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A new study from Dartmouth researchers challenges mammography screening; published in Archives of Internal Medicine (10/24/11)


Message from Dr. Cutler: I was quite pleased to see the valuable editorial in today's (Oct. 27. 2011) New York Times, “More Questions About Mammograms” reinforcing my long-held views that mammography has been oversold to U.S. women. Clarifying that a mammogram is a screening test not a treatment, by itself it cannot “save lives”, and also that “overdiagnosis”-detecting tumors that never would have been fatal ---is a serious problem.

The authors of the Dartmouth study were Dr. Welch and Brittney Frankel. Dr. Welch has significantly stated:

“The presumption often is that anyone who has had
cancer detected has survived because of the test, but that's not true. In fact, and I hate to say this, in screen-detected breast and prostate cancer, survivors are more likely to have been overdiagnosed than actually helped by the test.” {'Mammogram's Role as Savior is Tested', NYTimes, Parker-Pope, 10/24/11}

The Welch/Frankel study, published in Archives of Internal Medicine (online October 24, 2011) concludes:

'Most women with screen-detected breast cancer have not had their life saved by screening. They are instead either diagnosed early (with no effect on their mortality) or overdiagnosed.'
Ms. Parker-Pope's important article on this study also states that the research “…raises questions about whether there are better uses for the hundreds of millions of dollars spent on awareness campaigns and the $5 billion spent annually on mammography screening.'

It is an important question, and one that the editorial addresses as well, referring to Ms. Pope's article and the study:

'Fewer than 1 in 1,000 healthy women screened over a decade will have a cancer found at just the right moment for successful treatment. The rest will undergo a decade's worth of radiation for no medical benefit or, worse yet, undergo unnecessary treatments that can be harmful to eliminate tumors that would never have killed them.' (More Questions About Mammograms 10/27/11)

My most recent book, Hormones and Your Health: The Smart Woman's Guide to Hormonal and Alternative Therapies for Menopause (Wiley & Sons, 2009) offers women and their practitioners an entire chapter on the risks and misperceptions of mammograms. So it is encouraging years later to read this study, and New York Times articles challenging the common belief that 'mammograms save lives'. In Chapter 10: The Hidden Truth about Mammography, Radiation, Hormones and Cancer I write:

'Symbolic pink ribbons are everywhere. Famous personalities urge us to have mammograms to detect our cancer early. And an emerging “breast-terror industry” alarms women with marketing methods that are ostensibly designed to generate money for research but that also coincidentally increase product sales and support an army of people who do not do any research. I find that these messages subtly misinterpret data.

***


Here's what the current science has to say-and it's not as frightening a picture as the breast-terror industry would have you believe:

  • The actual incidence of breast cancer is much lower than that of cardiovascular or bone disease.
  • Breast cancer is highly unlikely to kill you
  • Mammograms are not “treatment”; they are stressful detection techniques.

Hormones and Your Health and several recent publications with colleagues have recognized the problem of searching for early stage breast cancer since 1 in 3 such "cancers" are now recognized as non-problematic. In other words, they would never have come to medical attention because the woman's body would either arrest or reverse these early cancers. The presumption that finding cancer early extends life does not withstand scrutiny. What saddens me most is that so many women undergo surgical cutting, chemotherapy and radiation, causing pain, disfigurement, and psychological debilities, and they are recruited to advertise their belief that this "treatment" saved their life when actually it harmed them.

I believe that widespread screening is good for those who make money from the process: fundraising groups, radiologists, medical practices that invest in the machinery and space and personnel that needs to be supported. For we who are fundamentally healthy women, I believe that health practices listed in my book will render our likelihood of breast cancer so low that it should only be dealt with if an annual exam with their gynecologist finds a reason to search further.

Here now with this exciting new current study and media coverage, I am pleased that their conclusion reinforces my own, and helps get the message out to women everywhere. That we should not believe it is unanimously accepted that annual mammograms are required. Remember it is effective prevention and treatment, not detection, of breast cancer that decreases the death rate.

--Winnifred Cutler, Ph.D. October 27, 2011

 

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