Women's Health

Does Mammography Save Lives?

According to Dr. Charles J. Wright of the University of British Columbia and Dr. C. Barber Muelle of McMaster University in Ontario, Canada, there is no proof yet that mammography screening saves lives. In fact, no clinical trial has ever found any benefit whatsoever to women under the age of 40, and there is now a cloud of doubt that hangs over the claim that mammography screening has value to older women.

This is not to call into question the benefit of mammography as a tool in diagnosing breast cancer. But this is far different than promoting it as a screening tool. For 20 years, the nation's leading cancer organizations have proselytized mammography for screening purposes. The result is that this technique has been widely accepted and hospitals and x-ray facilities have made huge investments in mammography equipment. Public education campaigns fail to cite the harm associated with mammography screening, such as unnecessary surgeries and misdiagnosis - which includes false positives and the 10-15% of early cancers that are missed by this screening technique. An unanswered question is whether mammography actually promotes the disease they are purported to detect, through both mechanical and radiation trauma to the breast tissue. A well-known (and never mentioned) medical fact is that it takes approximately 18 months for healthy tissue to repair radiation damage. Repeated irradiation of damaged tissues results in cumulative damage.

The RFHC shares the concern of Drs. Wright and Mueller that three disturbing issues related to mammography need to reach the public's attention:
1) The results from clinical trials;
2) The ratio of benefit to harm; and
3) The actual financial costs, which are staggering.

These issues are all but ignored in the glowing, optimistic messages that go out to the public. Some examples you may have heard:

> "Most women with breast cancer could be saved by early detection with mammography."
> "Mammography helps your doctor see breast cancer before there is a lump, when cure rates are near 100%"
> "If you are over 35 and haven't had a mammogram, you need more than your breast examined."

The "public service" messages from organizations as the American Cancer Society (ACS) fail to tell women that their organization is dominated by surgeons and radiologists. Could financial interests have any impact upon the ACS's strong campaigns advising the public to undergo cancer screening tests before there is data to support the advice? As early as the 1970's the ACS began advising breast examination to symptom-less women as a screening tool. Remember, the medical community has redefined "prevention" to mean early detection.

Any effort to retract the existing recommendations has met with swift resistance. Take for example a national Cancer Institute (Canada) recommendation that mammography no longer be employed as a screening tool for women in their 40¹s. Critics, largely radiologists, who may have seen their livelihood threatened, came forward to purport the study flawed. The result: a confused public. .

Keep in mind that an industry has been built around the use of mammography to provide early detection of breast cancer. It will be very difficult to cut back on an industry into which massive health care dollars have been poured. The dollars spent are far out of proportion to what the technique can deliver by way of results. Drs. Wright and Mueller state that a "saved" life costs about $1.2 million.

At the same time, massive amounts of lobbying funds have been spent to prevent the safe, non-invasive method of thermography from becoming a recognized cancer screening tool. I recommend thermography as the initial screening tool for high risk women in my practice, and for women over 55.

I want every woman in my practice to know that there is conflicting data in the half dozen clinical trials over the last 20 years that have evaluated mammography. In theory, cone could expect mammographic techniques to have improved over the years. A study in the `80's should certainly be expected to show better results than one conducted in the 60's. In fact, the opposite is true. Only the first two trials show any benefit to the screenings. The latter four do not. Which study should we believe? I would like to see an honest, public evaluation of mammography.

The ratio of benefit to harm and the dollar costs associated with providing screening requires that we rethink the process. It only makes sense for women at highest risk: those who have a first-degree relative with premenopausal breast cancer. A case can be made for screening this category of women. And, there may be more effective screening tools than mammography.

Women need to know the hard truth, as stated by Drs. Wright and Mueller, "In most cases, the disease has been present for many years before it is diagnosable by any means." This fact reinforces what was emphasized repeatedly at September's Cancer Symposium - no cancer treatment is as effective as avoidance of the disease. Remember, 75% of all cancers are caused by dietary factors or tobacco. Breast cancer is a dietary issue. The evidence is abundantly clear. There are practical, everyday changes you can make in your diet to substantially reduce your risk of developing breast cancer, including appropriate supplementation. For a personal evaluation of your nutritional status, call the RFHC today and I will be happy to customize a program for your needs.

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