How a Mammogram Can Kill You
False diagnosis does not give rise just to psychological problems such as stress and anxiety; according to one of the authors in the BMJ it results in physical harm and even death. Women who are wrongly diagnosed undergo unnecessary surgery, from which there is always some (if statistically small) danger, both from the surgery itself and the anaesthesia. More importantly, the majority of those who are falsely diagnosed as having cancer will receive radiotherapy, which itself causes, or at least is statistically associated with, an excess of deaths later in life from lung cancer and coronary artery disease. Again according to this author, for each life saved by mammography by detecting cancer early there are between 1 and 3 deaths caused by its other consequences. That is why trials of mammography that report only on death rates from breast cancer are insufficient and even misleading. As treatment for breast cancer improves, the presumption against mammography only gets stronger: unless the mammography itself improves in accuracy.
The situation is further complicated by the fact that not everyone agrees with these statistics. In the very same edition of the journal, another expert comes to the conclusion that breast screening is worthwhile, despite overdiagnosis. The harms of radiotherapy, for example, are decreasing as techniques are refined; moreover, diagnosis is becoming ever more accurate and sophisticated, allowing treatment to be tailored to the different kinds of cancer from which women suffer.
A third paper points out the ethical dilemmas of doctors in advising their patients. What should they tell them about mammography? If experts who have devoted most of their professional lives to studying the problem cannot agree even on the facts, for example about how great are the harms caused by overdiagnosis, what hope is their for the ordinary doctor who has only lightly touched the subject?
The chances are, for various reasons, that he will advise screening, for it is a fundamental truth that there is more rejoicing by malpractice lawyers over one false negative than over ninety-nine false positives.
*****
Images courtesy shutterstock / Monkey Business Images
More from Dr. Dalrymple at PJ Lifestyle:
If you take Planned Parenthood up on it and they have no idea of what they’re looking at because 99.4% of the time what they actually do is abortion so you miss finding out you’ve got cancer until it’s too late.
Many years ago, my mother and a group of her friends all decided to participate in a 25 year breast cancer study. As part of the study, they all agreed to get an annual mammogram, which at the time the study began was not usually done unless there was a reason to suspect a problem.
Over the 25 years, my mother received at least 6 — or perhaps it was 9 — false positives. Six times she was hospitalized for a biopsy, with the understanding that if the doctor found cancer, he would immediately remove the breast and any other tissue necessary to remove. At the time of the first biopsy, the procedure was to remove the nipple (which was preserved and reattached), and basically quarter the breast looking for trouble in the suspect quadrant. For what the procedure was, the plastic surgeon who did the re-assembly did a nice job, with little scarring. But the procedure was still horrific, for a response to a false positive. Mom would go on to have 5 more biobsy, of which the last was a needle biopsy. So, that procedure was improved, and perhaps it would not have been, if fewer women had false positives.
I believe Mom had three more false positives after those 6, some of which were resolved by re-imaging, getting different views, or needle biopsy.
Personally, I am not eager to run in for an annual mammogram, myself. Once every 5 years is plenty for me, and if I get a positive, I will not believe it right away.
my thanks to your mother and her friends who participated in the study. it is due to people like her, that progress is made.
1) Have children; 2) don’t get mammograms; 3) don’t wear a bra; 4) don’t wear underwear; 5) don’t smoke; eat vegetables of the kohl crops, . . . and the woman suddenly drops into the lowest percentile for most common cancers, . . .
The title of the article implies mammography kills women.
But the article says its treatment taken after the mammography that kills women.
In the case of a specific Jane patient the outcome of the which choice is more likely to kill me right now is going to be to believe the doctors best guess. My conclusions are
(1)It’s all very well for everyone else’s wives and daughters to not get tested but not my own.
(2) Sounds like we need a better screen for cancer not no screening at all. No duh, I realize thats not a surprise.
Actually, I would delay and limit mammograms for myself, and any other woman I loved.
Once one has a positive test result, even with a test such as this, where the false positives may be as high as 50%, “do nothing and pretend it did not happen” is not an option.
At a minimum, one must repeat the test, generally over vociferous protest from medical professionals, who are not accustomed to having even preliminary test results questioned, and who will accuse those who ask for second views of denying reality, wasting the insurance companies money, wasting time, insulting the person who made the diagnosis, and so on.
