Study: US Spends $4B a Year from
False-Positive Mammograms and Breast Cancer Overdiagnosis
April 22, 2015
Story at-a-glance
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Every year in the US, $4 billion is spent on
false-positive mammograms and breast cancer
overdiagnosis
Rates of false-positive results are as high as 20-56
percent after 10 mammograms
Diagnosis and treatment of early stage cancer like
ductal carcinoma in situ, or D.C.I.S., is controversial
because it often causes no health problems
By Dr. Mercola
A mammogram, which is an x-ray of your breasts, is offered by
conventional medicine as the best “prevention” strategy for
breast cancer. The idea is that by detecting potential cancer
early on, it is easier to treat and therefore should be less
dangerous and, ultimately, less deadly.
Unfortunately, this theory is flawed for several reasons,
including the fact that it does not account for the risks of the
screening itself. Mammography is not an innocuous risk-free test.
As an x-ray, mammography exposes you to ionizing radiation that
can cause cancer. Perhaps even worse, its rate of false
positives is high, which means women are being subjected to
additional invasive testing, psychological distress, and even
treatment for “cancers” that pose no real health threat.
In November of 2009, the US Preventive Services Task Force, a
federal advisory board, revised their cancer screening
recommendations for these very reasons, saying annual mammograms
weren't necessary for women under age 50 and that screenings were
recommended only every two years after that.
The panel based the new guidelines on data indicating that
mammography does more harm than good when used on younger women.
Many cancer groups refused to adopt these guidelines, however, and
still recommend women over the age of 40 to be screened annually.
This includes the American Cancer Society, the National Cancer
Institute, and the American College of Radiology. But yet another
study, this one conducted by a research fellow at Boston Children's
Hospital along with a professor at Harvard Medical School, has again
questioned mammography’s merits…
Mammograms Result in $4 Billion a Year in Unnecessary Medical Costs
in the US
Every year in the US, $4 billion is spent on false-positive
mammograms and breast cancer overdiagnosis among women ages 40-59,
according to new research published in Health Affairs.1
The researchers noted:
“The costs associated with false-positive mammograms and
breast cancer overdiagnosis appear to be much higher than
previously documented… the economic impact of false-positive
mammography results and breast cancer overdiagnosis must be
considered in the debate about the appropriate populations for
screening.”
The findings echo previous research that has found a strikingly
high rate of false positives. In 2007, the Archives of Internal
Medicine published a meta-analysis of 117 randomized,
controlled mammogram trials. Among its findings: rates of
false-positive results are as high as 20-56 percent after 10
mammograms.2
Similar results were found in a 2009 meta-analysis by the
Cochrane Database Review, which found that breast cancer
screening led to a 30 percent rate of overdiagnosis and
overtreatment, which actually increased the absolute
risk of developing cancer by 0.5 percent.
The review concluded that for every 2,000 women invited for
screening throughout a 10-year period, the life of just ONE woman
was prolonged, while 10 healthy women were treated unnecessarily.3
And in 2014, the Swiss Medical Board reported that for every
breast-cancer death prevented in US women over a 10-year course of
annual screening beginning at 50 years of age:4
490 to 670 women are likely to have a false-positive
mammogram with repeat examination
70 to 100, an unnecessary biopsy
Three to 14, an over-diagnosed breast cancer that would
never have become clinically apparent
False-Positive Mammograms Exact a Large Psychological and
Potentially Physical Toll
When a woman is told she may have breast cancer, it causes
considerable anxiety and psychological distress. Meanwhile, you will
be subjected to more testing, such as biopsy or surgery, which carry
their own set of risks, unnecessarily.
If a mammogram detects an abnormal spot in a woman's breast, the
next step is typically a biopsy. This involves taking 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.
The problem is that 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 no
diagnostic standards for D.C.I.S., and there are no requirements
that the pathologists doing the readings have specialized expertise.
Dr. Shahla Masood, the head of Pathology at the University of
Florida College of Medicine in Jacksonville, told the New York
Times:5
"There are studies that show that diagnosing these
borderline breast lesions occasionally comes down to the flip of
a coin."
Some even hesitate to call D.C.I.S. “cancer” at all. Also known
as stage zero cancer—or cancer you may die with but not
from, D.C.I.S. is often essentially harmless... According to
Dr. Christiane Northrup, a practicing physician and ob-gyn
specialist:
"[Researcher Gilbert Welch] pointed to a study [from] way
back, of women who died in car accidents in their 40s. They
sectioned their breast tissues and found that 40 percent of them
– this is normal healthy women dying in car accidents – had
evidence of ductal carcinoma in situ that was never going to go
anywhere. This is the big dilemma."
