Should You or Should You Not Get a Mammogram?

Norwegian study, published in the British Medical Journal, concludes, “Thus, 15% to 25% of cases of cancer are overdiagnosed, translating to 6 to 10 women overdiagnosed for every 2500 women invited for screening.”That may not sound like very many, but that translates to 35,000 to 58,000 woman in the US who are being overdiagnosed and unnecessarily treated every year for Invasive Breast Cancer they don’t have.
What is even worse is the finding from the Independent UK Panel on Breast Cancer Screening that, “For every 10,000 women who have regular 3 yearly (every 3 years) screenings between the ages of 47 and 73, experts estimate that there will be between 3 and 6 extra breast cancers caused by radiation.” That translates to between 10,000 to 20,000 cases of Breast Cancer caused by the radiation from Mammography Screening every year in the US.

 “Mammography might not be appropriate for use in breast cancer screening because it cannot distinguish between progressive and non-progressive cancer,” said Mette Kalager, M.D., lead author of new research linking mammograms to significant overdiagnosis of breast cancer. Based on this new research, for every 2,500 women screened by Mammography, 2,470 to 2,474 will never be diagnosed with breast cancer and 2,499 will never die from breast cancer. Only one death from breast cancer will be prevented. But 6 to 10 women will be overdiagnosed, and treated with surgery, radiation therapy, and possibly chemotherapy without any benefit.
 

 

The Independent UK Panel on Breast Cancer Screening, chaired by Sir Michael Marmot, professor of epidemiology and public health and Director of the Institute of Health Equity at University College, London, concluded, the screening programs have contributed to reducing deaths from breast cancer in women. But they have also resulted in some over diagnosis among women who go for screening. It is now vital to give women information that is clear and accessible before they go for a mammogram so they can understand both the potential harms and benefits of the process.” 

The Norwegian research conducted by the Harvard School of Public Health (HSPH) suggests that routine mammography screening — long viewed as an essential tool in detecting early breast cancers — may in fact lead to a significant amount of overdiagnosis of disease that would have proved harmless.
Based on a study of 39,888 women in Norway, the researchers estimate that between 15 percent and 25 percent of breast cancer cases are overdiagnosed and cause women to undergo surgeries, chemotherapy and radiation needlessly. The researchers analyzed data from 39,888 women with invasive breast cancer in Norway, 7,793 of whom were diagnosed during the 10-year rollout of the Norwegian Breast Cancer Screening Program.
The researchers did not find a reduction in late-stage disease in women who’d been offered screening. They did find, though, a substantial amount of overdiagnosis: Among the 7,793 women diagnosed with breast cancer through participation in the screening program, 15 percent to 25 percent were overdiagnosed — between 1,169 and 1,948 women. Based on those numbers, the researchers further estimated that, for every 2,500 women invited to screening, 2,470 to 2,474 will never be diagnosed with breast cancer and 2,499 will never die from breast cancer.
Only one death from breast cancer will be prevented. But six to 10 women will be overdiagnosed, and treated with surgery, radiation therapy, and possibly chemotherapy without any benefit. Source: Harvard School of Public Health CommunicationsAnnals of Internal Medicine, April 3, 2012.

More Bad News: Mammograms Cause Cancer!

The National Cancer Institute admits that  Mammograms emit ionizing Radiation that causes cellular damage associated with aging and DNA mutations that cause cancer.  A woman ages about 4 years every time she gets a Mammogram. Although the dose of radiation is very low for each X-Ray, the cumulative effects can be life threatening.   

A Woman Ages about 4 Years Every Time She Gets a Mammogram

Contrary to common assurances, the radiation exposure of Mammography is certainly not trivial. The routine practice of taking two films for each breast amounts to about 600 millirem (6mGy) focused directly on each breast and at least 1200 millirems total. That is equivalent to the amount of radiation a person gets every four years from environmental exposure. Some women get even more due to radiology technician error, false positive mammograms, or x-ray guided imagery used to take a biopsy of a suptected lump. All of these require a woman to come back for more x-rays. The bottom line is that there is no safe dose of x-rays and the DNA damaging effects are cumulative.

