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Wednesday, January 02, 2013

30 Years of Breast Screening: 1.3 Million Wrongly Treated

You are showering and you feel an inconsistency in one of your breasts.  Given all the pink hoopla about the breast cancer epidemic, you worry yourself sick that you may have breast cancer.  You rush off to your doctor who orders a mamogram.  The mamogram results show what may be a tiny lump.  You are referred to a breast expert.  You are on the conveyor belt.  Once on, it may be next to impossible to get off.  You are in the "System".

Here's the problem: The latest research (Nov 2012) concludes that over 90% of early detection cases for breast cancer are false positives.  In other words, if left alone, over 90% of cases would never have come to anything!  The problem for  your doctor is this:

"If over 90% of positive mamograms are actually false positives, how do we detect and then treat the few remaining percent that may go on to be invasive cancer?"

The answer currently being employed is to treat just about every case that may actually be false positives as being positives.  In other words - treat these as one would an aggressive invasive cancer.  This is very bad news for women.  

Millions of women, worldwide, who may not have had a life threatening breast cancer have had their breasts removed and/or undergone debilitating chemotherapy, radiation therapy and hormone therapy - all for no benefit but for a whole lot of harm!

Why is breast cancer the feared epidemic it is today?  

Breast cancer may be on the increase.  But much less than one might think, given all the publicity and wall-to-wall fund-raising.  Most of the scary increase in breast cancer is actually due to early stage detection through mamograms of conditions, most of which never progress to being invasive cancer.  Plus, there is a ton and a half of media hype being generated by huge charitable and commercial industries that feed on the cancer epidemic - be it real or not - making the problem seem much worse than it really is.

Why does your doctor treat all these "positives" so aggressively?

Cancer is a terrible disease that I would not wish upon my worst enemy.  One of my aunties passed away a few years ago, some 15 years after discovering she had breast cancer (She opted for no "conventional" treatment at all, a decision I did not agree with at the time).  She enjoyed over a decade of good health before finally succumbing to its ravages.

The problem with breast cancer is it may be next to impossible to know which of these many false positives will go on to be invasive cancer.

If there is an aggressive cancer present, then the sooner it is treated - aggressively - the better the chances of survival.  

If your doctor decides to take a "wait and see" approach and it consequently develops into an aggressive cancer, he/she has got a serious problem - a very unhappy patient who may complain to the authorities and even sue for negligence.  Better to play it safe, professionally, and order the full works for the patient with no expenses spared.  No doctor ever got sued for over-treating a breast lump (as far as I know anyway).  And no doctor ever wants to lose a patient through "under treatment".

If I found a breast lump, here is what I would do:

(this does apply to men as well as women):
Example of a thermogram
  • Do not fiddle with it - that means, leave it alone!  Do not poke and prod and do not crush it with a mamogram or allow a biopsy at this stage.  You do not want to break up any tumour tissue, causing cells to migrate to other parts of the body.  As an aside: a mamogram is ionising radiation which increases your lifetime risk of getting cancer, so I would be inclined to use less invasive and less potentially harmful assessment tools in the early stages of investigation.
  • Get a thermogram, or a repeat if you have had one in the past, for comparison (repeat thermograms are extremely valuable because they will show any changes that may have happened). A thermogram, is totally non-invasive and is valid for all, young and old.  This is best done directly via a thermogram screening service. A thermogram is totally non-invasive.  It will pick up the heat signature, in remarkable detail, of vascularisation associated with a growing tumour. A number of my clients have had this done and the results are most useful - and reassuring.  Go here for more information.
  • If the thermogram shows something suspicious then it is time to escalate and go see your doctor armed with your thermogram results.  Incidentally, the people providing the thermogram service are extremely helpful, reassuring and caring - listen to their advice.
  • Regardless of the results, also consult someone who can advise on nutrition,breast tissue effleurage and other strategies to promote breast health.  Again, the people who provide the thermogram service may be your first port of call for where to find this assistance.

Mamograms are early detection - not real prevention!

The mamogram is not true prevention.  There is a lot that can be done to prevent the development of cancer - well before there are any lumps to show on a mamogram.  Measures that put the odds more favourably in your camp.  Read on.

Have you ever wondered what comes before cancer?  

A cancer does not develop overnight out of thin air.  In most cases there must be conditions that stress the cells for years, if not decades, like a lifetime of smoking, or a bra strap that has been rubbing a mole for years, or repeated CT scans and x-rays that have zapped you many times with radiation.  There must almost always be chronic oxidative stress within the cellular environment, often due to the deficiency of a nutrient such as selenium, and/or the presence of a toxin such as lead or mercury.  

Oxidative stress is most commonly experienced as inflammation, such as with a swollen prostate gland.  In the case of the breast tissue, inflammation may develop into fibrocystic breast disease.  While the usual advice with a condition, like fibrocystic breast disease, is to treat it with anti-inflammatories and hormones, there is a lot more that can be done.  There are several practical natural health interventions that quell inflammation and return unhealthy tissue to a state of normality.  These may involve personalised nutrition and gentle effleurage massage guided by a suitably trained health professional.

Diets that reduce cancer risk

We can all do much better with our diets - even me!  When I take a diet recall of a client's foods, the most common issue is the lack of variety and lack of nutrient-dense foods. Here's a good website to help you get started quickly:
http://www.joybauer.com/cancer.aspx

If breast screening has caused far more harm than good, why hasn't this been headline news?