One of the Largest and Longest Mammogram Studies to Date: Mammograms
Do Not Save Lives
Last year, one of the largest and longest studies of mammography
to date, involving 90,000 women followed for 25 years, found that
mammograms have absolutely NO impact on breast cancer mortality.6
As reported by the New York Times:7
"One of the largest and most meticulous studies of
mammography ever done, involving 90,000 women and lasting a
quarter-century, has added powerful new doubts about the value
of the screening test for women of any age.It found
that the death rates from breast cancer and from all causes were
the same in women who got mammograms and those who did not. And
the screening had harms: one in five cancers found with
mammography and treated was not a threat to the woman's health
and did not need treatment such as chemotherapy, surgery or
radiation."
Research published in The Lancet Oncology in 2011 also
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.8
Susan G. Komen for the Cure Uses Misleading Statistics to Promote
Mammography
A 2012 report in the British Medical Journal9
(BMJ) exposed how Susan G. Komen for the Cure is using misleading
statistics to persuade women to undergo
mammography. The authors wrote:
"Unfortunately, there is a big mismatch between the
strength of evidence in support of screening and the strength of
Komen's advocacy for it. A growing and increasingly accepted
body of evidence shows that although screening may reduce a
woman's chance of dying from breast cancer by a small amount, it
also causes major harms.
In fact, the benefits and harms are so evenly balanced
that the National Breast Cancer Coalition, a major US network of
patient and professional organizations, ‘believes there is
insufficient evidence to recommend for or against universal
mammography in any age group of women.’
...In contrast, Komen's public advertising campaign gives
women no sense that screening is a close call... The
advertisement states that the key to surviving breast cancer is
for women to get screened because 'early detection saves lives.
The 5-year survival rate for breast cancer when caught early is
98%. When it's not? 23%.'This benefit of mammography
looks so big that it is hard to imagine why any woman would
forgo screening. She'd have to be crazy. But it's the
advertisement that is crazy..."
The data Komen uses—the five-year survival data—presents a
dramatically distorted picture. Furthermore, the advertisement makes
no mention of any of the harms clearly associated with the
screening at all. The authors go on to explain why survival data
cannot be used to make a case for or against mammography:
"To see how much lead time can distort five-year survival
data, imagine a group of 100 women who received diagnoses of
breast cancer because they felt a breast lump at age 67, all of
whom die at age 70. Five-year survival for this group is 0%. Now
imagine the women were screened, given their diagnosis three
years earlier, at age 64, but still die at age 70. Five-year
survival is now 100%, even though no one lived a second longer."
Overdiagnosis also distorts survival statistics because women who
receive false positives are counted as having survived the cancer!
As mentioned earlier, for every woman saved, 10 women are
misdiagnosed and treated unnecessarily, so the distortion due to
overdiagnosis is massive. And, as the authors explained, the more
women are overdiagnosed, the more the survival statistics are
skewed.
"If there were an Oscar for misleading statistics, using
survival statistics to judge the benefit of screening would win
a lifetime achievement award hands down. There is no way to
disentangle lead time and overdiagnosis biases from screening
survival data," the authors stated.
Mammograms May Also Offer a False Sense of Security
Aside from false positives, there's also the risk of getting a
false negative, meaning that a life-threatening cancer is missed.
It's important to realize that a negative mammogram cannot
be equated with a clean bill of health. All a negative mammogram can
tell you is that IF you do have cancer, it hasn't grown large enough
yet to be detected. This is particularly true for women with dense
breast tissue. Dense breast tissue and cancer both appear white on
an x-ray, making it nearly impossible for a radiologist to detect
cancer in these women. It's like trying to find a snowflake in a
blizzard.
Forty-nine percent of women have high breast tissue density,10
and mammography's sensitivity for dense breasts is as low as 27
percent11—meaning
about 75 percent of dense-breasted women are at risk for a
cancer being missed if they rely solely on mammography.
Even with digital mammography, the sensitivity is still less than 60
percent.
Breast density laws have been passed in California, Connecticut,
New York, Virginia, and Texas, making it mandatory for radiologists
to inform their patients who have dense breast tissue that
mammograms are basically useless for them. A law is now being
considered at a federal level as well.
Some radiologists already provide density information to their
patients and encourage them to utilize other options. I believe it
reasonable for a woman to trust that her radiologist is not
withholding vital breast-density information. Unfortunately, many
have kept this potentially lifesaving data from women for decades,
and our government agencies have failed to protect them from this
unethical, albeit profitable practice.