Women are Scared and Confused

Does this story sound familiar? “I have just gone through a long breast cancer scare the last couple of months, writes a woman who goes by “coffeelatte” on a popular woman’s health blog, “but I was extremely lucky in that the lumpectomy revealed my mass was not a cancer.” “However, I was terrified for more than three months and I am wondering if the fear was worth it and also if the radiation from mammograms is safe or is it another source of problems?” “I ask this because my suspicious mass was back against the breast wall so the radiologist had a very hard time finding the right area to target the wire for the excisional biopsy. In all, it took her over one hour and I had 12 mammogram pictures before she found the right spot for the wire.” “I am just so upset because I feel if I didn’t have the cancer this time, I sure will the next from all the radiation they are exposing me to. Is this unrealistic of me?” “I feel I try so hard to take care of myself but I end up with problems from the medical care part. I also have a huge, sore incision and scar which is a constant reminder of this miserable ordeal. “Do you ladies think it is best to continue with these mammograms? I just am so confused.” (posted by “coffeelatte” July 2009)

How Many Women Actually Get Cancer from Mammograms?

According to calculations by Dr. David Brenner, professor of radiation oncology and public health at Columbia University, mammography is likely responsible for as many as 6,400 radiation induced cancers every year. Dr. Samuel Epstein, a professor of environmental medicine at the University of Illinois at Chicago School of Public Health, argues that the radiation risks of mammography are notoriously underestimated. Mary Helen Barcellos-Hoff, a radiation biologist at Lawrence Berkeley Laboratories in San Francisco, the average American gets about 360 millirems (a unit for measuring absorbed doses of radiation) of radiation annually, from natural background radiation coming from rocks, radon and cosmic rays, as well as man-made sources.”
To help protect women, the Food and Drug Administration limits the amount of radiation that X-rays can deliver to women’s breasts to 300 millirems per film per view, says Kramer. Even with that restriction, Epstein says, women receive too much radiation. Radiologists routinely take two films per breast. Reporting in the International Journal of Health Services, Epstein and coauthors Rosalie Bertell and Barbara Seaman argue that the premenopausal breast is particularly sensitive to radiation. They estimate that every 1000 millirems of radiation exposure increases the risk of breast cancer by 1 percent. The typical mammogram consists of two X-Rays of each breast for a total of 1200 millirems of radiation and many women get much higher doses do to technician error that require extra retakes.
The American Cancer Society says for every 1,000 women in their 40s screened for 10 years, there will be 600 who will be called back for a repeat mammogram for something suspicious, 350 who will get biopsied, and about five will end up with a diagnosis of breast cancer. And some women might get treated for a cancer that would never have caused a problem. Therefore, women who start getting annual mammograms at age 40 would have at least a 12% increased risk of developing breast cancer due to the screening procedure by the time they turn 50. That does not sound like preventive care to me.

New Mammogram Study Stirs Debate

A new study from Sweden is stirring fresh debate over whether women in their 40s should get mammograms. It suggests that mammogram screening tests can lower the risk of dying of breast cancer by 26 percent or more in this age group. According to Dr. Otis Brawley, the American Cancer Society’s chief medical officer, “If we screened all 22 million American women who are aged 40 to 49 this year, this study suggests it would translate to 2,000 to 2,200 lives saved.” What your doctor and virtually all of the researchers have neglected to tell you is that radiation studies dating back to 1998 reveal that for every 66 women in their 40s whose lives are saved by mammography, 1 is killed by mammography. (J Med Screen 1998;5:81–87; Rotterdam Study; Petra Beemsterboer et.al.; Department of Public Health, Erasmus University, Rotterdam, the Netherlands) That means that if all 22 million American women get annual mammograms, 33 women will die from the radiation, while 2200 will be saved.

Are You Willing to Take the Risk?

According to the authors of the Rotterdam study, “For a screening programme, age group 50–69 (two year interval, 2 mGy, or 200 millirems radiation per view), the balance between the number of deaths induced versus those prevented was favourable: 1:242. When screening is expanded to the age group 40–49 with a one or two year interval the results may be less favourable, that is, 1:66 and 1:97.”
In plain English, this means that in women age 50-59 who get a mammogram every two years, 1 woman will die due to the radiation from mammography for every 242 women saved by early detection  of a mammogram and treatment;  in the 40-49 year old age group who get a mammogram every two years, 1 woman will die for every 97 saved, and 1 woman will die for every 66 saved in the women age 40-49 who get a mammogram every year.

