Mammograms Have 'Limited or No Effect' on Breast Cancer Deaths: Study
Foodconsumer's comment: Summary: 1) Breast cancer screening cannot detect aggressive breast cancer early enough to prevent it from becoming an advanced tumor, which is the real killer for breast cancer patients. In other words, the screening does not really cut risk of death from breast cancer. 2) Breast cancer screening overdiagnoses breast cancer and leads to treatment of many tumors that would not need to be treated otherwise. 3) Increased survival rate may be due simply to the early diagnosis alone and may not have anything to do with treatment, and may not actually extend the survival by one day. The seemingly increased rate of survival can be misleading.
By Dr. Mercola
With only a few weeks to go before the annual October rush promoting mammograms begins, a new study published in the Journal of the National Cancer Institute is raising some doubts on mammography's purported merits.
The findings showed mammograms have little or no influence on reducing the number of women who die from breast cancer … and considering there are serious health risksinvolved, too, what, then, is the point?
Mammograms Again Shown to Have Little to No Value
Breast cancer mortality rates in Sweden have been declining since 1972. Even though this was before mammography was introduced, the reductions have continued and many have attributed it to mammography screening.
The researchers that authored the current study also expected to see a reduction in breast cancer deaths associated with mammograms, but the results showed otherwise:1
"County-specific mortality statistics in Sweden are consistent with studies that have reported limited or no impact of screening on mortality from breast cancer among women aged 40-69."
In light of these findings, the study's lead researcher Dr. Philippe Autier, at the International Prevention Research Institute in Lyon, France, noted:2
"Information to women on mammography screening should better reflect uncertainty on the effectiveness of that test, and underline the risk of overdiagnosis and overtreatment."
And this is not the first time the effectiveness of mammograms has been called into question. In 2010, another study concluded that the reduction in mortality as a result of mammographic screening was so small as to be nonexistent—a mere 2.4 deaths per 100,000 person-years were spared as a result of the screening.3
Mammograms May Cause More Harm Than Good
Many women are under the impression that a mammogram is simply an innocuous test that might or might not help you detect breast cancer sooner. But research shows this screening may end up harming more women than it helps.
Earlier this year, the Nordic Cochrane Center issued a leaflet explaining the potential benefits and potential harms of mammography, stating that, based on the available research, it no longer seems reasonable for women to attend breast cancer screening. After systematically reviewing the randomized trials of mammography, they concluded that:4
"If 2,000 women are screened regularly for 10 years, one will benefit from screening, as she will avoid dying from breast cancer because the screening detected the cancer earlier.
Since these trials were undertaken, treatment of breast cancer has improved considerably. Women today also seek medical advice much earlier than previously, if they have noted anything unusual in their breasts...
Because of these improvements, screening is less effective today and newer studies suggest that mammography screening is no longer effective in reducing the risk of dying from breast cancer.
... Since it is not possible to tell the difference between the dangerous and the harmless cell changes and cancers, all of them are treated.
Therefore, screening results in treatment of many women for a cancer disease they do not have, and that they will not get. Based on the randomized trials, it appears that:
If 2,000 women are screened regularly for 10 years, 10 healthy women will be turned into cancer patients and will be treated unnecessarily. These women will have either a part of their breast or the whole breast removed, and they will often receive radiotherapy, and sometimes chemotherapy.
Treatment of these healthy women increases their risk of dying, e.g. from heart disease and cancer."
So, to recap, in order for mammographic breast screening to save ONE woman's life:
- 2,000 women must be screened for 10 years
- 200 women will get false positives
- 10 will receive surgery and/or chemotherapy even though they do not actually have cancer
Yet another study, this one published in The Lancet Oncology late last year,5 described the natural history of breast cancers detected in the Swedish mammography screening program between 1986 to 1990, involving 650,000 women. Since breast lesions and tumors are typically aggressively treated and/or removed before they can be determined with any certainty to be a clear and present threat to health, there has been little to no research on what happens when they are left alone.
This study however, demonstrated for the first time that women who received the most breast screenings had a higher cumulative incidence of invasive breast cancer over the following six years than the control group who received far less screenings! The study concluded that:
"Because the cumulative incidence among controls did not reach that of the screened group, we believe that many invasive breast cancers detected by repeated mammography screening do not persist to be detected by screening at the end of 6 years, suggesting that the natural course of many of the screen-detected invasive breast cancers is to spontaneously regress."