Women with BRCA ½ Mutations Are Especially at Risk from Mammogram
Another at-risk group are women with BRCA 1/2 mutation, which is
associated with an increased risk of breast cancer. But results
published in BMJ in 2012 showed that women carrying this
mutation are particularly vulnerable to radiation-induced
cancer.12
Women carrying this mutation who were exposed to diagnostic
radiation before the age of 30 were twice as likely to
develop breast cancer compared to those who did not have the mutated
gene. They also found that the radiation-induced cancer was
dose-responsive, meaning the greater the dose, the higher the risk
of cancer developing. The authors concluded that:
"The results of this study support the use of
non-ionizing radiation imaging techniques (such as magnetic
resonance imaging) as the main tool for surveillance in young
women with BRCA1/2 mutations."
Despite these findings, the National Cancer Institute reports
that some expert groups recommend women with BRCA 1/2 mutation have
a mammogram every year starting as young as age 2513
– the exact scenario that the BMJ study found may
double their breast cancer risk!
Please understand that there are other screening
options, each with their own strengths and weaknesses, and you have
a right to utilize those options. Also remember that in order to
truly avoid breast cancer, you need to focus your attention on
actual prevention and not just early detection.
How to Lower Your Risk of Breast Cancer Naturally
Cancer screening that does more harm than good can hardly qualify
as your “best bet" against becoming a cancer statistic. I believe
the vast majority of all cancers could be prevented by strictly
applying basic, commonsense healthy lifestyle strategies, such as
the ones below.
Avoid sugar, especially fructose, and processed
foods. All forms of
sugar are detrimental to health in general and promote
cancer. Refined fructose,
however, is clearly one of the most harmful and should be
avoided as much as possible. This means avoiding processed
foods, as most are loaded with fructose.
Optimize your vitamin D levels.
Vitamin D influences
virtually every cell in your body and is one of nature's most
potent cancer fighters. Vitamin D is actually able to enter
cancer cells and trigger apoptosis (cell death).
If you have cancer, your vitamin D level should probably be
between 70 and 100 ng/ml. Vitamin D works synergistically with
every cancer treatment I'm aware of, with no adverse effects.
Ideally, your levels should reach this point by exposure to the
sun or a safe tanning bed, with oral vitamin D used as a last
resort.
Optimize your gut health.
Gut microbiota is known to affect inflammation and
metabolism, both of which are hallmarks of cancer. Microbes can
affect cancer susceptibility by modulating your immune system
and inflammation. They can also influence gene expression, and
appear to have the ability to alter the stability of your genes.
Gut microorganisms even appear to impact the efficacy of
various cancer treatments. In addition to avoiding sugar, you
can optimize your gut health by eating fermented vegetables
and/or taking a high-quality probiotic supplement.
Limit your protein. Newer research has
emphasized the importance of the mTOR pathways. When these are
active, cancer growth is accelerated. One way to quiet this
pathway is by limiting your protein to one gram of protein per
kilogram of lean body mass, or roughly a bit less than half a
gram of protein per every pound of lean body weight.
For most people, this ranges between 40 and 70 grams of
protein a day, which is typically about 2/3 to half of what they
are currently eating.
Avoid unfermented soy products.
Unfermented soy is high in plant estrogens, or
phytoestrogens, also known as isoflavones. In some studies, soy
appears to work in concert with human estrogen to increase
breast cell proliferation, which increases the chances for
mutations and cancerous cells.
Improve your insulin and
leptin receptor sensitivity. The best way to do
this is by avoiding sugar and grains and restricting carbs to
mostly fiber vegetables. Also make sure you are exercising,
especially with
Peak
Fitness.
Exercise regularly. One of the primary
reasons
exercise works to lower your cancer risk is because it
drives your insulin levels down, and controlling your insulin
levels is one of the most powerful ways to reduce your cancer
risks. It's also been suggested that apoptosis (programmed cell
death) is triggered by exercise, causing cancer cells to die.
Studies have also found that the number of tumors decrease
along with body fat, which may be an additional factor. This is
because exercise helps lower your estrogen levels, which
explains why exercise appears to be particularly potent against
breast cancer.
Maintain a healthy body weight. This will
come naturally when you begin
eating
right and exercising. It's important to lose excess body fat
because fat produces estrogen.
Drink a pint to a quart of organic green vegetable
juice daily. Please review
my juicing instructions for more detailed information.
Get plenty of high-quality, animal-based
omega-3 fats,
such as krill oil.
Omega-3 deficiency is a common underlying factor for cancer.
