Do Mammograms Cause More Harm Than Good?
I will create this into a more informative blog post very soon but for now I just wanted to get this information and research up onto the website in reference to my latest TikTok video.
‘Breast cancer mortality started dropping all around the world at about the same time, regardless of when mammogram screening started. There was “no relation at all between start of screening and the reduction in breast cancer mortality.” “The declines…are more likely explained by the introduction of [the estrogen-blocking drug] tamoxifen.” You can see it really clearly in the U.S. data, with the breast cancer death rate plummeting in the United States after FDA’s tamoxifen approval in 1990.
Why aren’t mammograms more effective? It seems “so simple.” “Catch the disease early.” Right? It turns out that by the time breast cancer is caught by mammograms, it may have already been growing for literally decades. “It is therefore misleading to say that [breast] cancers are caught ‘early’ with screening.” They [may actually be] caught very late.” Without mammograms, breast cancer may not be caught for 22.8 years, but with mammograms, breast cancer may only grow and spread for 21.4 years. No wonder mammograms don’t do a better job at preventing breast cancer deaths, if the cancer can spread before you can cut it out. Concerns have even been raised that the trauma from surgery may accelerate the growth of any cancer left behind, and maybe that would help explain why there’s not more benefit to screening.’
‘A 2011 review raised the disturbing possibility that screening could be doing more harm than good. Its authors said: This means that for every 2,000 women invited for screening throughout 10 years, one will have her life prolonged, and 10 healthy women, who would not have been diagnosed if there had not been screening, will be diagnosed as breast cancer patients and will be treated unnecessarily. Furthermore, more than 200 women will experience important psychological distress for many months because of false positive findings.’
‘For 1,000 women invited to mammography screening every second year for 20 years from age 50, 200 will experience a false positive mammogram, 30 will undergo a biopsy due to a false positive mammogram. This resulted in 15 overdiagnosed women and 2 to 3 prevented breast cancer deaths per 1,000 women. No deaths are prevented overall’
‘The trials with adequate randomisation did not find an effect of screening on cancer mortality, including breast cancer, after 10 years. Screening is likely to reduce breast cancer mortality. As the effect was lowest in the adequately randomised trials, a reasonable estimate is a 15% reduction corresponding to an absolute risk reduction of 0.05%. Screening led to 30% overdiagnosis and overtreatment, or an absolute risk increase of 0.5%. This means that for every 2000 women invited for screening throughout 10 years, one will have her life prolonged and 10 healthy women, who would not have been diagnosed if there had not been screening, will be treated unnecessarily. Furthermore, more than 200 women will experience important psychological distress for many months because of false positive findings. It is thus not clear whether screening does more good than harm.’
‘The paper, based on the World Health Organisation (WHO) database, set out to demonstrate that the introduction of screening by mammography in some countries in Europe was associated with a steeper fall in mortality from breast cancer than in neighbouring countries that had delayed offering this service.
To their surprise they discovered that paired neighbouring countries had experienced the same and very welcome fall in breast cancer mortality whether or not screening had been introduced. Furthermore the steepest fall in mortality observed was among the women under 50 who had NOT been invited for screening in all of the countries taking part in their study. They concluded that the recent downward trend in breast cancer mortality was nothing to do with screening but all thanks to improvements in treatment and service provision.
The original estimate of a 25% reduction in breast cancer deaths can be translated into absolute numbers as follows. In order to avoid one breast cancer death over a 10-year period, 1,000 women have to be screened whereas the more up-to-date number is closer to 2,000. One woman avoiding a breast cancer death in 2,000 is of enormous value but has to be weighed against the risk of over-diagnosis and over-treatment.
In February 2009 a group of 24 experts, which included eight professors of epidemiology and public health from around the world, wrote a letter to the Times, drawing attention to the serious harmful consequences of screening associated with the over-diagnosis of breast cancer leading to an increase in the number of mastectomies. Over-diagnosis implies the detection of small non-palpable tumours that, although looking like cancer under the microscope, do not have the potential to develop into life-threatening disease.
One should note in passing the recent high-profile announcement by the cancer charities about the increasing incidence of breast cancer that was blamed on lifestyle. Most commentators ignored the fact that the most important lifestyle choice contributing to this increase was the acceptance of an invitation for screening.’
So Should you Get A Mammogram Or Not?
We can’t tell you whether you should get a mammogram or not, and unfortunately we can’t give any specific advice to anyone in relation to their condition or diagnosis as we are not doctors or health care providers but what we are trying to do is give you the facts so that you can make your own informed decision, and this isn’t just in relation to mammograms but your whole cancer treatment or prevention plan.
It is YOU and only you that should be the one making decisions around your cancer treatment and no doctor, health care provider or scientist. Yes absolutely consult these professionals, ask their advice and lean on their wealth of experience but don’t be afraid of getting a second and third opinion, refusing their proposed treatment plan or asking them to show you studies or evidence in relation to this proposed treatment. Remember it is YOU not them that will be living with the aftermath of these decisions (good or bad) and if the downside risk of a treatment outweighs the potential upside then don’t be afraid of making the tough decision to refuse a treatment or scan or choose another treatment or diagnostic technique the standard medical industry don’t support or advise.