Generally, doctors advise a woman to proceed to a biopsy, and to proceed as if the diagnosis is really certain. It can be hard,especially for an inexperienced patient (most of us) to resist the pressure to plunge headlong into fairly intensive treatment.
A person who, by age or family history or other factors, has an elevated risk, may want more frequent mammograms. A younger woman, often, faces a higher probability of false positive from a mammogram, and a lower probability of missing a chance to treat cancer, from delaying mammograms.
If the mammogram result was the sole basis of diagnosis, this might be more trenchant.
The question is: what is the most effective way to detect breast cancers in time for effective treatment, without generating false results, either negative or positive – looking at the entire diagnostic process, not just the mammogram.
If mammograms produced many false positives, but no false negatives – and the false positives could be eliminated by a second test, such as a biopsy – then mammograms would be desirable.
The article implies that a mammogram can be diagnostic of breast cancer. A mammogram detects certain patterns of the tissues (small deposits of calcium, certain star-shaped patterns of scarring) that are statistically associated with an increased probability of a malignancy being their cause. That is NOT a diagnosis. Any “positive” mammogram is an indicator that a malignancy may be present, but the diagnosis is made by some form of biopsy, and it is a lot more difficult to prove that a cancer is not present, than to determine that one is present.
The management of breast cancer has evolved over the last several decades, from when I was a surgical resident, and all breast cancers were diagnosed by finding a lump in the breast and doing a biopsy, followed by a radical mastectomy, to present-day methods of management with lumpectomy, partial mastectomy, and adjuvant radiotherapy or chemotherapy.
Dr. Dalyrymple mentions the bottom line almost casually: the rate of death from breast cancers has been dramatically decreased over the years. We must be doing something right. It has been my observation that British medicine under their NHS has become overly nihilistic, and much of their current literature appears to be aimed at saving money by denying that medical care makes any difference. Maybe that’s true for the British, but then ask yourself why he’s over here.
Last year’s winner of the Intel Science Fair developed a fast, inexpensive and reliable method of detecting pancreatic, lung and ovarian cancers. I see great promise in Jack Andraka’s technique for detecting other types of cancer, perhaps including breast cancer. His technique could be widely used in a doctor’s office setting, saving technologies like mammograms for additional confirmation on positive results. If it lives up to its potential, we’ll be building statues to honor Jack Andraka.
I lost a brother to lymphoma two years ago. He was misdiagnosed and mistreated for 3 years before they got the diagnosis correct. Unfortunately, by then it had spread too far throughout his body and he died 8 months later.
Something here is not right- we’re not given the citations for the articles, but the interpretation of them itself is concerning. As Topknife has already pointed out, mammograms don’t diagnose anything- they are screening tools. It’s the biopsy and surgical pathology that is diagnostic.
Because of this confusion, the article is a little hard for me to follow. The implication here is that half of all women diagnosed with breast cancer don’t actually have it, and are then subjected to unnecessary treatment, which is not true. The 70,000 American women referred to in the article have false-positive mammograms, not a false diagnosis of cancer. No mention is made of the fact that these women will then go on to have a biopsy and then the vast majority of these women will have no further treatment because no cancer is found. That’s how we know the diagnosis is “false” in the first place. I do agree that biopsies are not quick & easy procedures as lab tests go, and it would be wonderful if we had better mammograms to reduce their frequency.
However, it would have to be under very unusual circumstances that a women would have actual treatment for cancer (with all the risk that entails) yet not have biopsy-proven cancer- perhaps a very strong family or genetic history, or other unusual lab/clinical findings.
But perhaps women in the UK really ARE routinely treated with radiation therapy without a biopsy-proven diagnosis of cancer. They must be doing something differently in the UK, since their five-year survival rates are only half as good as ours, and the worst in the developed world.
…how great are the harms caused by overdiagnosis…
What about the cumulative effects of x-raying the breast ?
Hormone replacement therapy for women started in the 1940′s. It was only in 2002 that HRT (oral estrogen) was tied to increased risks of breast cancer, heart disease, stroke, and blood clots.
Ironic that mainstream medical advice over 7 decades may actually have done more harm than good.
…a fundamental truth that there is more rejoicing by malpractice lawyers over one false negative than over ninety-nine false positives.