FDA Secretly Monitored Mammogram Whistleblowers' Emails
The U.S. Food and Drug Administration (FDA) secretly monitored the personal e-mail of nine whistleblowers—its own scientists and doctors—over the course of two years. The monitored employees had warned Congress that the agency was approving medical devices that posed unacceptable risks to patients.
Six of the monitored scientists and doctors recently filed a lawsuit against the FDA, charging that the agency violated their constitutional rights to privacy by monitoring lawful activity in personal email accounts, and using that information to harass and ultimately relieve some of them of their positions.
According to the Washington Post6:
"All had worked in an office responsible for reviewing devices for cancer screening and other purposes. Copies of the e-mails show that, starting in January 2009, the FDA intercepted communications with congressional staffers and draft versions of whistleblower complaints complete with editing notes in the margins. The agency also took electronic snapshots of the computer desktops of the FDA employees and reviewed documents they saved on the hard drives of their government computers."
The FDA has declined to comment on the allegations, stating it does not comment on cases involved with litigation. However, according to internal FDA documents obtained by the plaintiffs under the Freedom of Information Act, the agency had asked the Department of Health and Human Services' (DHHS) inspector general to conduct an investigation back in May 2010, stating suspicions that the plaintiffs had improperly disclosed confidential business information about the devices.
The HHS inspector general's office found no evidence of criminal conduct, stating the doctors and scientists had legal right to share their concerns with Congress and journalists. Hence no investigation was launched. But the FDA was not satisfied.
On June 28 that same year, Jeffrey Shuren, director of the FDA's Center for Devices and Radiological Health wrote that, "We have obtained new information confirming the existence of information disclosures that undermine the integrity and mission of the FDA and, we believe, may be prohibited by law," and again requested action be taken against the employees in question. After consulting with general prosecutors, the inspector general declined the second request for an investigation as well. Now the question is whether the agency monitored their employees within legal limits, and whether the purpose of the extensive monitoring was reasonable. Senator Charles Grassley doesn't seem to think so, stating that:
"The FDA has a huge responsibility to protect public health and safety. It's hard to see how managers apparently thought it was a good use of time to shadow agency scientists and monitor their e-mail accounts for legally protected communications with Congress."
Former FDA Reviewer Speaks Out About Intimidation, Retaliation and Marginalizing of Safety
A recent article by Martha Rosenberg gives even more details about what’s really going on at the FDA7. She writes:
“For reporting the safety risks, the scientists became targets of the now-disclosed spy program and some lost their jobs. "It has been brought to our attention that FDA management may have just recently ordered the FDA Office of Criminal Investigations (OCI) to investigate us, rather than the managers who have engaged in wrongdoing!" wrote the FDA scientists in a follow-up letter a few weeks later to President Obama. "It is an outrage that our own Agency would step up the retaliation to such a level because we have reported their wrongdoing to the United States Congress."
Dr. Kavanagh worked as an FDA drug reviewer from 1998 to 2008, and reportedly encountered the same kind of hostile and coercive working environment as the device reviewers. Rosenberg interviewed Dr. Kavanagh for her article, in which he makes the following shocking statements:
“In the Center for Drugs [Center for Drug Evaluation and Research or CDER], as in the Center for Devices, the honest employee fears the dishonest employee. There is also irrefutable evidence that managers at CDER have placed the nation at risk by corrupting the evaluation of drugs and by interfering with our ability to ensure the safety and efficacy of drugs.
While I was at the FDA, drug reviewers were clearly told not to question drug companies and that our job was to approve drugs. We were prevented, except in rare instances, from presenting findings at advisory committees. In 2007, formal policies were instituted so that speaking in any way that could reflect poorly on the agency could result in termination. If we asked questions that could delay or prevent a drug's approval - which of course was our job as drug reviewers - management would reprimand us, reassign us, hold secret meetings about us, and worse. Obviously in such an environment, people will self-censor.”