Curcumin. This is the active ingredient in
turmeric and in high concentrations can be very useful
adjunct in the treatment of cancer. It actually has the most
evidence-based literature supporting its use against cancer of
any nutrient, including vitamin D.14
For example, it has demonstrated major therapeutic potential in
preventing breast cancer metastasis.15It's
important to know that curcumin is generally not absorbed that
well, so I've provided several
absorption tips here. Newer preparations have also started
to emerge, offering better absorption. For best results, you'll
want to use a sustained release preparation.
Avoid drinking alcohol, or at least limit
your alcoholic drinks to one per day.
Avoid electromagnetic fields as much as possible.
Even electric blankets may increase your cancer risk.
Avoid synthetic hormone replacement therapy,
especially if you have risk factors for breast cancer.
Breast cancer is an estrogen-related cancer, and according to a
study published in the Journal of the National Cancer
Institute, breast cancer rates for women dropped in tandem
with decreased use of
hormone replacement therapy. (There are similar risks for
younger women who use oral contraceptives. Birth control pills,
which are also comprised of synthetic hormones, have been linked
to cervical and breast cancers.)
If you are experiencing excessive menopausal symptoms, you
may want to consider bioidentical hormone replacement therapy
instead, which uses hormones that are molecularly identical to
the ones your body produces and do not wreak havoc on your
system. This is a much safer alternative.
Avoid BPA, phthalates, and other xenoestrogens.
These are estrogen-like compounds that have been linked to
increased breast cancer risk.
Make sure you're not iodine deficient, as
there's compelling evidence linking iodine deficiency with
certain forms of cancer. Dr. David Brownstein, author of the
book Iodine: Why You Need It, Why You Can't Live Without It,
is a proponent of iodine for breast cancer. It actually has
potent anticancer properties and has been shown to cause cell
death in breast and thyroid cancer cells.16
For more information, I recommend reading Dr. Brownstein's
book. I have been researching iodine for some time ever since I
interviewed
Dr. Brownstein as I do believe that the bulk of what he
states is spot on. However, I am not at all convinced that his
dosage recommendations are correct. I believe they are far too
high.
Avoid charring your meats. Charcoal or
flame-broiled meat is linked with increased breast cancer risk.
Acrylamide—a carcinogen created when starchy foods are baked,
roasted, or fried—has been found to increase cancer risk as
well.
What Are GMOs?
From April 19th through April 25th we launch GMO Awareness Week.
We set aside an entire week dedicated to providing you with
information on GMOs and labeling initiatives.
GMOs are a product of genetic engineering, meaning their genetic
makeup has been altered to induce a variety of “unique” traits to
crops, such as making them drought-resistant or giving them “more
nutrients.” GMO proponents claim that genetic engineering is “safe
and beneficial,” and that it advances the agricultural industry.
They also say that GMOs help ensure the global food supply and
sustainability. But is there any truth to these claims? I believe
not. For years, I've stated the belief that GMOs pose one of the
greatest threats to life on the planet. Genetic engineering is NOT
the safe and beneficial technology that it is touted to be.
Help Support GMO Labeling
The Grocery Manufacturers Association (GMA)—Monsanto’s Evil
Twin—is pulling out all the stops to keep you in the dark about
what’s in your food. For nearly two decades, Monsanto and corporate
agribusiness have exercised near-dictatorial control over American
agriculture. For example, Monsanto has made many claims that
glyphosate in Roundup is harmless to animals and humans. However,
recently the World Health Organization (WHO) had their research team
test glyphosate and have labeled it a probable carcinogen.
Public opinion around the biotech industry's contamination of our
food supply and destruction of our environment has reached the
tipping point. We're fighting back. That's why I was the first to
push for GMO labeling. I donated a significant sum to the first
ballot initiative in California in 2012, which inspired others to
donate to the campaign as well. We technically "lost the vote, but
we are winning the war, as these labeling initiatives have raised a
considerable amount of public awareness.
The insanity has gone far enough, which is why I encourage you to
boycott every single product owned by members of the GMA, including
natural and organic brands. More than 80 percent of our support
comes from individual consumers like you, who understand that real
change comes from the grassroots.
Thankfully, we have organizations like the Organic Consumers
Association (OCA) to fight back against these junk food
manufacturers, pesticide producers, and corporate giants.
Together, Let's Help OCA Get The Funding They Deserve
Let’s Help OCA get the funding it deserves. I have found very few
organizations who are as effective and efficient as OCA. It’s a
public interest organization dedicated to promoting health justice
and sustainability. A central focus of the OCA is building a
healthy, equitable, and sustainable system of food production and
consumption. That's why I'm proud to announce I will be matching
donations up to $250,000 this week.
Please make a donation to help OCA fight for GMO labeling.
Copyright 1997- 2015 Dr. Joseph Mercola. All Rights Reserved.