Dear Reader, 

 For a moment, I thought my doctor might "fire" me.

 I've been going to my OB/GYN now for more than 10 years. I
 like him, I trust him, and at times he's provided invaluable  advice and care. But we recently had a serious disagreement.

 During a checkup, he told me I should have a mammogram.
 Without a moment's hesitation, I told him I wouldn't. And  with no hesitation  on his part he strongly recommended that I  should reconsider. When I  refused, he became defensive,  listing the reasons why mammograms are safe  and necessary.
 After a somewhat heated discussion - with neither of us budging on our positions - I finally offered to sign a release, stating that I had declined his recommendation of a  mammogram. (He didn't have a release available.)

So he didn't "fire" me as a patient. But he wasn't at all happy with my decision.
Like many doctors, my OB/GYN is sold on the idea that mammograms save lives. And because this is the mainstream thinking accepted by the general public, I'm sure my doctor  is accustomed to little or no resistance when he recommends  mammography. But then most of the general public is simply unaware of the realities.  

Myths Abound    
                        
Besides the fact that I'm not in any of the high risk groups  for breast cancer (why test early for something you're not at risk for?), I have read many reports that clearly refute the mainstream medical establishment dogma that mammography is safe and effective.

In fact, it's neither.

The most recent call to resist mammography came from a report last month in the British Medical Journal in which the authors make the case that most women simply don't know what they're getting into when they agree to have a mammogram. As a result, rather than learning the dangers beforehand, they
learn by experience that this uncomfortable exam often creates more problems than it solves.

Over the past 20 years, three primary myths about mammography have evolved to the point that they're generally accepted as facts. But if women knew the true details of these myths, quite a bit of needless heartache, worry, and physical pain could be avoided. And there's a good chance that lives would be saved as well.

 Vise Grips         
Myth 1: Mammograms are safe.
Fact: Mammograms may actually prompt an existing cancer to spread.

Women who have never had a mammogram are often surprised to find out how remarkably uncomfortable it is. The breast is compressed between two flat surfaces so that the tissue will be sparse enough to allow tumors to be revealed. At the very least this is uncomfortable and often painful. At worst, however, it may actually break down cancer tissue and rupture small blood vessels that support the cancer, causing it to spread.
 

In the January 2002 issue of his Real Health newsletter,  William Campbell Douglass, M.D., wrote about what he calls the "compression contradiction." Dr. Douglass says, "I find it maddeningly contradictory that medical students are taught to examine breasts gently to keep any possible cancer from spreading, yet radiologists are allowed to manhandle them for a mammogram."

And then there's the radiation question.
My doctor argued that the radiation from a mammogram is less than an airline passenger is exposed to on a cross-country flight. I haven't seen statistics to back that up, so I'll take his word for it. But even if it's true, the difference
between having your body generally radiated, and focusing all of that radiation on a compact area is obvious. And the amount of radiation used is not trifling. When four films are made of each breast, the radiation exposure is about one RAD, or radiation absorbed dose. That's approximately 1,000 times  more radiation than you receive from a chest x-ray.

Pre-menopausal women in particular have been shown to be sensitive to this radiation exposure that can cause cancer. And yet the American Cancer Society recommends that all women over the age of 40 receive yearly mammograms.

              Harsh Options                                     
             
Myth 2: When breast cancer is caught at an early stage by a  mammogram, the need for surgery is reduced because tumors can be treated in other ways.
Fact:  If a tumor is large enough to be detected with a mammogram, it's
           already in an advanced state. Furthermore, the typical alternatives to
           surgery can do more harm than good.

Three years ago, scientists at the Nordic Cochrane Center in Copenhagen, Denmark, reviewed seven of the largest  mammography studies yet conducted. They found that women who underwent regular screening had about 30 percent more mastectomies and lumpectomies than women who weren't screened. They also found that tumors detected by mammograms are likely to be treated with radiation, which carries a high risk of cardiovascular damage. The authors wrote,

 "As screening primarily seems to identify slow-growing tumors, the adverse effects of treatment could potentially reduce or even neutralize any possible benefits."

The rate of false positive results from mammograms is also very high, leading to unnecessary biopsies, radiation, mastectomies and lymph node removal. A National Cancer  Institute study showed that over the course of nine  mammograms for women between the ages of 40 and 69, the risk  of a false positive was well over 40 percent.

Even up      
                    
Myth 3: Mammograms save lives.
Fact:   Mammograms do not save lives.

There are certainly cases where a mammogram has detected a  life-threatening cancer and the patient's life was saved by the follow up treatment. But overall, the statistics simply don't support the argument that mammograms save lives.

The Nordic Cochrane researchers cited two definitive studies in their report. The first, conducted in Malmo, Sweden,  compared the experience of 21,088 women who had regular  mammograms to 21,095 women who did not. After nearly nine years, 63 women in the mammogram group and 66 women in the  control group had died of breast cancer.

 The second study,  performed in Canada, tracked almost 90,000 women for 13  years. Approximately half of the women had mammograms, and half did not. Deaths due to breast cancer numbered 120 in the mammogram group, and 111 in the control group.

These are just two of many studies that have come to the same conclusion: mammograms do not save lives.

On a personal note; as my doctor was handing me the  slip "ordering" my mammogram, he told me that he had never had a case of breast cancer in a pre-menopausal woman that  wasn't fatal. "The cancer is always just too aggressive in those cases," he said. I wondered if he realized that he'd just told me he wanted me to get tested so we would both know if I was about to die. After all, he'd just admitted he couldn't save me. But he was already pretty frustrated and I had to get to work, so I dropped the debate. ---------------------------------------------
The Good News
--------------------------------------------------------------
No woman should assume that a yearly mammogram will save her from breast cancer, or that surgery and radiation are the only acceptable responses to a positive reading.

As numerous studies have demonstrated, these previously accepted "facts" about mammograms are largely based on myths that are
perpetuated by the medical mainstream.

In tomorrow's e-Alert I'll continue this topic with some good  news: there are safe alternatives to mammography, and some of  them have been shown to be more effective than mammograms.
To Your Good Health,   

Jenny Thompson

Sources: 
 "Women Need Better Information About Routine Mammography"
          British Medical Journal, 2003; 327: 101-103, 7/12/03, bmj.com

  "Mammography Myths Remain Unexposed" Dr. Joseph Mercola,
           7/30/03, http://www.mercola.com/

     "Cochrane Review on Screening for Breast Cancer with
           Mammography" The Lancet, 2001; 358: 1340-1342,
                   http://www.thelancet.com/

       "Screening Mammography - an Overview Revisited" The Lancet,
           2001; 358: 1284-1285, http://www.thelancet.com/

      "Is Screening for Breast Cancer with Mammography
           Justifiable?" The Lancet, 2000; 355: 129-134,
                           http://www.thelancet.com/

        "The Cruel and Costly Hoax of Breast Cancer Screening:
             Protect Yourself from Mainstream Mammography Mania" William
             Campbell Douglass, M.D., Real Health, January 2002,
                      http://www.realhealthnews.com/

         "Medicine Mum on Mammography... Do the Math" Alternative
              Medicine, 10/23/00, alternativemedicine.com
              "Happy People get Fewer Colds" United Press International,
                7/28/03,  http://www.nlm.nih.gov/

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