Mammogram Radiation Kills

The National Cancer Institute estimates that annual mammography of 100,000 women for 10 consecutive years beginning at age 40 would result in up to eight radiation-induced breast cancer deaths. (J Natl Cancer Inst Monogr. 1997;(22):119-24. Radiation risk from screening mammography of women aged 40-49 years.) Eight deaths out of 100,000 women doesn’t sound like too many, unless of course it is you or someone you love. However, extending that rate to the 11 million women aged 40-49 who get a mammogram every year in the U.S., means that 88O radiation-induced breast cancer deaths will likely occur in that group over their lifetime.
Women deserve to know that Mammography exposes them to considerable risk of death over their lifetime. The earlier a woman begins getting mammograms the higher her risk. Sadly women are not being warned of this risk. Dr. David Brenner, with the Center for Radiological Research at Columbia University, says that the real number may be much higher than estimated. Dr. Brenner says that younger women have more cells that are actively dividing, making them even more vulnerable to radiation’s effects than women over the age of 50. Additionally, Mammograms are less reliable in younger women because of their denser breast tissue. While the risk of getting cancer from a mammogram is extremely low for the individual woman, Brenner says, it becomes a complicated public health question. He points out that currently 30 to 40 million women get mammograms each year. According to his calculations, given these theoretical models, mammography is likely responsible for 4,800 to 6,400 radiation induced cancers every year.
At the current rate of 41,000 breast cancer deaths per 186,000 cases annually, that translates into as many as 1400 deaths caused by mammograms every year in the U.S. That’s too many deaths. There has to be a better way. Mammography is not prevention. It is a cause of Cancer.

What Should You Do Instead of a Mammogram?

Dr. Gavin T. Royle and colleagues from the Southampton Breast Unit studied diagnostic data for 350 women with suspected breast cancer. Presenting their findings to the 7th Nottingham International Breast Cancer Conference, Royle’s group said that mammography was up to one-third less likely to detect lumps than were physicians. However, mammography was much more effective in determining whether lumps were benign or malignant. (Eur J Cancer 2001 Sep;37 Suppl 5:1-48) General practitioners (GPs) successfully identified lumps in 78% of cases, while breast surgeons were found to be slightly better with an 82% success rate. Mammography only proved sensitive in 63% of patients. “Both GP and breast surgeon clinical examination were more sensitive than mammography in determining if a lump was present,” Royle told conference participants.
The study also found that ultrasound, which emits no radiation, was the best noninvasive way of determining whether lumps were benign or malignant. Instead of a Mammogram, get a physical breast exam by the same physician every year. If he or she finds a suspicious lump, get an Ultrasound. If the lump is found on Ultrasound to be hollow in the center, then it is a cyst. If it is solid in the center, then you should get an MRI. If the MRI is positive then you will need to get a biopsy. If you decide you want to get mammograms, you would be wise to follow the US Preventive Services Task Force recommendations: don’t get a mammogram until age 50, then only get a screening mammogram (only 2 views per breast) every other year until age 74, then don’t get any more.

Hormonal Keys to Breast Cancer Prevention

Excess Estradiol / Deficient Progesterone / Low Estriol

Estradiol is the principal estrogen found in both men and women. A small amount is necessary for optimal function. However, too much Estradiol is associated with causing cancer of the breast, uterus and prostate. Estradiol is fed to beef cows in the U.S. to make them put on more weight so that they can get them to market sooner and sell for more money. Estradiol is also concentrated in milk due to modern dairy farming techniques designed to boost milk production, including feeding cows hormones and milking pregnant cows until very late in their pregnancy. Unfortunately, the trade-off we suffer is a higher rate of Estrogen induced disease, including cancer, which is not recognized or at least not admitted by the Dairy and Beef Industry.

Estrogenic Compounds in Plastics Linked to PMS and Cancer

Polyethylene terephthalate (PETE), the main ingredient in the plastic bottles most widely used for water, sodas, fruit juices, sports drinks, ketchup, mayonaise, peanut butter, vinegar and just about every other food you can think of, has been found to leach harmful estrogenic chemicals into the bottles’ contents. Known as phthalates, these chemicals have now been linked to the disruption of both male and female hormones and may be a significant reason for the dramatic increase in PMS, uterine fibroids, endometriosis and cancer.

To learn more about how PETE plastics may affect your health, click here.

