Mammograms and breast cancer

Leia

This article was published on mercola.com and other sites: Here is the article from Mercola but you can google it elsewhere.

http://articles.mercola.com/sites/articles/archive...

The headline:

"Largest, Longest Study on Mammograms Again Finds No Benefit."

These are scientific studies, not anecdotes. 

But my anecdote, I am 59 and have not had a mammogram in 5 years. In 2006, via a Mammogram I had a 2cm IDC. That was cut out with huge margins. They were forcing radiation on me, I refused. Radiation, itself, causes cancer. Why would I ever do that. Answer, I refused.

I did have a whole body thermogram in September, 2011 that was totally blue for breast cancer and for all other cancers. For 10 years. 

My point? Mammograms are NOT the answer. What is most important is maintaining a 75 D3 level. Eliminating sugar. etc etc.

Relying on a "radiation" test to prevent cancer is just moronic. Since radiation promotes cancer.

wyo

Gee what a nice thing to read on the alternative thread- I take this as people (like me) who have conventional imaging are "moronic"?  Next time I read about how everyone is bashing the people on the alternative thread I will remember this comment. 

suzieq60

Leia - how do you think most women on this site were diagnosed????? Duh - that mammogram saved my life. Gee imagine if I hadn't had one - with HER2+ve grade 3 bc, I probably wouldn't be here right now.

AZ85048

Leia - Really?  To each his own, but your beliefs are just that - yours.  And I certainly don't think you have the right or the credentials to call the rest of us who were treated and diagnosed through conventional methods 'moronic'. 

Anonymous

Yup, the facts are in. This is the third study.

Screening mammograms don't help women live any longer. Even Dr. Susan Love is on board with these facts.

Mammograms may catch a cancer earlier than palpation but it is now proven that screening does not help women longer. So much for the early detection theory.

abigail48

how many xrays did most of the women here have before the one that diagnosed cancer?  dental, chest (chest xrays used to be usual with a checkup)

vlnmama

You know, I can see how people might feel a bit defensive about leia's choice of words (moronic) to describe how she feels about mammograms, but the scientific data remain facts! 

Another fact is that in Europe (at least in some parts of Europe, for sure) they don't recommend mammograms until age 50, and the reason that DOCTORS (and yes, breast cancer specialists) state when asked, is that the additional radiation exposure women get for the 10 years before that, actually increases their overall chance of developing cancer earlier!!! 

I doubt that I'll have mammograms in the near future. I've been told that breast thermography has its cons also (as in in doesn't necessarily detect everything either), but there is no risk of it causing cancer. Breast MRI (without contrast) is an option too. And there are blood tests too. So all of those together can be helpful in detecting cancer early also.

Just my 2 cents...

(edited for typo)

Anonymous

I think people are defensive if they have been duped all these years into thinking "mammograms save lives."

We were all told that. None of us thought to ask if they could proove that. We didn't know we were being experimented on.

I lost count of the number of mammograms I had before I began asking questions. I'm so embarrassed I didn't ask questions.

Leia

I stand by my comment that relying on a "radiation" test to prevent cancer is moronic. I was a moron. I had all of those mammograms and then, finally, I was diagnosed with breast cancer. Correlation does not imply causation, but it makes you wonder. 

The breast cancer I was diagnosed with May, 2006: a 2cm IDC, ER+/PR+/HER-. But let us get this into perspective: 2cm is .789 inch. That is less than one inch. I have 36D breasts. Those other markers, great as well. Not an aggressive cancer.

But then, after my clear margin surgery they wanted to do whole breast radiation. To "make sure" they got all of the cancer. Again, more radiation. I refused.

I make no apologies; this is nonsense. 

Susan G. Komen got an aggressive breast cancer in her 30's and died. No mammograms would have helped Susan G. Komen. She was 33 when she was diagnosed with breast cancer, 36 when she died. 

There are so many things we can die from. Countless. And yet this focus, on breast cancer. Because a breast is an external "thing" you can put into a radiation machine and charge for it. 

And, it does make a lot of $$$. For the Medical Industrial Complex. 

No thanks. I am not a part of this, anymore. 

Ariom

I think I must be missing the point here.

I am not meaning to inflame the situation, just merely trying to understand your points of view.

