Mammograms and the way we are taught to think
I recently posted this as my FB status
So, my doc wants me to get a mammogram. There’s no breast cancer in my family (either side), I breastfed for almost 7 years, and I have no other risk factors other than being a woman over 40. Studies, pro and con either way? I mean, I breastfed my kids…
I got 27 responses.
I am touched that so many of my friends give a shit in one way or another about my tits.
But, I am a little concerned about how this played out, on a sociological level. I was pretty damned specific: I have these risk factors, I have taken these preventative steps, here is a test that is being offered to me–want to know the safety and efficacy (does it do what it says it’s going to do) for lower-risk younger people.
I got a lot of opinions, and a lot of anecdotal evidence, some misinformation, some shit-talkin’ about non-trad-western meds, some people trying to say that I have more risk factors than I presented (trying to undermine my original statement) and an undercurrent of “if you don’t do this, you will die from cancer”.
Ok, let’s go back. Aside from being a woman over 40, I am at relatively low risk for breast cancer. There is NO family history, and there’s longevity for ladies on both sides (there’s elevated risk for kidney disease, but that’s not the current cause celebre these days, so no-one offers to test for it). I did breastfeed long term, which is KNOWN to reduce the risk for breast cancer by 50% (if you nurse for only 6 months). So, does it make sense for me to get a mammogram?
1. Do mammos detect breast cancer in women in my age range?
2. Do they prevent death from breast cancer for women in my age range?
3. Are they accurate?
4. What are the risks involved in having a mammogram?
5. Are there alternative tests?
1. “The USPSTF has reached the following conclusions:
For biennial screening mammography in women aged
40 to 49 years, there is moderate certainty that the net
benefit is small. Although the USPSTF recognizes that the
benefit of screening seems equivalent for women aged 40
to 49 years and 50 to 59 years, the incidence of breast
cancer and the consequences differ. The USPSTF emphasizes
the adverse consequences for most women—who will
not develop breast cancer—and therefore use the number
needed to screen to save 1 life as its metric. By this metric,
the USPSTF concludes that there is moderate evidence
that the net benefit is small for women aged 40 to 49 years.”
(http://www.annals.org/content/151/10/716.full.pdf+html)
2. “The Danish research team looked at annual changes in breast cancer deaths in two Danish regions where breast cancer screening programs were offered to the public and compared this to data collected in non-screened regions throughout the rest of the country. To get a broad picture of the trend toward more or less breast cancer mortality, they analyzed breast malignancy rates in the decade before the screening was started and also looked at the ten years after screening was introduced.
The results showed that breast cancer deaths declined by 1% in women between the ages of 55 and 74 in the areas where regular mammography was frequently used. However, breast cancer rates went down more — 2% per year — in women of the same age living in non-screened areas. And this trend was the same in younger women, too. For those between the ages of 35 and 54, breast cancer mortality went down by 5% per year in the screened areas but it went down more, 6% per year, in the non-screened areas during the same time frame.
The researchers noted that there’s no evidence that the drops in cancer deaths in the women screened for breast cancer had anything to do directly with mammograms, either. “We were unable to find an effect of the Danish screening program on breast cancer mortality,” the researchers concluded in their study, which was just published in the British Medical Journal (BMJ). “The reductions in breast cancer mortality we observed in screening regions were similar or less than those in non-screened areas and in younger age groups, and are more likely explained by changes in risk factors and improved treatment than by screening mammography.” http://www.naturalnews.com/028530_brst_cancer_mammograms.html
3. “Mammograms are positive when abnormal tissue is detected. False positive tests occur when mammograms mistakenly identify cancer in normal tissue. A 2005 review of randomized controlled trials published in the Journal of the American Medical Association (http://jama.ama-assn.org/content/293/10/1245.abstract) found that 95 percent of positive mammography results are false. A Harvard study published in the New England Journal of Medicine found that only three percent of abnormal mammography results were valid, making the frequency of failure 97 percent.” (http://wisdom-magazine.com/Article.aspx/1465/)
4. “The harms resulting from screening for breast cancer
include psychological harms, unnecessary imaging tests and
biopsies in women without cancer, and inconvenience due
to false-positive screening results. Furthermore, one must
also consider the harms associated with treatment of cancer
that would not become clinically apparent during a woman’s
lifetime (overdiagnosis), as well as the harms of unnecessary
earlier treatment of breast cancer that would have
become clinically apparent but would not have shortened a
woman’s life. Radiation exposure (from radiologic tests),
although a minor concern, is also a consideration.
