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A study was presented on December 1, 2009 at the annual meeting of the Radiological Society of North America (RSNA) that verified that annual mammography screenings may be responsible for causing breast cancer in women who are predisposed to this disease.
Dr. Jansen-van der Weide suggests that women with genetic of familial predisposition to breast cancer choose alternative screenings methods, such as Ultrasounds, MRIs, and heat thermography screenings -- which do not expose patients to radiation.
The study evaluated women in the high-risk group and determined that low-dose mammography radiation increased these women's risk of developing breast cancer by 150 percent.
Dr. John W. Gofman, an authority on the health effects of ionizing radiation, estimates that 75 percent of breast cancer could be prevented by avoiding or minimizing exposure to the ionizing radiation. This includes mammography, x-rays and other medical and dental sources.
People are beginning to understand the limitatons of mammograhy. In dense tissue, they spot only half of all tumors! Even more disconcerting, excessive compression of the breast (like during a mammogram) can actually break apart cancerous cell masses and cause the cancer to spread.
According to Barbara Brenner, Executive Director of 'Breast Cancer Action Organization' (BCA), "Efforts to eradicate breast cancer has not focused on prevention, but largely on efforts that promote mammography screening. Since its inception in 1990, BCA has raised concerns about mammography's effectiveness and the dangers of misleading the public about the benefits of breast cancer "early detection" through screening mammography.
Brenner states that mammography has several potential harmful outcomes, especially for younger women, among them:
- Radiation Exposure - may possibly result in cell death, damage to cellular genetic material, including induction of cancer, and accelerated aging - http://www.medscape.com.
- Dr. John W. Gofman, an authority on the health effects of ionizing radiation, estimates that 75 percent of breast cancer could be prevented by avoiding or minimizing exposure to the ionizing radiation. This includes mammography, x-rays and other medical and dental sources.
- According to Russell L. Blaylock, MD, one estimate is that annual radiological breast exams increase the risk of breast cancer by two percent a year. So over 10 years the risk will have increased 20 percent. In the 1960s and 70s, women, even those who received 10 screenings a year, were never told the risk they faced from exposure.
- In the midst of the 1976 radiation debate, Kodak, a major manufacturer of mammography film, took out full-page ads in scientific journals entitled About breast cancer and X-rays: A hopeful message from industry on a sober topic.
- High Incidence of False-negative or False-positive Readings - Recent data from the University of Washington and Harvard University reveals that over a period of a single decade, one out of every two women will have a false positive result as the result of mammography, and of those, nearly 20 percent will undergo an unnecessary breast biopsy. Only one biopsy in six was found to be positive for cancer when done on the basis of a positive mammogram or breast examination. The combined false positive rate was determined to be as high as 89 percent
Brenner warns that routine mammography screening, particularly for younger or pre-menopausal women, may cause more harm than good.
A group of researchers led by Dr. Goetzsche, whose non-profit organization is part of the highly respected Cochrane Collaboration - an international organization providing healthcare analyses worldwide, reviewed all seven randomized mammography trials conducted prior to June 2005, involving half a million women. Most of the trials enrolled women ages 45 to 64; although one, the Canadian National Breast Screening Study included women ages 40 to 49.
One of the highest-quality mammography trials in Gotzsche's review, a Canadian study led by Cornelia J. Baines, MD, of the University of Toronto, Ontario, followed more than 50,000 women. The results after seven years in 1992 showed 36 percent MORE deaths from breast cancer amongst screened women than amongst unscreened women. Called the "breast cancer mortality paradox" at the 10-year follow-up, this percent then fell to 14 percent. "Even if the results are not officially statistically significant, when the same results are observed multiple times, in multiple studies, the trend deserves attention," says Baines.
Gotzsche's overall findings based on all trials, including those of poor quality, show an absolute risk reduction in cancer mortality of just 0.05 percent (for all women attending annual or semi-annual mammography screenings). Screening also led to over-diagnosis and over-treatment, resulting in an absolute risk INCREASE of 0.5 percent. "This means for every 2,000 women invited for screening throughout 10 years, one will have her life prolonged," explains Gotzsche. "In addition, 10 healthy women will be diagnosed as breast cancer patients and will be treated as such, unnecessarily.