Are you, the ladies who have read and have taken this study on board, saying that you won't be having any more mammos and that you'll just take pot luck and let the disease take its course if no lump or other symptom alerts you to a problem? 

For me, I was Dx with DCIS grade 3 which had most likely been missed on my previous analogue mammo, it couldn't be seen. Had I not moved to an area that had a new state of the art Digital Mammogram with Tomosynthesis, Machine,which showed that sucker in all its glory, it is quite likely that it would have been missed again. I am grateful every day that this was discovered and not left to fester for another couple of years.

We are in a damned if you do, damned if you don't, situation. It's the theory of balance, a positive is balanced oftentimes with a negative. We just have to do what we feel is right for us. What is right for one, will not be right for all, but judging each other for our choices is just, wrong.

Moron, is a nasty word and implies that the decision was not considered. I don't think there is anyone here who didn't feel angst over this, and all the other decisions we are faced with.

TB90

I for one would much rather find out about a health issue while I may still have some control over it's course.  My breast cancer was found very early and the weight I have subsequently lost, the exercise I now build into my routine, the wine I have cut out (mostly) and the healthy diet I have encompassed, may have an enormous impact not only on my longevity, but on my quality of life.  To have just let it run its course and then discover it at a much later stage, when there is much less one can do about it, just seems like throwing my hands in the air and letting fate determine the course of my life.  Not for me.  Sure, I should have done all these things in the first place, but like the majority of people on this earth, we need something to motivate us and there is nothing like the threat of death to do just that.  There is a lot more to life than simply breathing.  I for one like the opportunity to have a chance to make changes that will improve my life. 

As for mammograms being the enemy, all tests involve risks and MRI's are notorious for false positives that then lead to more tests.  Doesn't that just feed into those money grabbing companies.  Everything we participate in in North America is making someone money.  Isn't that the American way? Alternative therapies make all kinds of money too.

I agree that mammograms do seem barbaric, but these arguments against them are not very convincing for me.    

vlnmama

Ariom and TB90, I fully agree with what you're both saying. It IS a very difficult choice, and one that each of us has to make. Like I said before, I think the choice of word (moronic) was a bit poor, and (hopefully unintentionally) an invitation for attacks. But it is an undeniable fact that mammograms carry a significant risk of increase of chances to develop breast cancer. Again, that doesn't necessarily mean for everyone that they shouldn't be getting anymore mammograms, but I think that it's our right, as patients, to be made more aware of that risk, so we, as patients, can hopefully make the right decision for us. Now, at least in the US, we are pushed to get mammograms, without being given any warnings! 

For myself, I'm not quite sure whether or not I'll have a mammogram again, or when. I'm hoping not too soon at least. But then again, if I go in for more surgery, I may yet again have no choice, either right before (like with my first surgery, when they had to do the wire localization with mammogram), or who knows, after. But it will likely be very different this time, since I had a lumpectomy (2 weeks ago tomorrow), and if I do opt for another surgery, it will be a mastectomy.

I am now just a lot more aware of many of the risks and dangers of some of the conventional tests and treatments, and trying to make the best choices for myself, and for my family. This is a tough road for everyone, no matter what course of action we decide.

And yes, I have made tremendous lifestyle changes also since my diagnosis (right before Christmas). No more wine, coffee, only a very limited amount of sugar (which will likely have to go soon too, when I start my treatments with the Naturopathic Oncologist next week), lots more veggies, started a gluten free diet 6 days ago, doing a visualization/hypnotherapy CD every day, started to exercise more, and still working on improving things too. 

I just wish everyone could be respectful of each other's choices, and use every bit of research that we can share with each other in a positive way.

Sending hugs, positive thoughts and prayers to everyone!!!

Lily55

i refuse mammograms now based on my experience that it did not find anything in four years and even as close as THREE WEEKS before MRI found my 5Cm + ILC  so I now insist on MRI every year like so much with BC I think its an individual choice

Ariom

Hello Lily, I haven't seen you for a while, how are you doing?

So true, with everything to do with the choices, along this path, it is such an individual thing.

juneping

very interesting subject.

i agreed at the end of the day it's a personal choice. i felt the lump first so screening didn't exactly help me to find cancer. i also read the radiation can do more harm than good. but there're some ladies found cancer before feeling the lump here. i don't know if there's a right answer to this. 

but i do know women over the age of 40 CANNOT get a US without a mammo. i was very baffled at the imaging center when my doctor only prescribed me a US and the center told me no way i could get the US without the mammo. talk about free country and freedom.