The sharks are out there, swimming in the waters.
In the United States, we are bombarded with words about breast cancer.
How many of us know that highest rates are in the so called ‘developed’ world ? And even at that it’s 21 out of 100,000 in the United States?
Breast cancer incidence by country
Are we told about the relationship to diet, delayed pregnancy, shorter breastfeeding of infants, exposure to chemicals, and, even possibly long term use of the ubiquitous contraceptive pill ? Or the different types of breast cancer and the strong familial (genetic) connection to its deadliest form ?
(small political note: US democrats insist “the pill” be free. Must be part of their eugenics agenda)
This is the most irresponsible article I have ever seen published at PJM, and I have been a reader for a long time.
As noted by other commentators, mammograms do not diagnose anything, and no treatments (particularly radiation therapy) are ever delivered based upon abnormal mammographic findings. Mammograms provide circumstantial evidence of a possible malignancy, and lead to biopsies.
I preface the rest of this by saying that the Brits have been trying to disprove the value of cancer screening for years. This is in keeping with the philosophy that it is much cheaper to die of cancer than to be diagnosed and treated for it. National health care has its price.
With that said, the blunt statement that our improvement in outcomes with respect to breast cancer relate to better treatment vs. early detection is the silliest, most irresponsible, and frankly dangerous statement of this remarkably bad article. Tell me, DOCTOR, what the improvement in long-term survival has been from women diagnosed with metastatic cancer, or even non-metastatic advanced lymph node positive cancer. Better chemotherapy, targeted agents, and the like have led to incremental benefits in survival, at best.
The major difference has been because of early detection. Period. The smaller and less advanced a tumor is, the more likely we are to cure it, with less toxic treatment. Even if the science and data are beyond your comprehension, the common sense of this should at least strike you as meaningful, yes?
Look at the example of lung cancer. If you take the typical stage 3 non-small cell lung cancer, which is a pretty common presentation, our remarkable treatment improvements over the past few years have barely budged long term survival compared to the barbaric treatments of decades ago. Don’t take my word for it – look up the data.
On the other hand, patients diagnosed with small lung cancers who undergo surgery or radiosurgery have a greater than 90% chance of being cured. We can screen for these tumors, stage them very accurately, and be much more confident that these truly are early stage. AND WE CAN RELIABLY CURE THEM. Often with minimal (if any) toxicity in the case of radiosurgery.
Screening and early detection are the key. Not better drugs or magical thinking.
I don’t know what kind of doctor you are, Dr. Dalrymple, but you have done a serious disservice to those mislead by your ignorance of basic Oncology. Please take a moment to consider this next time you decide to write about something about which you clearly know little.
Dalrymple (Dr. Anthony Daniels) is a psychiatrist.
And a psychiatrist, obviously, is a medical doctor.
“And a psychiatrist, obviously, is a medical doctor.”
Yes – completely true. But a psychiatrist is as qualified to discuss controversial facets of Oncology as I am to discuss the appropriate diagnosis and treatment of ADHD. I can talk all I want about it – I can even read reams of journal articles. And yet I would lack the personal experience and knowledge to offer a true understanding of the nuances of that issue.
It takes an element of maturity and self awareness as a physician to not speak boldly about things we don’t truly understand. Just having the MD behind the name doesn’t make us experts in all things medical.
It saddens me that some doctors don’t have the humility to understand that. They are at best annoying, and very often dangerous to those who offer them respect and attention, just because they believe the title to connote wisdom.
I second Oncologist’s statements, and as a practicing Diagnostic Radiologist who interprets mammograms and breast ultrasounds and performs biopsies, the article is not up to Dr. Dalrymple’s usual standards.
I tell all patients that mammography is not the best tool to find breast cancer, but it is the most cost-effective tool to find MOST breast cancers. MRI is more sensitive to many breast cancers, particularly in women with dense breast tissue, but it’s also 10x more expensive and if you’re trying to screen a population for a sporadic disease, cost becomes an issue.
A ‘positive’ screening mammogram will result in a recall. The subsequent diagnostic mammogram with or without ultrasound is unlikely to end in a biopsy, the national average is that out of 1000 women screened using digital mammography, about 50-100 will be recalled and of those in any given year, most practices will expect to find 3-5 breast cancers out of the original 1000 patients.
