The long-held conventional medical advice has been for women to get an annual mammogram once they hit 40. A couple of years ago, the U.S. Preventive Services Task Force decided to alter their mammogram recommendation, advising women under the age of 50 to avoid mammograms, and limit them to every other year after the age of 50. The revision caused outrage among many cancer organizations. What was overlooked, however, was the reasoning behind the Task Force’s decision to change their recommendation.
The prior advice was given in 2002, before a host of new research came out showing the problems of overdiagnosis, including false positives.
If a mammogram detects an abnormal spot in a woman’s breast, the next step is typically a biopsy. This involves removing a small amount of tissue from the breast, which is then looked at by a pathologist under a microscope to determine if cancer is present. However, early stage cancer like ductal carcinoma in situ, or D.C.I.S., can be very hard to diagnose, and pathologists have a wide range of experience and expertise. There are actually NO universally agreed upon diagnostic standards for D.C.I.S., and there are no requirements that the pathologists doing the readings have specialized expertise…
Many conventional physicians view DCIS as “pre-cancerous” and argue that, because it could cause harm if left untreated it should be treated in the same aggressive manner as invasive cancer; however the rate at which DCIS progresses to invasive cancer is still largely unknown, with the weight of evidence suggesting it is significantly less than 50 percent – perhaps as low as 2-4 percent.
This suggests that watchful waiting may be the more sensible approach, but most women are not informed of this option and instead go through invasive breast cancer treatments like surgery, radiation and toxic chemotherapy that often turns out to be unnecessary. As discussed above, it’s really hard to justify harming 10 women with surgery and toxic chemotherapy treatment in order to possibly save the life of one woman …
New York and Virginia followed the lead of Connecticut and Texas and recently passed laws requiring women with dense breasts to be informed they may need to seek alternative screening methods. The Federal Breast Density Bill is (HR 3102) is also currently being considered.
Mammography and its subsequent tests, such as MRIs and stereotactic (x-ray guided) biopsies, likely contribute to cancer because of the cumulative radiation exposure that occurs over a lifetime and the particularly radiation-sensitive nature of breast cells, e.g. BRCA1/2 genes confer greater risk for breast cancer, in part, because they interfere with the repair of radiation-induced DNA damage. Even the National Cancer Institute states that “repeated x-rays have the potential to cause cancer.”8
And finally, although receiving a false positive is the major danger of mammograms, false negatives also occur. Mammograms are especially inaccurate for women with dense breasts; New York and Virginia recently passed laws requiring women with dense breasts to be informed they may need to seek alternative screening methods. It’s estimated that up to 75 percent of women in their 40s, and up to 50 percent of all women, have dense breasts, which increases the likelihood that a mammogram will be ineffective and inaccurate.9