SelenaWolf

So many people are misinterpreting and reading more into the results of this study that the study was actually saying.

Firstly, the reason for this latest study is, as follows.

In 1980 a randomised controlled trial of screening mammography and physical examination of breasts in 89,835 women, aged 40 to 59, was initiated in Canada, the Canadian National Breast Screening Study. It was designed to tackle research questions that arose from a review of mammography screening in Canada and the report by the working group to review the US Breast Cancer Detection and Demonstration projects. At that time the only breast screening trial that had reported results was that conducted within the Health Insurance Plan of Greater New York.  Benefit from combined mammography and breast physical examination screening was found in women aged 50-64, but not in women aged 40-49. Therefore the Canadian National Breast Screening Study was designed to evaluate the benefit of screening women aged 40-49 compared with usual care and the risk benefit of adding mammography to breast physical examination in women aged 50-59. It was not deemed ethical to include a no screening arm for women aged 50-59.

In addition, it must be remembered that this was a retrospective, observational study; to do otherwise would be deemed medically unethical.  So, complication Number 1.  The findings are observational only with no ethical way of testing them.

Also, it's not that they were trying to disprove that screening mammograms were of no use, they were trying to determine the risk/benefit of adding mammography to "usual care" in specific age groups.  The purpose was to see if adding mammograms to regular breast/health screening resulted in decreased mortality in a community-based setting.  This is where complication Number 2 factors in: mammography has improved tremendously during the last thirty years.  In 1980, only 50% of mammography images were of satisfactory quality, by 1987, this number had risen to 87% (see: Rational and Irrational Issues in Breast Cancer Screening).

The results of this new study revealed an over-diagnosis rate of about 20% by adding screening mammography to "usual care", meaning that this percentage received unnecessary treatment for breast cancers that may not have become life-threatening for the researched groups.  The problem with this result is, they did not separate out the nasty breast cancers from the ones that may never have developed into anything nasty.  Why?  Because, technically, we have no means of doing that yet.  And that's a bit of a grey area that causes such controversy about these findings. 

The study did, indeed, find that adding mammography to "usual care" in a community setting for these age groups did not decrease mortality from breast cancer, but - again - this is a grey area because there was no way to separate out the nasty breast cancers from the ones that may never have developed into anything nasty.  So, in a way, the point becomes moot.  There is no increase in survivability, but there is no way to know who would have survived anyway.

So, while the CNBSS shows that - by adding mammography to "usual care" results in a degree of over-diagnosis of "indolent" breast cancers and doesn't decrease one's mortality from breast cancer in a community setting - it comes nowhere close to establishing that screening mammography is useless or, even, dangerous.  What it does is establish that the role of screening mammography needs to be reassessed for women at average risk of breast cancer, but it in no way addresses the issue of screening mammograms for women at high risk (including those with strong family histories, as well as those with personal histories) of breast cancer.  Nor does it address the issue of how to identify tumours which may not need treatment from those that do.  More research and better imaging techniques need to be developed and that is, really, all this study is stating.  And the study continues to imply that - for the 60 and over age group - screening mammograms still play a role in saving lives.

If all radiation - meaning that it doesn't matter what the source is - caused cancer, Leia, then we'd all be dead.  We absorb more radiation into our bodies from "natural' sources than we do from medical sources.  It's in the air, our soil, our water and our food.  It cannot be avoided.  We ingest this radiation in our food and water at higher r levels than we would receive from a mammogram.  We are, also, born with radiation in our bodies: potassium-40, carbon-14 and lead-210.  The following article discusses how much of this radiation is absorbed by people who work at jobs at "high risk" for these exposures (including those in the medical field), so those of us who are not exposed to medical imaging on a daily basis may have a much lower exposure level.  Either way, medical procedures involving x-ray and mammograms consist of only a fraction of our radiation exposure.

http://mitnse.files.wordpress.com/2011/03/radiation_mm_06.pdf

Stating that screening mammogram are "moronic" and citing one- or two instances when they did not help "save a life" is missing the point entirely.  But, I'm finding, so many of those who are vested in furthering their own beliefs simply resort to fear-mongering to make a point or a flashy headline, or to further their own agenda, or product line.  The subtleties are lost on them because they only see the surface and not the substance.  Plus they want to make a great deal of money from exploiting vulnerable and scared people.

