Hormone Replacement Therapy: What You Need To Know
April 27, 2019
A Revolutionary Approach To Erectile Dysfunction
December 4, 2017
10 Signs of High Blood Sugar
June 4, 2019
Screening Mammograms – Are They Effective? Is It Time to Change Current Recommendations?
April 22, 2014
By Dr. Maiko Ochi, N.D., L. Ac.
The American Cancer Society (ACS) and the American College of Obstetricians and Gynecologists (ACOG) recommend women start getting screened for breast cancer by getting yearly mammograms beginning at age 40. Based on these recommendations, many primary care physicians and ob-gyns urge their patients to get annual mammograms, and because women trust their doctors, they comply. But what if this advice is incorrect? What if women aren’t getting the full story?
Last week, in the New England Journal of Medicine, the Swiss Medical Board presented their review of current mammography screening guidelines. And the results don’t look good for mammography.
Women believe screening mammograms to be much more effective than they actually are. In 2003, the majority of American women surveyed (72.1%) believed that screening mammograms done every 2 years for 10 years could prevent at least 80 deaths from breast cancer in a group of 1000 50 year old women, and 71.5% believed mammograms reduced breast cancer deaths by at least 50%. In actuality, screening mammograms will prevent only 1 breast cancer death and reduce breast cancer deaths by only 20%! This huge discrepancy between women’s expectations on how effective mammograms are and how effective they are in reality is concerning.
The current 20% relative risk reduction described by most expert panels today comes at the price of repeat mammograms, biopsies, and over-diagnosis of cancers that would never have become clinically significant. The results of the Canadian National Breast Screening Study showed that 21.9% of screening-detected breast cancers were over-diagnosed during the 25 years of follow-up. This means that these healthy women were wrongly diagnosed with and treated for breast cancer, resulting in needless surgeries, radiotherapy, chemotherapy, or a combination of these treatments. Furthermore, a Cochrane review of 10 trials showed no evidence suggesting that screening mammograms had an effect on overall mortality. In other words, more breast cancer may have been detected, but this didn’t lower breast cancer deaths. Not to mention that exposure to ionizing radiation from mammograms is itself a risk factor for developing breast cancer.
So to sum it all up, screening mammograms might prevent one breast cancer death for every 1000 women screened, but overall mortality may not be affected. Mammograms can even be harmful, because for every breast cancer death prevented in American women over a 10-year period of annual screening starting at age 40, 490 to 670 women can get a false positive on a mammogram, resulting in 70 to 100 women getting unnecessary biopsies and 3 to 14 women being diagnosed with a breast cancer that would never have been clinically significant.
So what options do women have if they’re concerned about mammograms? Breast ultrasounds and MRIs are possible alternatives. However, thermography is another viable option to be used not to replace mammograms, but as an adjunct. So what exactly is thermography? It’s a form of imaging that measures the amount of heat in tissues to indicate inflammation or increased blood flow, which can suggest the presence of a developing tumor. In 1982, the FDA certified breast thermography as an adjunct diagnostic breast cancer screening procedure. Since then, more than 800 peer-reviewed studies in the medical literature have established thermography as a safe and effective means to examine the human body. Breast thermography has an average sensitivity and specificity of 90%. Extensive clinical trials have shown that breast thermography can significantly increase long-term survival rates by as much as 61%, and when used with mammograms and clinical exams, 95% of early-stage cancers will be detected.
We’re pleased to be able to offer breast thermography at SageMED every Thursday in conjunction with Advanced Healthcare Alliance. We are one of the few locations on the Eastside to offer this service for our patients. This is a great non-invasive technology to take advantage of!
Biller-Andorno N, Jüni P. Abolishing Mammography Screening Programs? A View from the Swiss Medical Board. N Engl J Med. 2014 Apr 16. [Epub ahead of print].