Surgical biopsies in my experience have been almost completely supplanted by ultrasound-guided or mammographically-guided stereotactic biopsies. Many surgeons under the age of 50 do not even want to see a woman for consultation for a breast mass or suspicious calcifications until they have biopsy results. Surgical biopsies are generally reserved for indeterminate or discordant results (the pathologic findings do not agree with the expected diagnosis based on imaging appearance), or palpable findings where there is suspicion based on clinical exam findings but no mammographic or sonographic evidence of malignancy. Ultrasound-guided biopsies are routinely performed in my practice with near-zero complications, and what complications occur are often small hematomas (collections of blood) that resolve spontaneously. Both ultrasound and stereotactic biopsies do not use anesthetic other than local anesthesia and as such they lack the risk of general anesthesia. While there is potential for infection as the result of any percutaneous procedure, it is exceptionally rare.
There is a technological improvement in mammography over and above digital mammography, called digital tomosynthesis. This technology uses the same radiation dose as a standard mammogram but creates 3D images a millimeter thick through the breast. One of the limitations of mammography is that it takes flat pictures of round objects, the images are 2D and the breast is 3D. Superimposition of structures can both create the appearance of a mass (a common reason for a recall on a screening exam) as well as obscure a malignancy by sandwiching it between normal but dense tissues. The FDA has approved tomosynthesis and it is rolling out to mammography practices as we speak.
Part of the controversy Dr. Dalrymple refers to may be the result of the nature of Duct Carcinoma In Situ, which is an early form of breast cancer with a dual nature. About 60% of DCIS will progress into invasive breast cancer and pose a threat to the patient’s life if left untreated. About 40% of DCIS will follow an indolent course and if left untreated could represent a cancer that a woman would die with, rather than from. A similar situation is present in prostate cancer, with some tumors behaving aggressively and some benignly, despite having the pathologic appearance of cancer. There is no reliable way to differentiate between the indolent DCIS and the aggressive DCIS, and as a result any DCIS diagnosis is treated as aggressive DCIS and receives surgery as well as a recommendation for radiotherapy. It is possible that at some point DNA sequencing will allow tumors to be individually evaluated and the potential for aggressive behavior assessed, with no treatment for indolent findings and aggressive treatment for aggressive lesions, but we’re not there yet by a long shot.
Mammography’s value is frequently called into question by systems whose only significant concern is cost-effectiveness, and usually the question of cost-effectiveness is always decided on criteria most disadvantageous to mammography. Mammography will detect breast cancers an average of one cancer stage earlier than clinical exam or waiting for a woman to be able to feel a mass, and the earliest stage of breast cancer (DCIS) is rarely if ever palpable at discovery.
I appreciate Dr. Dalrymple bringing the issue up, but a more complete assessment of the issue would do PJM readers good. The ‘con’ argument for mammography has already been covered by the US Preventative Services Task Force of 2009, and it’s telling that the American Cancer Society, the American College of Surgeons, the American College of Radiology and a host of other organizations comprised of people who actually deal with the detection and management of breast cancer rejected the USPSTF recommendations for changing the use of mammography.
Thanks for taking the time to do this, doc.
I am a practicing radiation oncologist, and (as you can tell from my posts) I found the article to be alarmingly misleading and incorrect. I also see many of the fears of people who have posted replies conveyed to me during office visits with patients (and their families) newly facing the prospect of radiation therapy and/or chemotherapy. I don’t think it is possible to change any minds in the context of a web forum, but I set my consults at 2 hours, and often go over that, because these issues take time to discuss, and these very real fears take a great deal of TLC to address.
It would be easier for me, by far, to simply let people walk away. That would make no difference to my income, as I am not paid “by the patient”, so to speak. I do it because it is the right and responsible thing to do. Most of the time, I can correct misconceptions, allay fears, and begin a journey with the patient that s/he begins to understand and accept. Occasionally I cannot. I say with the greatest sincerity that I take no pleasure in reading such patients’ obituaries, and it is poor consolation to know that ulitmately, individuals still have the right to choose to die of their potentially curable cancers. Freedom includes freedom to be stubborn, self-destructive, and sometimes plain stupid.