Truly, this is an interview you’ll want to read in its entirety. It’s absolutely shocking. Dr. Kavanagh points out several of the ways drugs slip through the system. For example, drug safety studies usually include too few individuals and are too short to adequately evaluate health risks. Just one single adverse event during such a study can therefore be extremely important and must be taken seriously. Alas, according to this insider, in-depth evaluations and follow-up studies rarely take place. He also claims reviewers were specifically instructed to only read the summary and accept drugmakers’ claims without examining any of the submitted data!
“Other times I was ordered not to review certain sections of the submission, but invariably that's where the safety issues would be. This could only occur if FDA management was told about issues in the submission before it had even been reviewed,” he says.
Dr. Kavanagh’s testimony sends chills up my spine, as it so clearly describes the inner workings of an agency that is putting your health at grave risk instead of protecting you and your family from dangerous drugs and medical devices...
Why Getting a Mammogram Can be a Risky Decision
The long-held conventional medical advice has been for women to get an annual mammogram once they hit 40. A couple of years ago, the U.S. Preventive Services Task Force decided to alter their mammogram recommendation, advising women under the age of 50 to avoid mammograms, and limit them to every other year after the age of 50. The revision caused outrage among many cancer organizations. What was overlooked, however, was the reasoning behind the Task Force's decision to change their recommendation.
The prior advice was given in 2002, before a host of new research came out showing the problems of overdiagnosis, including false positives.
If a mammogram detects an abnormal spot in a woman's breast, the next step is typically a biopsy. This involves removing a small amount of tissue from the breast, which is then looked at by a pathologist under a microscope to determine if cancer is present. However, early stage cancer like ductal carcinoma in situ, or D.C.I.S., can be very hard to diagnose, and pathologists have a wide range of experience and expertise. There are actually NO universally agreed upon diagnostic standards for D.C.I.S., and there are no requirements that the pathologists doing the readings have specialized expertise...
Many conventional physicians view DCIS as "pre-cancerous" and argue that, because it could cause harm if left untreated it should be treated in the same aggressive manner as invasive cancer; however the rate at which DCIS progresses to invasive cancer is still largely unknown, with the weight of evidence suggesting it is significantly less than 50 percent -- perhaps as low as 2-4 percent.
This suggests that watchful waiting may be the more sensible approach, but most women are not informed of this option and instead go through invasive breast cancer treatments like surgery, radiation and toxic chemotherapy that often turns out to be unnecessary. As discussed above, it's really hard to justify harming 10 women with surgery and toxic chemotherapy treatment in order to possibly save the life of one woman ...
New York and Virginia followed the lead of Connecticut and Texas and recently passed laws requiring women with dense breasts to be informed they may need to seek alternative screening methods. The Federal Breast Density Bill is (HR 3102) is also currently being considered.
Mammography and its subsequent tests, such as MRIs and stereotactic (x-ray guided) biopsies, likely contribute to cancer because of the cumulative radiation exposure that occurs over a lifetime and the particularly radiation-sensitive nature of breast cells, e.g. BRCA1/2 genes confer greater risk for breast cancer, in part, because they interfere with the repair of radiation-induced DNA damage. Even the National Cancer Institute states that "repeated x-rays have the potential to cause cancer."8
And finally, although receiving a false positive is the major danger of mammograms, false negatives also occur. Mammograms are especially inaccurate for women with dense breasts; New York and Virginia recently passed laws requiring women with dense breasts to be informed they may need to seek alternative screening methods. It's estimated that up to 75 percent of women in their 40s, and up to 50 percent of all women, have dense breasts, which increases the likelihood that a mammogram will be ineffective and inaccurate.9
Thermography: Breast Health Monitoring That's as Safe as Taking Your Photograph
I recently interviewed Gaea Powell about the use of thermography as a safe way to monitor your risk of breast cancer over the long term. Thermographic breast screening is as safe as having your photograph taken and measures the infrared heat emitted by your body, translating this information into thermal images. Thermography does not require mechanical compression or ionizing radiation, and can detect signs of physiological changes due to inflammation and/or increased tumor related blood flow approximately 8-10 years before mammography or a physical exam can detect a mass.
So, if your thermogram shows areas of high inflammation, it doesn't mean you have cancer, but it lets you know you need to address that inflammation to avoid deterioration, and in some cases that the area needs further evaluation.
