Is mammography over rated?

July 31, 2010 No Comments

Dear Patient,

Is mammography over rated?

Breast cancer effects 1 out of 8 woman in the United States and has ranked second only to lung cancer and cancer related deaths among women. Breast cancer screening programs have shown that  regular screening leads to early detection and a reduction in breast cancer mortality.. Screening methods can be as low-tech as self breast examination or clinical breast exam by the doctor or as high-tech as ultrasound, mammogram,or MRI of the breast. Newer technology also includes breast thermography.

New recommendations from the United States Preventative Service Task Force ( USPSTF) as of November 2009 says that women in their 40s should not get routine mammograms for early detection of breast cancer. Women between 40-49 should talk to their doctors about the risks and benefits of the test then decide if they want to be screened. Women ages 50-74 should have routine mammograms every 2 years instead of annually. Risks and benefits of women age 75 or older getting mammograms is unknown. The groups previous recommendations was for routine annual screening every year for women 40 and older.

Why did this prestigious group of doctors and researchers reduce the use of screening mammograms ?  What should women do during the 30-40s? How can screening accuracy be improved and false positives be decreased?

Disadvantages of mammography

Premenopausal breasts (20-40s) are known to be quite dense which makes interpreting mammograms difficult. Mammograms might miss a tumor because of the breast being too dense. Routine mammography can miss approximately 40% of the breast cancers that develop among women ages 40-49 as a result of dense breasts.

Out of every 100 mammograms read as positive or suspicious for breast cancer only 2 or 3 will actually turn out to be cancer. There are approximately 1,000,000 breast biopsies done annually but only about 25% turn out to be cancerous. In other words there is added expense, increased anxiety, extra doctor visits and possibly unnecessary treatments as a result of overdiagnosis of breast cancer  with screening by mammography.

The link between radiation and breast cancer is also a potential concern. Breast cancer risk is much higher than normal among women treated with radiation for childhood Hodgkin’s disease. Although modern day mammography is safer now than in the past there is still no safe dose of radiation exposure and the risk of radiation is cumulative. This means that it adds up over time with repeated exposure. To make matters worse the premenopausal breast is quite sensitive to radiation exposure meaning too much xrays may stimulate cancer growth.

Abnormal mammograms usually require follow up studies which may include sonogram or MRI imaging. When the diagnosis needs to be confirmed, a breast biopsy and a lymph node biopsy is the final procedure used.

Does current breast cancer screening need any additional help or support?

Thermography represents a process of imaging the breast tissue with an infrared camera that produces a highly detailed picture of the heat levels and patterns from breast tissue. No radiation is involved and no compression of breast tissue was involved. Thermography evaluates the underlying physiology of the breasts where as sonograms, mammograms or MRI are looking at the anatomy of the tissue. Breast Thermography has undergone extensive research since the 1950s. Breast thermography has an average sensitivity and specificity of 90% which means that it has good accuracy in identifying true positives. An abnormal thermogram is 10 times more significant as a future risk indicator for breast cancer then a first order family history of the disease. When used as part of a multi-modal approach such as clinical examination plus mammography plus thermography there is a 95% chance of successful early cancer detection. I believe that thermography should be an additional adjunctive tool in the war against breast cancer.

Ronald Lynch

Ronald Lynch, M.D.,  iAMT*
Medical Director
Integrative Medicine of Lake Mary, Inc.
www.naturalfamilymed.com

References:
The Complete Natural Medicine Guide to Breast Cancer “ A Practical Manual for Understanding Prevention & Care, Sat Dharamkaur, ND, 2003

The Breast Cancer Prevention Program:. Samuel S. Epstein, MD and David Steinman with Suzanne LeVert, 1998

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