I want to make one addendum to your excellent summary above. Breast MRI is a very useful tool when used properly, but it is not simply the cost that makes it a poor choice for screening. Breast MRI is highly, highly sensitive, but not very specific. In English, that means that it shows every little doodad and doohicky in the breast, most of which are harmless. Most of these spots would not show up on mammography, which is a good thing, because although you guys are getting better at determining which MRI findings are suspicious and which are not, MRIs still lead to tons of biopsies – just to make sure…
I hope Dr. Dalrymple voluntarily retracts or ammends this article. If he reads these comments and persists with his misstatements, I can only conclude that he does not care about causing harm, as long as he gets eyeballs looking at his sensationalistic (and incorrect) article. That’s not acceptable – when you’re a doc, you’re a doc first and foremost. FIRST, DO NO HARM.
Mr T:
I always enjoy your articles, however, you have made a serious mis-statement (at least in regards to medical practice in the US) in that you say:
“(t)he majority of those who are falsely diagnosed as having cancer will receive radiotherapy”
I worked twenty years in Radiation Oncology (as a medical physicist) and NO PATIENT IS EVER TREATED WITH RADIATION WITHOUT A POSITIVE PHYSICAL (BIOPSY) PROVEN DIAGNOSIS OF CANCER unless they have known metastatic cancer (i.e. they have biopsy proven cancer and a likely site of metastatic disease–this is done to protect the patient from repeated painful and dangerous biopsies when serial diagnostic scans showing that the possible metastatic site shows all the characteristics of cancer, i.e. rapid growth, etc.).
All non-invasive medical tests have a certain fraction of “false positives” and “false negatives” (biopsies, IMHO, can have false negatives, but a false positive (as opposed to an inconclusive result) would require an incompetent pathologist.
The current full court press against early diagnosis of cancer in the US and Europe is, IMHO, based solely on the desire to reduce the cost of medical care by reducing what is called “over-diagnosis”. This means finding cancers that are real, but, would in the opinion of the bureaucrats, not have killed the patient before they died of something else.
Certainly, early diagnosis of cancer does result in treatment of cancer before there are physical symptoms of their disease (pain, metastatic spread, paralysis, etc). Some of these cancers would never have overtly threatened the patients life (although they may contributed to bad health or even death without being the “cause” of death.
The problem is we currently cannot identify which patients benefit from early diagnosis and treatment of cancer and which don’t.
The bureaucrats answer is only to find and treat cancers that have been “proven” (evidence based medicine is the new catch phrase) to “benefit” from early diagnosis and treatment. That was the basis for the recent decision to “discourage” (really eliminating) PSA testing for men (“discouraging” mammography is the latest project along this line).
This will save a lot of money for the government but will condemn to a painful death many people who could have been saved by early diagnosis and treatment. It will also prevent people who will NOT benefit from early diagnosis and treatment (i.e. they would have died from something else before their cancer showed symptoms) from being treated.
Once again the problem is that we DON’T KNOW WHICH PEOPLE FALL INTO EACH CATEGORY. If we did we could in good conscience not treat the people who would not benefit. But I wonder how we can deny life-saving treatment to everyone in order to prevent over-treating some people.
PS. I have terminal cancer already so this doesn’t affect my employment just the lives of my friends and relatives.
A note of the “scientific” basis for discontinuing cancer screening.
First, I think it is no coincidence that the cancers for which screening is being (or has been) discouraged share three characteristics: (1)Good, non-invasive screening tests are available (2)Very common cancers, and (3)Effective, but expensive, treatment is currently available.
Three examples:
1) LUNG CANCER. Chest x-rays used to be a part of almost everyone’s annual physical. While not perfect, they are (probably) the only inexpensive way to diagnose lung cancer prior to symptoms. Usually, lung cancer is very advanced before symptoms are noted. Ending screening chest x-rays was sold to the public based on the “high risks” from the tiny amount of radiation required for the test. Despite the widely held view that only smokers get lung cancer, many people who have never smoked are lung cancer victims.