Women have been told that mammograms will save their lives; and yet the best studies don't support this claim. Even mammography's most outspoken advocates acknowledge, however, that women should first focus on prevention.
However, breast cancer is a serious disease and early detection is important. The following measures have been recommended:
- If you're under 50, ask your doctor about digital mammography. In a large new study, this computer-based technique found 27% more tumors in certain women.
- A study involving 11,220 women indicated that just adding an ultrasound test to your mammogram can raise the cancer detection rate to a near-perfect 97% -- even for women with the densest breast tissue. That's nearly two times better than standard mammography.
Claims: Ultrasound is a noninvasive, harmless and painless imaging technique in which high-frequency sound waves bounce off breast tissue and convert them into an image of the breast's interior, called a sonogram. The procedure helps distinguish between solid masses and harmless cysts and may prevent the need for an invasive breast biopsy.
Cons: Although ultrasound is a helpful diagnostic tool in separating benign lumps from cancerous tumors in dense breast tissue, it is most often used to evaluate lumps that already have been detected by Clinical Breast Examination or mammogram. Ultrasound cannot detect microcalcifications, small calcium deposits found within the breast tissue that may or may not indicate an underlying tumor.
Claims: An emerging offshoot of ultrasound, elasticity imaging holds promise for even greater specificity in distinguishing benign from cancerous breast lesions. A 2006 study by Northeastern Ohio University's College of Medicine published in the Journal of the American Medical Association found that a real-time handheld elasticity imaging device used in correlation with a routine ultrasound exam was 99 to 100 percent effective at identifying malignant versus benign lesions.
Cons: While elasticity imaging holds great promise to predict malignant versus benign lesions, and help reduce a major harm of screening mammography (over-diagnosis, resulting in unnecessary biopsies), no one is ready to say it's a replacement for mammography.
- This technique uses an infrared camera to reveal "hot spots" in your breasts. Some cancers do show up, but this is not more reliable than mammography. It fails to detect many existing cancers, and often finds "false positives" that aren't actually malignant.
- Entirely safe and appropriate for women of all ages
- Entirely pain free and non-invasive
- Absolutely no radiation!
- Quick - only takes 15 minutes
- Prevents implants from possible rapture
- Typically detects "abnormalities" as much as 5 years earlier than traditional methods.
Cons: However, thermography does not have the ability to pinpoint the location of a tumor. Consequently, breast thermography's role is in addition to mammography and physical examination, not in lieu of. Breast thermography does not replace mammography and mammography does not replace breast thermography, the tests complement each other. Since it has been determined that 1 in 8 women will get breast cancer, we must use every means possible to detect cancers when there is the greatest chance for survival (1). Proper use of breast self-exams, physician exams, thermography, and mammography together provide the earliest detection system available to date). (International Academy of Clinical Thermology)
Molecular Breast Imaging (MBI) is said to catch three times the number of breast cancer cases than mammography. It's said to be especially effective for women with denser breast tissue who are usually at a higher risk for developing the disease. MBI works by first injecting the patient with a radiotracer which helps to track the behavioral difference between cancerous tissue and normal tissue.
One study using MBI found 10 of 13 cancer cases in a sample group of 375 patients. In the same group, mammography found just three of those 13 cancers. According to the study author Carrie B. Hruska, a radiology researcher at the Mayo Clinic, "MBI detected more cancers than screening mammography, but didn't produce more false positive results." Obviously, this is encouraging news. MBI was also found to have a higher percentage of biopsies that resulted in the discovery of an actual cancer (28 percent with MBI compared with 18 percent with mammography). What's more, MBI is also relatively inexpensive.
Cons: Researchers are proposing that it be used only as an adjunct to mammography, not as a replacement. Excessive compression of the breast (like during a mammogram) can actually break apart cancerous cell masses and cause the cancer to spread. Mammography also results in a high number of "false positive" results. Also, MBIs are still not widely available.
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