end of the screening period, an excess of 142 breast cancers occurred in the mammography arm compared with the control arm.... This implies that 22% (106 of 484) of the screen-detected cancers in the mammography arm were overdiagnosed".
In simple English, this means that 22% of those diagnosed with CANCER did not actually have Cancer. I would assume that most, if not all of these women then fell into the category of "Overtreated" In fact, there were researchers from around the world (Dr. Mette Kalager, MD, of the University of Oslo in Norway was one of the most renowned) who looked at the study and said that since the type of Breast Cancer called "ductal carcinoma in situ" that accounts for 25% of all Breast Cancers was not included in the study, the numbers would actually be worse than Miller's group determined --- significantly worse. Gulp. Dr. Kalager's team published an editorial in the same issue of BMJ titled, "Too Much Mammography". But not everyone agreed with these findings.
Two doctor's groups lost their collective minds over Miller's study --- The American College of Radiology (ACR) and the Society of Breast Imaging (SBI). They issued a joint statement accusing Miller and his colleagues of all sorts of underhanded and dirty tricks, as well as using shoddy research techniques and outdated equipment. In a statement issued by Miller that addressed every issue brought up by these two groups, he said that his team's study was undoubtedly "unwelcome to this highly financially conflicted group, but which will be of substantial interest to policy makers in considering the future of screening for breast cancer." Wow! Financial conflict-of-interest in medicine? You don't say. If you have a couple of minutes sometime, breeze through a few of our numerous articles on EVIDENCE-BASED MEDICINE to get a small taste of what Miller is up against as he takes on this sacred cow. The crazy thing about this research is that like Dr. Wender told us at the very top of the page, it's not really new information.
The November, 2012 issue of the New England Journal of Medicine published a study called, "Effects of Three Decades of Screening Mammography on Breast-Cancer Incidence". What were the conclusions of this thirty year study that looked crunched governmental statistics for the entire United States? Are you sitting down? The authors stated that, "we estimated that breast cancer was overdiagnosed (i.e., tumors were detected on screening that would never have led to clinical symptoms) in 1.3 million U.S. women in the past 30 years. We estimated that in 2008 alone, breast cancer was overdiagnosed in more than 70,000 women; this accounted for 31% of all breast cancers diagnosed. Despite substantial increases in the number of cases of early-stage breast cancer detected, screening mammography 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 overdiagnosis, 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."
If you get out your calculator and do the math, this study showed a whopping 93% "False Positive" rate. Re-read that and let the magnitude of what it is implying about our current model of diagnosing and treating Breast Cancer sink in for a moment. And the final bite-in-the-butt for those of you keeping score at home is that they did not even include the Breast Cancers that were thought to have been caused by the ongoing HRT (Hormonal Replacement Therapy) fiasco (HERE), which would have made the numbers even worse. But that's not all. This study only dealt with False Positives. What about the "False Negatives"? Listen to what our government's NIH website has to say on this topic. "Assuming an average sensitivity of 80%, mammograms will miss approximately 20% of the breast cancers that are present at the time of screening (false-negatives)". 93% False Positives plus 20% False Negatives adds up to 113% --- an impossiblity. Let's just say that the False Positives are over 50% (the government admitted in the quote from the very top of the post that, "most abnormal mammograms are false-positives"). Throw in the False Negatives and the absolute best you could hope for was 30% accuracy. Could be why recent studies are leading some doctors to conclude that women who get regular mammograms have a better chance of dying of Breast Cancer than those who do not get mammograms at all.
Patients who are not aware of this information are sitting ducks to be cajoled into doing things they do not want to do (I spoke of the same thing going on with appendicitis in THIS recent post on CT Scans --- a scenario that happened to our family three years ago). I have included a sample conversation from the average doctor's office to help you understand the situation. PATIENT: But doctor Smith, I really don't want to have that mammogram. I read on the internet that they aren't all they've been cracked up to be. DR. SMITH: I'm sorry Mrs. Jones, but if you don't agree to get the test, you'll have to find another doctor. And really; you should stop putting so much faith in articles you find on the internet. You know you can't trust any of that stuff anyway. Especially if it comes from Dr. Schierling's site. Trust me instead. I'm a doctor. This scenario is playing out all over the United States. The bottom line is that if you are a female who is concerned about Breast Cancer, whether for yourself, your daughters, or grand-daughters, you need to educate yourself. In my humble opinion, the best thing you can do is to stop the process before it starts ---- after all, this is what the word "Prevention" really means.
How do you prevent Breast Cancer? You would prevent it the same way you would try to prevent any Cancer --- or for that matter, practically any disease period (HERE). One of the very first things you need to do is to understand the relationship between Estrogen and Female Cancers. From there you can begin learning about something called "ESTROGEN DOMINANCE". Another important step in this puzzle would be figuring out how to resolve Estrogen Dominance before it begins fueling cellular mutations of the breast (HERE). As always, never take my word for anything. The internet has placed huge amounts of valuable information at your finger tips. Like I stated earlier, knowledge is power. Empower yourself and your family by learning more about Breast Cancer and the ways to stop it dead in its tracks before it ever has a chance to gain a hold in your life.
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