2) PROSTATE CANCER. Recently, the US government decided there was no “benefit” to screening for the most common cancer in men (prostate) using a simple blood test (PSA). While the PSA does have significant false positives, it is valuable for the men who will gain the most from screening for prostate cancer: those young and otherwise healthy. Discontinuing PSA testing for elderly men in poor health is probably reasonable since prostate cancer is usually slow growing (in the elderly) and may have few symptoms until it spreads beyond the prostate. However, prostate cancer can be very aggressive in younger men. I have read the research that this decision was based and it is, IMHO, weak. The two studies, especially the North American study, were very poorly designed and seem to have been intended to find the “correct” answer. While supposedly still available at patient request, some doctors (mine for example) will already NOT order a screening PSA test. The only rationale for not screening with PSA is that it leads to “over diagnosis.” It is painless and relatively inexpensive but it does lead to finding lots of non-symptomatic, early stage cancers that are expensive to treat. Some, admittedly, don’t really “need” to be treated but except for early stage cases in very elderly men (or those in very bad health), it is impossible to know which patients don’t need treatment.
3)BREAST CANCER. Mammography is the screening test for the most common type of cancer among women. It is coming under increasing attack as “unsafe,” once again because it leads to treatments that are not “needed” (with the “high” risk of the tiny radiation dose from the test thrown in as a bonus reason). Having read some of the so-called “research” on which this conclusion is based, I think that the “let them have cancer” crowd has a very weak case. However, the writing is on the wall. Mammography screening will become rare because it finds too many cancers that are expensive to treat.
Certainly, not all cancers should be treated. An argument can be made that early stage prostate cancer in elderly (or infirm) men should be watched instead of treated aggressively. Similarly, breast carcinoma in-situ might be a candidate for the same “watchful waiting” approach in elderly (or infirm) women. However, the current attempt to discredit cancer screening for some very common cancers for virtually everyone is criminal, IMO. I am willing to bet that the same political elites that want to stop you being screened will continue to be screened (along with their loved ones). It reminds me of the Canadian politicians that defend Canadian Medicare to the (i.e. your) death but come to America for treatment when they have a life-threatening illness.
“Certainly, not all cancers should be treated.”
Absolutely. And this decision should be the result of an honest discussion between a patient and his physician.
NOT the government.
Gary,
Part of the reason for dropping chest plain films as a screening tool for lung cancer is that to make a significant difference in the outcome for lung cancer a tumor needs to be identified and excised before it exceeds 10mm in diameter. That is a very small lesion.
There are some recommendations for low-dose screening CT exams, which have a better sensitivity to tiny lesions, but there are a lot of false positives. One example is a fungal infection common in the midwest called histoplasmosis, it’s usually not a problem but people who have had and beaten histoplasmosis can often have small masses in their lungs called granulomas…roughly the size and shape of a baby cancer. Most granulomas are calcified, but the non-calcified ones have to be followed.
How to find lung cancers early is a topic of much discussion right now. We haven’t given up, but plain films find cancers a little too far down the road to allow a cure in many cases. The 2-year survival rate of a 10mm small cell lung cancer is something like 10%.
I’ve had three mammograms. The first when I was in my early 30′s , as part of a well-woman exam. They admitted at the time that since young breast tissue is so dense, there is very little they can tell from the images, but I guess if there had been any strong anomaly they could have done further tests. Not more than 6 months later I received a certified letter urging me to schedule another mammogram for follow-up. I thought it was odd and ignored it (I’m sure most would not have ignored this…) 10 years later I had my 2nd mammogram. This time, they found an “anomaly” and a follow-up mammogram was scheduled right away. During the exam the second time, I asked the technician what she could see (of the anomalous region). She said something to the effect “Well the doctor (of radiology) will have to make the determination. But off the record, I can say that we see this all the time and it’s completely normal.” I got a certified letter some time later urging me to schedule another one soon, that although the “anomaly” was deemed “normal” …and so on. Incidentally I have a high-deductible plan. The follow-up mammogram, which isn’t considered preventive–it is TREATMENT at that point, was cash out of pocket. I paid this willingly, of course. But it does make me wonder and I’ve grown suspicious of the whole mammography business.
My first wife had her first round of breast cancer treatment at the age of 26; lumpectomy amd radiation.
At 42, she fell to the floor with a siezure. A completely different kind of breast cancer had already metastasized to her liver, spine, and brain. She died about 18 months later, after throwing everything in the medical toolbox at it.
Over her lifetime, she had over 20 mammographies.
Not one was positive.
