Everybody is missing the point on screening mammography
A debate has sprung up over the last few weeks. It is not a new debate; it concerns mammography. Recently there has been research that shows 4000 people in the UK are unnecessarily treated as a result of ‘Over-diagnosis’ by screening mammograms. The ‘pro’ side immediately says ‘1300 lives are saved and have to be set against this’. And then journalists from the Telegraph and BBC jump in on the act. Unfortunately, few know their facts. I won’t be updating our article on mammography at CANCERactive because, as usual, we were well ahead of this debate. What I thought you might like to read is the essence of my piece to the Telegraph, and why I think everybody seems to be missing the important issue:
Firstly, there is no confirmed research data that mammography saves 1300 lives a year in the UK. Until recently the Cancer Research UK website admitted that fact. There are various studies and reports, for example, showing the figures of 1300, 850 and zero. Take your pick.
Secondly, whilst people have been debating issues such as over-diagnosis and unnecessary treatment and distress, the debate has missed the fact that mammography can likely cause breast cancer. For example, about 25 per cent of breast cancers are linked to inherited genes where the person usually has one of the pair defective, and only one operating correctly. American research is quite clear that these people are at greater risk of developing breast cancer if sent off from an early age for an annual mammogram ‘to be safe’. The cumulative radiation is statistically far more likely to damage a single gene than a pair.
Thirdly, some ‘diagnosed’ women consider having double mastectomies. The idea of a double mastectomy is palpable non-sense with no evidence whatsoever in terms of numbers over who might have been prevented from developing cancer! Cancer is an all over body disease with symptoms like cancer markers, low blood oxygen and poor immune response evident throughout the body. If you have a BRCA1 or 2 problem, it will cause poor immune recognition or DNA replication control everywhere in your body. If a woman has toxic chemicals in her body, they will not only collect in the fatty breast tissue but in other such tissue too.
Fourthly, to add to the confusion, about 50 per cent of the ‘irregularities’ detected by mammography are lobular, and 50 per cent ductal. While Christies, Manchester were warning some 5 years ago that DCIS could be extremely dangerous and were looking at trials to see which drug might be used to prevent an aggressive cancer developing, at the annual Breast Cancer Symposium in America a paper was presented showing that DCIS was caused by calcium deposits, and 80 per cent never became cancers. The finding that women with the highest blood levels of vitamin D and omega-3 do not develop breast cancer may be linked to their effects with calcium.
European research has shown that depending on the density of the tissue, screening mammography may be only 65 per cent accurate at best. Other studies have shown that in order to detect the cancer it has to be of sufficient size – a size produced by about 20 cell divisions. At 40 you are dead. Screening mammography is neither accurate nor early detection.
How many of the 4000 women who are then unnecessarily treated die as a result of the chemotherapy drugs provided? How many have impairment to their heart and/or lungs as a result of radiotherapy? Is it is more than the 1300? But surely even this question is off the point: Why are we using such an outdated and inaccurate system which can lead to quite barbaric consequences (double mastectomy?).
Surely, the energy, time and the money would be better spent developing blood tests that are already coming through from private companies in Nottingham and America that can spot cancer in the pre-cancer stages.
This argument about screening mammography is completely off the real point and is propagated by vested interests. How many hospitals and cancer centres would be stuck with an expensive machine if an accurate blood test were available tomorrow? (Although I should point out that mammography is the current gold standard once a cancer has been confirmed and further information is required.)
The real question we should be asking is this: ‘How do we develop a simple, accurate and early diagnosis test for cancer?’ The answer has nothing to do with mammography.
For a fuller report see:
http://www.canceractive.com/cancer-active-page-link.aspx?n=1420&Title=Breast cancer screening and cancer risk
http://www.canceractive.com/cancer-active-page-link.aspx?n=666&Title=False Positive Mammograms
http://www.canceractive.com/cancer-active-page-link.aspx?n=2644&Title=The Development of Thermal Imaging