Don't read too much into the articles from questionable sources that claim that mammograms (or x-rays or MRI's of PET scans) put your life in danger.  That simply is untrue.

Fallleaves

Thanks for your post, SelenaWolf, I always get a lot from your perspective.

Fallleaves

Juneping, I agree with you about the strange rigidity of having to get a mammogram before you can get a US. My own BS said she couldn't see anything on my mammogram (the one with the cancer), so why should I get another one? If something shows up, I'd be able to get a US. But what if something doesn't show up (which in probability it wouldn't)? Will they tell me there's no reason to get a US then? 

Ariom

Selena, thank you!

juneping

just watched this documentary: pink ribbons inc

this woman said - early detection, works for some, they find cancer early enough, they get treatment and they live a long life. for others, it means finding something were never life threatening and they got treatment anyway and they got sick from it (the treatment). and for some it means the early detection finds something so aggressive and the current available treatments are not effective....and then she went ahead and said ppl don't like that message, and ppl want to believe they belong to the first group.

Anonymous

Serena, you've misread the study. It never said "in one or two instances mammograms didn't save a life."

It said statistics showed mammos never saved a life or extended life even tho it may have detected the disease earlier.

So much for that early detection myth...

I consider myself a moron for not asking whether mammograms had any evidence. I didn't know we were being experimented on for 30-some years.

Beesie

Lucy, NO, you are misinterpreting the study.  

A research study cannot prove that something is not effective.  Research is done to determine if there is a statistically significant difference in the results between two options.  If there is no statistically significant difference, this only says that a difference can't be proven.  It does not say that it is proven that there is no difference.  There is a HUGE difference.

In actual fact, the study did show that there were fewer deaths from breast cancer in the mammogram arm of the study:

- Of 44,925 women in the mammogram group, 500 succumbed to breast cancer.  The rate of breast cancer deaths per 10,000 women was 108.4.   

- Of 44,910 women in the control (non-mammogram) group, 505 succumbed to breast cancer, i.e. more deaths in a group with slightly fewer women.  The rate of breast cancer deaths per 10,000 women was 110.2.

The wording in the study is that the "25 year cumulative mortality from breast cancer was similar between women in the mammography arm and control arm".

The reason for the conclusion that mammograms provide no mortality benefit is because the difference in mortality between the two groups is not statistically significant at the 95% level.  That is the bar that all medical research must pass.  A 95% statistically significant result means that if a study were to be replicated 100 times, the result would have to be the same 95 times out of the 100.  Therefore if the numerical difference is not great enough to guarantee that '95 out of 100 times' result, then the study results are deemed to not be 95% statistically significant and the official conclusion is that there is no difference between the groups.  But that doesn't mean that there really is no difference.  It just means that there is no difference that can be proven at the 95% level. 

In this case, there was a slight difference.  And as I mentioned in other posts in an earlier thread, if one were to remove the women who were diagnosed in the first year of the study and look only at years 2 to 25, the results weigh much more strongly in favor of the mammogram arm (although likely still not at a 95% statistically significant level).  For some reason, the mortality rates for those in the mammogram arm who were diagnosed in year 1 of the study were much higher than the mortality rates for those in the control arm who were diagnosed in year 1.  This was not seen in across the rest of the years of the study.

Anyway, I thought this was important to clarify.  The study should be interpreted properly and not misinterpreted to suggest that it is saying something that it's not. In fact it might be that mammograms have saved many lives, just not enough to get to the 95% statistically significant bar.

AZ85048

Thank you, Selena and Beesie!

Anonymous

No, You are not reading the actual study. You can't twist NO SURVIVAL VALUE.

Sometimes conventional researchers admit they've failed to extend survival. Good for them!

I'm not sure why you you're clinging to disproved procedures. I guess it's human nature to try to defend what we did.

Cheers!

abigail48

radiation is everywhere, & even required by the international building code detectors in buildings/houses etc.  why add more? when you don't need to

exbrnxgrl

Beesie,

As always, you are rational and real

Beesie

Yes, I am reading the actual study.  Here's the full report from the British Journal of Medicine.  Not an interpretation, but the actual write-up of the study:

Twenty five year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study: randomised screening trial

And just to clarify, the study did find a survival difference.  What they didn't find was a a statistically significant mortality rate difference.