Estriol is the Safe, Protective Estrogen

Estriol is known as the weak estrogen because it is 1000 times weaker than Estradiol. However, it is found in high livels in women during pregnancy and while breast feeding.  It is believed to be the reason for the 7% decreased risk  of breast cancer for each pregnancy and the 4.3% decreased risk for each 12 months of breastfeeding. Estriol is found in high quantities in women without breast cancer and low levels in women with breast cancer. It is known to block the harmful effects of Estrone and Estradiol on breast tissue. It is 1000 times less stimulating to breast and uterine tissue than Estradiol. When it is found in a woman in sufficient quantities it will bind to breast tissue and prevent cancer by blocking Estrone and Estradiol.

Compared to women who had never used HRT, taking Bio-Identical Estriol alone produced a 30% reduced risk of breast cancer. Estriol selectively binds to estrogen receptor-beta (ER-beta), which inhibits breast cell proliferation and prevents breast cancer development. (Source: Postgraduate medicine, Vol 121, Issue 1, January 2009Endocrinology. 2006 Sep;147(9):4132-50. Epub 2006 May 25.)

Progesterone and Cancer

In women, a deficiency of Progesterone and/or an excess of Estradiol is associated with PMS, uterine fibroids, endometriosis and Osteoporosis, as well as Breast, Ovarian and Uterine Cancer. Progesterone is the natural counter-balance to Estradiol. Progesterone activates Tumor Suppressor Protein (p53) to suppress excessive cell growth that can lead to cancer. Progesterone increases the Tumor Suppressor Protein known as p53, the “guardian of the cell” and decreases the cancer activating protein known as bcl-2. The Tumor Suppressor Protein p53 guards against cellular mutations that can cause cancer in the following ways:

  1. Activation of DNA repair
  2. Stops Cell growth when necessary to allow DNA time to repair
  3. Initiates programmed cell death (apoptosis) when DNA damage is irreparable

Estradiol, on the other hand, does the opposite of progesterone. It causes a decrease in p53 and activates bcl-2, the opposite acting protein that promotes cancer cell growth. Breast cancer cells do not multiply when women have a sufficient supply of Estriol and Progesterone. 
(Source: Ann Clin Lab Sci. 1998 Nov-Dec;28(6):360-9Int J Cancer. 2003 Jul 10;105(5):607-12)
 

PREVENTION SUMMARY

Dr. Hansen Rx for Breast Cancer Prevention:
1. Don’t get routine mammograms; Get a breast exam from the same physician every year. If a lump is found get an Ultrasound; If the lump is hollow its a cyst and no further testing is needed. If the lump is solid then get an MRI, which is more sensitive than a Mammogram. If you decide you want to get mammograms, follow the US Preventive Services Task Force recommendations: don’t get a mammogram until age 50, then only get a screening mammogram (only 2 views per breast) every other year until age 74, then don’t get any more.
2. Avoid synthetic estrogens, in Birth Control Drugs, hormone replacement therapy (HRT), plastics and pesticides.
3. Eat a Healthy diet: 2 fruits daily (especially flavonoid-rich fruits like grapes, blueberries, plums, cherries and cranberries that destroy cancer cells; 3 vegetables daily (include broccoli regularly because it sweeps the harmful estrogens (estrone and estradiol) out of the body; 4 grains;  eat meat sparingly; avoid saturated fats, especially estrogen fed beef and dairy products; eat soy regularly because it contains a plant estrogen that is identical to Estriol, the body’s cancer preventing estrogen.
4. Take a High Potency Multi-Vitaminwith 20x the RDA for B Vitamins, including Folic acid;  antioxidants (including Vitamin A, Beta-Carotene, C, & E, plus GSE Ultra Grape Seed Extract a potent anti-cancer agent, that blocks production of Estrone and Estradiol within the Breasts by inhibiting excessive Aromatase activity that is known to be increased in women with Breast Cancer)
5. Test your hormones annually and take natural, bio-identical, plant derived Estriol and Progesterone to balance your hormones and help prevent cancer.

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Dr Hansen, Hansen Clinic of Natural Medicine

About the Author

Dr. Clark H. Hansen is a licensed Naturopathic Medical Doctor (N.M.D.) who has been in private practice in Scottsdale, Arizona, since 1986. He is the President and Medical Director of the Hansen Clinic of Natural Medicine, Aesthetics and Mesotherapy. Dr. Hansen is one of the most well respected Naturopathic Physicians in the country and a Diplomat of the World Society of Anti-Aging Medicine.

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