If it gives so many false positives AND false negatives, of what use is it?
My sister is so thankful that she had a mammogram – she’s now a breast cancer survivor. Note to the good doctor – conflating screening with diagnosis can kill women as well.
It’s reported that the intense pressure used in the mammogram can actually cause cancer cells to spread to other parts of the body if the woman does have breast cancer.
Also, radiation and chemotherapy treatment CAUSE CANCER! It is extremely wrong and UNETHICAL that radiation and chemotherapy is used on anyone. Many people are dying sooner from the radiation and chemotherapy than they are from cancer. Also, older people are not supposed to have radiation and chemotherapy because they just cannot take this massive assault on their bodies.
Linda Rivera Akin, is it?
Who is Akin?
Todd Akin. You seem to have a similar understanding of science as Todd Akin.
Very, very pitiful.
Everything you said is wrong.
Everything.
Are you claiming that chemotherapy and radiation don’t cause cancer? Radiation and chemotherapy do CAUSE CANCER! It is an established fact!
Risk of cancer caused by radiation therapy or chemotherapy: Less than 1%. In most cases, much, much less, usually after many years.
Risk of having cancer if you have been prescribed chemotherapy or radiation therapy: 100%.
So if I am to understand you, you would prefer to die of an established cancer, because you are worried that the potentially curative treatments have a miniscule risk of causing cancer, up to decades in the future?
This makes sense to you?
The incidence of cancer in the human population overall is about 20%. One out of five people will develop a malignancy.
Against that background, finding a cancer caused by radiation therapy, diagnostic radiology or chemotherapy is statistically difficult. It does happen, but the incidence of finding a breast cancer induced by mammography is exceptionally low, on the order of 1-2 per million women screened over a lifetime. Even then, that is a theoretical risk because proving that a malignancy came from mammography is not possible.
I most definitely believe in the surgical removal of cancer!
Add 6) stay off hormone treatments; 7) stay off the pill – it’s a number 1 carcinogen and 8) don’t ever have an abortion…to PhillipGaley’s list abov at comment #2.
I stopped having mammograms over 4 years ago. Due to cysts they are painful and I believe cause more damage to the tissue than they are worth, my gyn gave me a scrip for an MRI instead. I wouldn’t be surprised that in the future they find mammograms actually cause or exacerbate cancer.
Your article is poorly written. 70,000 women have not been falsely diagnosed with breast cancer. The correct statement should have been that they were told that there is an area of suspicion that needs to be biopsied for a conclusive diagnosis. That is not being diagnosed falsely with breast cancer. Get your facts straight, write a more truthful article. I know from what I speak. I am a mammographer who also happens to be a breast cancer survivor. On a second note, quoting British Medical Journals and their socialized medicine nightmare loses all credibility in my book.
Some years ago an article appeared in The New Yorker magazine called, as I recall, “Pictures.” It was about photographic images, not mammography, but it talked about a study of autopsy results that showed, if I remember correctly, that 40% of women who died of other causes, had tiny, apparently non-threatening, breast cancers.
This got me thinking, and I have read many articles since that discuss, sort of like what happened with men and prostate cancer, the benefits of not treating these tiny cancers, since they will never kill you.
One thing to remember if you do have a false positive or ambiguous result, as I did – once you have a needle biopsy, scarring shows up in future mammograms as questionable tissue – leading to more biopsies. Once I realized this I stopped getting mammograms – but there is an argument every time I visit a doctor. I’m 68 and had my last mammogram more than 20 years ago.
I personally know two women who as the result of a mammogram were diagnosed with tiny breast cancers. They had surgery followed by DAILY radiation treatments of both breasts for 6 weeks. Needless to say, it wasn’t many years later, that the other breast showed evidence of cancerous cells. More surgery and radiation.
I think the exposure to radiation is also dangerous: those of us who grew up sticking every available part of our bodies under those xray machines they used to have in shoestores, and who got chest xrays as part of every physical exam, might want to limit their exposure.
I fault the Komen types who exaggerate the “benefits” (if there are any) of mammography in order to raise money. Cancer “cure” rates are incomprehensible too. I know women whose breast cancer was diagnosed “early” who are dead, and women diagnosed in the late stages who are alive 15 and 20 years later. So I even question whether “early diagnosis” has any effect.