Breast cancer survival

Overall,
1005 women died from breast cancer during the 25 year follow-up period
(1.1%) including 351 of 1190 women (29.4%) with a diagnosis during the
screening period. The 25 year survival was 77.1% for women with tumours
of less than 2 cm, compared with 54.7% for tumours greater than 2 cm
(hazard ratio 0.46, 95% confidence interval 0.37 to 0.58; P<0.001).
The 25 year survival was 70.6% for women with breast cancer detected in
the mammography arm and 62.8% for women with cancers diagnosed in the
control arm (0.79, 0.64 to 0.97; P=0.02). The 25 year survival for women
with a palpable cancer was similar between women in the mammography arm
and control arm (66.3% and 62.8%). The 25 year survival of women with
breast cancer diagnosed by mammography only (non-palpable) was 79.6%. In
the mammography arm, the survival of women with a non-palpable cancer
was much longer than that of women with a palpable cancer (0.58, 0.41 to
0.82; P<10⁻⁴) as was the survival of women with a screen detected cancer compared with interval cancer (0.61, 0.45 to 0.82; P=0.001).

Breast cancer mortality

All
cause mortality was 9477 (10.6%) in the follow-up period. The 25 year
cumulative mortality from all causes of death was similar between women
in the mammography and control arms (fig 2⇓)
(1.02, 0.98 to 1.06; P=0.28). Overall, 1005 deaths occurred from breast
cancer. The 25 year cumulative mortality from breast cancer was similar
between women in the mammography arm and control arm (fig 2) (0.99,
0.88 to 1.12; P=0.87).

Edited to add:

Just to clarify, I am not defending screening mammograms or suggesting that they are the best thing and absolutely necessary for everyone.  Honestly, I don't know how much benefit there is.  I suspect that there is a small mortality benefit, but I doubt that there is enough benefit to register as a statistically significant difference in any study.  Personally I believe that mammograms have a role in screening (and more so in diagnostics) but we probably depend on them way too much and generally believe that they are more effective than they really are.  What we really need is a better and more effective way of screening, so that we can end this debate about mammograms.

I do think however that if anyone is going to use this study to support whatever position they take, they should use the real data from the study and not misinterpret the study.  The study is not saying that mammograms do not save individual lives.  What the study is saying is that mammograms have not been proven (at a 95% statistically significant level) to extend mortality rates within large groups of women.   But within large groups of women, the individuals (and specfically the few who might benefit from mammograms) get lost in the numbers.

Anonymous

Yup. No survival value in screening mammograms. That's what the headlines around the world are shouting. It's being picked up by the other cancer journals in editorials as "How come we prescribed mammograms so long?"

This is becoming a huger scandal by the day. The socialized medicine countries feel like they've been duped out of billions.

We were all fooled. We just have to get over it.

Robinsegg

My doctor believes in mammograms only if you have a lump. He called the yearly ones a "Ponzi scheme."

wyo

People are going to believe what they want to believe even in their interpretation of the actual research.  I don't put stock in editorials and headlines that are written to interpret and spin with peer-reviewed literature available. 

Just read the actual number of women in the study and the number of women in each arm as well as the percentages who either lived or died. Isn't that what this is about- living and dying and how long it takes to do it and is breast cancer the cause.  I never thought a screening mammogram would save my life but maybe with early detection and "source control" I have a shot at dying of something else. I suppose its more palatable to talk about survival rates than mortality rates but there is a relationship of course. 

You can sure forego mammography and wait til you feel it- but even with mammography the survival data for palpable lumps is not great.   The 25 year survival of women with breast cancer diagnosed by mammography only (non-palpable) was 79.6%. In the mammography arm, the survival of women with a non-palpable cancer was much longer than that of women with a palpable cancer (0.58, 0.41 to 0.82; P<10−4)

I won't loose a wink of sleep over the poor socialized medicine countries $$ lost for allowing mammo- I have read enough about Stafford Hospital (Staffordshire Trust UK) and others to know that I will take our system as flawed as it is. 

Beesie

READ THE STUDY, NOT THE HEADLINES.

It's a complicated issue, and headlines and newspaper articles simplify it and try to create the most newsworthy quotes.  But if you want to understand what the study really says, you need to read the whole study.