A New Breast Health Assessment Paradigm - Thermography, BSE/CBE, Ultrasound, then MRI
Although scientific evidence supports elimination of mammography as a screening tool, it is currently considered the standard of care. Replacing it with a new breast health assessment paradigm is warranted and inevitable. The new paradigm begins with thermography, a non-invasive physiological screening that can only serve to enhance all anatomical screenings that may follow, such as BSE/CBE, ultrasound and/or MRI. Please understand though that because this paradigm is not yet accepted as the standard of care, most insurance companies will not cover a thermogram, nor an ultrasound or MRI without a "positive" or "suspicious" mammogram. However, when choosing an MRI as an elective procedure, one can typically shop around and find a facility that will perform one without insurance for under $1,000.
New Study Shows This Vitamin Can Prevent Breast Cancer …
There are a number of lifestyle changes that can help prevent breast cancer from ever becoming a reality for you. For starters, we cannot discuss breast cancer without mentioning the importance of vitamin D. Vitamin D, a steroid hormone that influences virtually every cell in your body, is easily one of nature's most potent cancer fighters. Receptors that respond to vitamin D have been found in nearly every type of human cell, from your bones to your brain. Your liver, kidney and other tissues can convert the vitamin D in your bloodstream into calcitriol, which is the hormonal or activated version of vitamin D.
New research published in the journal Steroids has found that calcitriol inhibits the growth of cancer cells, including breast cancer cells, through the following mechanisms:10
- Cell cycle arrest
- Promotion of apoptosis (cancer cell death)
- Inhibition of invasion, metastasis and angiogenesis
Vitamin D is actually able to enter cancer cells and trigger apoptosis or programmed cell death. When JoEllen Welsh, a researcher with the State University of New York at Albany, injected a potent form of vitamin D into human breast cancer cells, half of them shriveled up and died within days!11
It is my professional opinion that for those who are diagnosed with cancer it is criminal malpractice not to recommend vitamin D and aggressively monitor a cancer patient's vitamin D level to get it between 70 and 100 ng/ml.
So please do watch my one-hour free lecture on vitamin D to find out what your optimal vitamin D levels should be for prevention and treatment … and how to get them there. This is one of the most important steps you can take to protect yourself from cancer.
Eight More Breast Cancer Prevention Tips
Prevention truly is worth a pound of cure when it comes to cancer, and the following healthy lifestyle strategies can help you avoid ever becoming a cancer statistic.
- Radically reduce your sugar/fructose intake. Normalizing your insulin levels by avoiding sugar and fructose is one of the most powerful physical actions you can take to lower your risk of cancer. Unfortunately, very few oncologists appreciate or apply this knowledge today. Fructose is especially dangerous, as research shows it actually speeds up cancer growth.
- Optimize your vitamin D level, as mentioned. Ideally it should be over 50 ng/ml, but levels from 70-100 ng/ml will radically reduce your cancer risk. Safe sun exposure is the most effective way to increase your levels, followed by safe tanning beds and then oral vitamin D3 supplementation as a last resort if no other option is available.
- Maintain a healthy body weight. This will come naturally when you begin eating whole foods like those in my nutrition plan and exercising using high-intensity burst-type activities, which are part of my Peak Fitness program. It's important to lose excess weight because excess estrogen is produced in fat tissue, which can contribute to cancer risk.
- Get plenty of high quality animal-based omega-3 fats, such as those from krill oil. Omega-3 deficiency is a common underlying factor for cancer.
- Avoid drinking alcohol, or limit your drinks to one a day for women.
- Watch out for excessive iron levels. This is actually very common once women stop menstruating. The extra iron actually works as a powerful oxidant, increasing free radicals and raising your risk of cancer. So if you are a post-menopausal woman or have breast cancer you will certainly want to have your Ferritin level drawn. Ferritin is the iron transport protein and should not be above 80. If it is elevated you can simply donate your blood to reduce it.
- Breastfeed exclusively for up to six months. Research shows this will reduce your breast cancer risk.
- Avoid xenoestrogens. Xenoestrogens are synthetic chemicals that mimic natural estrogens. They have been linked to a wide range of human health effects, including reduced sperm counts in men and increased risk of breast cancer in women. There are a large number of xenoestrogens, such as bovine growth hormones in commercial dairy, plastics like bisphenol A (BPA), phthalates and parabens in personal care products, and chemicals used in non-stick materials, just to name a few.
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