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Saturday, November 21, 2009

New Mammography Guidelines

Just this week the U.S. Preventive Services Task Force issued new guidelines regarding routine mammograms for women in their forties suggesting that they skip the dreaded routine mammograms until later on. "The benefits are less and the harms are greater when screening starts in the 40s," said Dr. Diana Petitti , vice chair of the panel. The new recommendations are not without controversy, as a few vocal healthcare professionals and journalists feel that women may now become "complacent about the dangers of breast cancer". Although some medical professionals are up in arms about the new guidelines, they may actually be a blessing for women.

As a medical procedure, mammography is certainly not without risk. Mammography uses low levels of radiation to detect cancer. Terry Rondberg, author of Under the Influence of Modern Medicine argues that radiation-induced breast cancer is a growing concern. Taking four films of each breast in a standard mammography means that "premenopausal women undergoing annual screening over a ten-year period are exposed to a total of about 10 rads for each breast," according to Samuel Epstein, MD. In addition, according to Epstein and Seaman, the breasts of premenopausal women are "highly sensitive to radiation, each rad of exposure increasing breast cancer risk by 1 percent, resulting in a cumulative 10 percent increased risk over ten years of premenopausal screening, usually from ages 40 to 50."

Mammographies may also be less effective than women are led to believe. False positives are common in mammograms, with studies showing that "70 to 80 percent of all positive mammograms do not, upon biopsy, show any presence of cancer." Dr. Samuel S. Epstein, author of The Politics Of Cancer, "claims that in women ages 40 to 49, one in four instances of cancer is missed at each mammography."

So why the protest and disagreement coming from organization such as the American Cancer Society? According to the Cancer Prevention Coalition "cancer is a multi-billion dollar business". Large organizations such as the American Cancer Society have much at stake here. James Bennett, professor of economics at George Mason University, stated that "in 1988 the ACS held a fund balance of over $400 million with about $69 million of holdings in land, buildings, and equipment. Of that money, the ACS spent only $90 million— 26 percent of its budget— on medical research and programs." Both the ACS and the National Cancer Institute (NCI) have been criticized for conflicts of interest, including links to the major manufacturers for mammogram films and machines, such as DuPont, Kodak, and General Electric. Corporate "heroes" and "friends" listed by ACS include Pfizer, Johnson & Johnson, and Novartis, among others. Novartis manufactures Femara, a breast cancer drug, and earlier this year Johnson & Johnson acquired Cougar Biotechology, a maker of experimental cancer medicines.

Once again it is up to women to become informed and educated about the risks and benefits of a medical procedure such as a routine mammogram. Women should explore alternatives, such as thermography, with their healthcare providers and also take into account what is behind the messages and recommendations that they receive from their doctors or through ad-driven campaigns targeting their participation.

2 comments:

  1. Thank you, thank you, thank you. There is a reason why these un-affiliated task forces are asked to do a job. The science behind it needs to be praised. Even though I've had experience with breast cancer (my mom had it and I had a baseline mamo. done at age 29), we can't let emotions on this issue cloud the truths that are out there.
    I highly recommend listening to the podcast here http://www.wnyc.org/shows/bl/episodes/2009/11/20/segments/144728
    They take a good look at a lot of the findings and the rumors associated with them (such as 'not doing a breast exam')

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  2. Thank you for posting this awesome info. I'm still shocked that this announcement was allowed to get out in national forum. I've never had a mammogram (I'm 51) and don't have any plans to unless some strong reason comes up, for these very reasons and more. The choice needs to be individualized however.

    I'll LIST below what are thought to be LOW RISK factors to help some who may not be aware of some of these. My risk profile is pretty zilch, making the choice easy for me. I'm no oncologist (retired chiropractor turned infant health, nutrition, and lactation author/consultant) but I did work performing/compiling literature research of breast, colon, prostate and cervical cancers for 3 years for two drugless cancer research companies, alongside very enlightened doctors and PhD's.

    The incidence of breast cancer in the presence of BRCA1&2 genes is frighteningly high but of course it does not occur in every one with these genes. A woman (or a heavy man) with presence of those genes would certainly want regular monitoring. Ultrasound and thermography are two non-cancer-causing screening methods to consider as part of arsenal.

    The potential number of breast cancers that could be prevented with good dietary and lifestyle measures will likely always exceed the number that can be "cured" through treatments that are far more torturous than eating greens and taking a walk, and that otherwise shorten lifespan as well. The expense of educating the public and taking pro-active public health measures would also be less than the expense of marketing and fund-raising measures taken by pharmaceutical industries (that's not a comment about drug research itself although one comment there is that negative studies are consistently swept under the table). It's good to at least see trans fats being reduced in available foods.

    Low risk factors for breast cancer:
    >Small breasts
    >Non-dense breast tissue
    >Late beginning of menses
    >Early menopause
    >Being breastfed
    >Breastfeeding; the longer the better
    >Low dairy consumption (a LOT of reproductive and growth hormones in that stuff, meant for babies, not adults)
    >High vegetable consumption
    >Low red meat consumption
    >Good soy consumption; (if ignore the sensationalistic articles with silly references and lacking solid science research bases, with theories that contradict actual epidemiology, soy is statistically a powerful reducer of many cancers. It slightly increases thyroid cancers though these are least fatal and easily treatable. Soy increases bone density as well.)
    >Low alcohol consumption
    >Non-smoking; unlike the manner in which lung cancer risk can go down over time after quitting, many other cancer risks seem to remain
    >Low trans fat consumption
    >Good DHA & EPA consumption (fish oil)
    >Non-over-weight
    >Regular exercise
    >Low stress
    >Regular positive social contact
    >Having been raised with low stress during infancy (affectionate, responsive care without cry-it-out or scheduling of feedings). This sets the stage for good lifelong cortisol regulation/low depression/low inflammation.
    >Regular consumption of antioxidants. Curcumin (turmeric) seems to be one of the most powerful anti-cancer supplements. Unless you live in India, the amount one can consume daily as spice even with good efforts is low compared to what can be consumed easily in supplements. Cancer prevention and treatment studies have used average of 4 grams/day. High doses are needed for good statistical results but, in my absence of any known cancer presence or great risk, I do 1 gram/day as I consume other good antioxidants as well.
    >Resveratrol, found in peanuts (and peanutbutter), red wine, dark grapeskins, or grapeseed extract, is another potent factor.
    >Low lifetime radiation exposure
    >Good vitamin D levels. I think some of that needs to come from the sun.
    >No estrogen replacement
    >Progesterone replacement, when clinically indicated, may reduce breast cancer risk
    >Good ancestors

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