This week’s article is comprised of excerpts from a compelling and well-researched article by Christie Aschwanden titled, “What If Everything Your Doctors Told You About Breast Cancer Was Wrong?” It explores the rhetoric, hype, politics, and costs of mammography, detrimental effects on women, and personal perspectives.
For every 10,000 screened by mammography, 10 women will avoid dying of breast cancer
… that is 1/10 of 1% and a striking statistic that speaks to the inadequacy of mammography. According to JAMA, for every 10,000 women who have annual mammograms for 10 years, starting at age 50, over 60% will receive a false positive and less than 40% will have normal results. Of the 302 women that will be diagnosed with breast cancer, 173 will survive; 62 will die despite the screening; 57 women will be diagnosed with a cancer that would have never hurt them; and 10 will avoid dying of breast cancer, possibly because they got a mammogram.
We currently spend about $10 billion annually on mammography in the US.
The British Medical Journal revealed that most women are unaware that mammograms routinely detect harmless early-stage cancers and anomalies like DCIS (ductile carcinoma in situ). DCIS now accounts for 20% to 30% of all breast cancer diagnoses, and the adoption of digital mammography is pushing those numbers even higher.
Aggressive treatments like surgery have become alarmingly common for women diagnosed with DCIS, even though the vast majority of them would never turn into breast cancer.
A study published in JAMA Oncology of more than 100,000 women with DCIS found that their risk of dying of breast cancer was virtually identical to that of the average woman without DCIS or any signs of breast cancer.
The cost of false-positive mammograms is about $4 billion per year.
National Cancer Institute researchers have discussed removing the word carcinoma from the DCIS name and renaming the condition IDLE, for "indolent lesions of epithelial origin," to discourage unnecessary treatment and help women avoid the fear that comes with the C word.
Language matters. Our discomfort with the words "cancer" and "carcinoma" points to a larger problem: The minute a mammogram shows us something scary, we become emotional, and that usually means we go down a spiral of escalating tests and diagnoses. Fear prevents rational decision-making.
"If mammography were a drug, the FDA would never approve it,"
says Dr. Eric Topol, a professor of genomics at the Scripps Research Institute and editor-in-chief at Medscape, an information website for health care professionals. "We've crossed the line," he adds.
The energy thrown at the mammography wars is standing in the way of progress on fighting breast cancer, says Otis Brawley, chief medical officer at the American Cancer Society. "Instead of arguing about whether we should recommend this flawed test for women in their 40s, we need to find something better," he says.
So what should women do?
"If you feel something when you're in the shower or putting on a shirt or making love, get it checked out," says breast surgeon Susan Love. There are non-radiation tests.
The author, Christie Aschwanden, wants each woman to make her own informed decision and is choosing to opt out of mammograms, reminding readers that lung cancer kills more women each year than breast cancer, as does heart disease.
We owe it to ourselves to take the time to learn the facts, make evidence-based decisions, and not react out of fear, losing parts of ourselves and our lives unnecessarily.
To Learn More
See the full article: What If Everything Your Doctors Told You About Breast Cancer Was Wrong?
Get Empowered: Better Breast Health - for Life!™
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