The report that breast screening has done so much harm was published in not just any old journal, but in the New England Journal of Medicine.  This news is sensational!  I can only speculate why this report has not received the attention it so deserves:
  • Like Greece and Spain, or the US Big Banks, the breast screening industry is just far too big to fail.  There are many vested and powerful interests in continuing with the status quo.
  • Breast cancer is BIG money.  There is no money to be made from true prevention, like sunlight, good food and cheap, non-patented natural vitamins and minerals.
  • Mainstream media operates in sound bites.  It will take many sound bites to make sense of this confusing matter, especially since it goes completely against everything we have been told so far about breast cancer screening.  It will end up totally confusing the public and undermine a number of charitable fund-raising schemes, so better to remain quiet.  
  • Who goes first will be accused of causing widespread hysteria and confusion. It is  like telling the Emperor that he has no clothes, or accusing Lance Armstrong of being a drugs cheat!  Those who value their heads will remain silent.
  • If the report was about a million men being maimed - not women - then there would surely be an outcry.  Maybe.  By the way, similar issues surround excessive false-positives and consequent over-treatment with prostate screening (I can feel another article coming on!).
  • Breast cancer is war!  In order to win this war, we must be prepared to take collateral damage in the form of civilian casualties (in this case, women).  Of course this is the mis-applied logic of a mad-man (or woman).
  • Pressure from women for treatment to the point of over-kill.  This is happening because the war on cancer has been too effective in drumming up support on the home front.  Women are demanding the most aggressive and most expensive treatment available; even when the evidence of there being any benefit is scant that the treatment is worthwhile.  This was most apparent  about a year ago when a panel of cancer experts issued a report that mamogram screening of women less than 50 years old may cause more problems than they solve:  " The federal task force said that unless a woman has unusual risk factors for breast cancer, being screened so early could potentially lead to more harm than good because mammograms tend to spot cancers that grow slowly and might never prove lethal and could lead to unnecessary biopsies and other invasive tests and treatments.Source:  http://well.blogs.nytimes.com/2012/07/02/fewer-younger-women-are-getting-mammograms/.  The response from many women has been surprising: They are demanding that they still have their mamograms, despite the evidence that there is no benefit other than for high risk younger women.

Further reading and further action

I have reproduced the New England Journal of Medicine study below with links to its source, so that you can judge for yourself whether or not I am being responsible or irresponsible.  I have also reproduced part of an article by Ji Sayer which I urge you to read in full by following the hyperlink below.  I have also taken some quotes from the website of the Caped Internet Crusader, Mike Adams.  On this issue, I agree with you, Mike (But I think your ideas on gun control are completely nuts).

Please leave your thoughts and comments using the "post a comment" tab at the end of this posting and please forward this article to others, thanks. 
Gary



"A disturbing new study published in the New England Journal of Medicine is bringing mainstream attention to the possibility that mammography has caused far more harm than good in the millions of women who have employed it over the past 30 years as their primary strategy in the fight against breast cancer"

"Breast cancer was overdiagnosed (i.e., tumors were detected on screening that would never have led to clinical symptoms) in 1.3 million U.S. women in the past 30 years."
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"We found that there were only around 0.1 million fewer women with a diagnosis of late-stage breast cancer. This discrepancy means there was a lot of overdiagnosis: more than a million women who were told they had early stage cancer -- most of whom underwent surgery, chemotherapy or radiation -- for a "cancer" that was never going to make them sick. Although it's impossible to know which women these are, that's some pretty serious harm."
Dr Welch quoted from Natural News Website 


Mike Adams: "In fact, if you do the math and calculate 0.1 million fewer women with advanced-stage cancer out of 1.5 million who were diagnosed, 93% of the "early detection" cancer cases studied were false positives, meaning that they would never have gone on to cause advanced-stage cancer anyway.



Effect of Three Decades of Screening Mammography on Breast-Cancer Incidence

Archie Bleyer, M.D., and H. Gilbert Welch, M.D., M.P.H.


BACKGROUND

To reduce mortality, screening must detect life-threatening disease at an earlier, more curable stage. Effective cancer-screening programs therefore both increase the incidence of cancer detected at an early stage and decrease the incidence of cancer presenting at a late stage.

METHODS

We used Surveillance, Epidemiology, and End Results data to examine trends from 1976 through 2008 in the incidence of early-stage breast cancer (ductal carcinoma in situ and localized disease) and late-stage breast cancer (regional and distant disease) among women 40 years of age or older.

RESULTS

The introduction of screening mammography in the United States has been associated with a doubling in the number of cases of early-stage breast cancer that are detected each year, from 112 to 234 cases per 100,000 women — an absolute increase of 122 cases per 100,000 women. Concomitantly, the rate at which women present with late-stage cancer has decreased by 8%, from 102 to 94 cases per 100,000 women — an absolute decrease of 8 cases per 100,000 women. With the assumption of a constant underlying disease burden, only 8 of the 122 additional early-stage cancers diagnosed were expected to progress to advanced disease. After excluding the transient excess incidence associated with hormone-replacement therapy and adjusting for trends in the incidence of breast cancer among women younger than 40 years of age, we estimated that breast cancer was overdiagnosed (i.e., tumors were detected on screening that would never have led to clinical symptoms) in 1.3 million U.S. women in the past 30 years. We estimated that in 2008, breast cancer was overdiagnosed in more than 70,000 women; this accounted for 31% of all breast cancers diagnosed.

CONCLUSIONS

Despite substantial increases in the number of cases of early-stage breast cancer detected, screening mammography has only marginally reduced the rate at which women present with advanced cancer. Although it is not certain which women have been affected, the imbalance suggests that there is substantial overdiagnosis, accounting for nearly a third of all newly diagnosed breast cancers, and that screening is having, at best, only a small effect on the rate of death from breast cancer.
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1 comment:

Alison White said...

Thanks for this. I have read similar things before but you put it together nicely. I was more than interested in your comment about Mike Adam's article on gun control - I had a similar reaction and have been debating about plucking up the courage and time to write something on his site.
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