Adequate evidence suggests that the overall harms associated
with mammography are moderate for every age
group considered, although the main components of the
harms shift over time. Although false-positive test results,
overdiagnosis, and unnecessary earlier treatment are problems
for all age groups, false-positive results are more common
for women aged 40 to 49 years…” (http://www.annals.org/content/151/10/716.full.pdf+html)
5. “Digital Infrared Thermal Imaging (DITI)
Thermography is method of detecting abnormal temperature areas in organs like breast. Thermography is the technique of imaging based on heat emission. Thermography helps physicians to identify tumors like breast cancer. The term thermography literally means writing with heat or writing heat. This equipment uses infrared head released from the tumor with the help of modern digital equipment to correctly map the presence of abnormality in areas like breast.
Modern digital technology has integrated digital imaging with thermography in technique called Digital Infrared Thermal Imaging (DITI). The Food and Drug Administration (FDA) approved Digital Infrared Thermal Imaging (DITI) n 1982 for additional evaluation of patients who were found to have suspicious lesions in the breast. Thermal cameras detect heat given off by the body and display it as a picture on a computer monitor. These images are unique to the person and they remain stable over time. It is because of these characteristics that thermal imaging is a valuable and effective screening tool to determine changes that could point to trouble down the road. As we all know, early cancer detection is important to survival. Thermography measures temperature changes in the body. Tumors create their own blood vessels. Where there are more blood vessels, there is more heat. It is in these areas on the body that the camera detects changes in heat or temperature.
Unlike mammography, there is no radiation exposure involved with Digital Infrared Thermal Imaging (DITI). Mammogram involve compression of the breast which is often painful and the use fo Digital Infrared Thermal Imaging (DITI) eliminate the need for compression.” (http://medicineworld.org/cancer/breast/mammogram-and-breast-cancer-scree…)
********
The question I’m not asking is the one that it seemed like a lot of people were answering: do mammograms PREVENT cancer? It felt like people were saying that getting a mammogram would keep me “safe”. It won’t. Mammograms DON’T REDUCE RISK. (breastfeeding does. so does regular exercise and eating a lot of vegetables. being born a guy also reduces risk, but I can’t go back in time on that one) They DON’T PREVENT CANCER. THEY ARE NOT MAGIC.
But this is what we are being fed now. We are being led to believe that all breast cancers are deadly, unless you catch them “in time”, and that THE way to catch them is with a mammogram. We are being scared shitless about breast cancer, and people are wearing stupid pink ribbons and raising money for a “non-profit” that has a lot of for-profit thoughts on its mind (http://www.huffingtonpost.com/2010/12/07/komen-foundation-charities-cure…) (and….In 2007, Komen spent 23.5% of total revenue on “Research for the cure”. In 2008, Komen spent 26.7% of total revenue on “Research for the cure”. In 2009, Komen spend 20.2% of total revenue on “Research for the cure”. — http://www.charitynavigator.org/index.cfm?bay=search.comments&orgid=4509). We are being led to believe that mammograms are NEEDED to “save” women from breast cancer, that mammos are safe, that the worst part about them is the “discomfort” from getting your tits squished, and it’s better to be “safe than sorry”.
IMHO, mammograms are diagnostic tools. In a situation where a woman has certain risk factors (age, fam history, exposure to radiation), it’s probably a good idea to get a mammogram. Or some other kind of testing. But, if a person doesn’t have those risk factors, and especially if a person is adverse to having any kind of cutting of body parts happening, then a mammogram is NOT a good idea.
