How Mammograms Improve Survival but Not Mortality

[Recursion]

http://www.theatlantic.com/health/archive/2014/02/how-mammograms-improve-survival-but-not-mortality/283779/

About 16 million breast x-rays (mammograms) are done every year in the U.S. in attempt to stem the 41,000 annual lives lost to breast cancer. A large, long-term study came out late yesterday in a major medical journal, BMJ, that says mammography may be a waste of time and money.

The actual study says that screening for cancer with mammography in women ages 40 to 59 "does not reduce mortality from breast cancer" in places where treatment is available.

The University of Toronto study split a group of 89,835 women in two. Half of them got mammograms, and half did not. After 25 years, the rate of death from breast cancer was the same in both groups. Some of the women who underwent mammograms ended up with unnecessary treatment.

...

Mammography may help us find cancers earlier, so people live longer with the diagnosis. That is an increased survival rate. Despite improving survival rate, mammograms don't, the Toronto study says, save lives.

[ohheckyeah]

1. Here's the thing...

there are a lot of concerns from different corners about mammograms. Mammograms aren't the end all and be all. Thermography is more reliable and safe....mammography isn't particularly safe. But, doctors are too heavily invested in mammography centers to admit they can cause cancer and exacerbate cancer.

I've had one and don't intend to have another. I will have a thermogram.

[Recursion]

2. What's most surprising to me is that this seems to undercut the "early detection is best" narrative

Because, at least as far as I can see, what this says is that we're now getting a lot better at finding out when people have cancer, but that hasn't actually translated into delaying their deaths at all.

That said, I'm not sure whether the data are showing that there's literally not a significant impact on mortality at all, or whether the adverse consequences of unnecessary treatments make it a wash -- if the latter, then we need better imaging. If the former, then we need to re-think what we're doing to begin with.

[ohheckyeah]

3. The very mammogram that may have caught the cancer, may

also have caused it to spread. That's one of the dangers of mammograms according to some doctors and researchers, but of course the National Breast Cancer Foundation says not. NBC trotted out a doctor to try and discredit the new report - it was so predictable and disingenuous. If you check who owns most of the mammogram centers in this country, the majority of owners are doctors. I even asked one doctor to order an ultrasound at my expense and he refused. Why? His answer was "we don't do that."

Can you imagine men agreeing to have their testicles smashed and x-rayed? I don't think so.

I'm not saying don't get checked, but there are safer ways to do it.

[lumberjack_jeff]

4. There must be a flaw with the article. Because the contradictory things it says can't be reconciled.

[Recursion]

5. How so? It makes perfect sense to me

Survival (how long someone lives with a diagnosis) is up, because cancer is detected earlier.

Mortality (when someone actually dies from cancer) is unchanged.

[lumberjack_jeff]

41. Perhaps you're right.

As a layman I'm having a hard time reconciling the fact that dictionaries treat "survival" and "mortality" as antonyms.

[hedgehog]

49. Without reading the source article, I might argue that survival time has not increased.

For example: Two people have a cancer on Day 1 that kills them on Day 2000. Person A finds out about it on Day 1000 when the tumor is large enough to feel, and survives another 1000 days. Person B finds out about it on Day 250 via a mammogram, and survives another 1750 days. Both people lived with cancer the same length of time, it's just that Person B knew about it longer.

So it might be argued that all Person B got out of mammograms was a lot of extra worry and treatment. Depending on the side effects, the treatment might have made her life worse.

[Recursion]

64. What you're describing is increased survival time

In your description, person B has a higher survival time than person A because she lived longer with the diagnosis.

[hedgehog]

67. I'm suspicious that the phrase "increased survival time" implies something that isn't true.

Regardless of whether they knew it or not, both women in my example lived the same length of time with cancer. The difference is, one was diagnosed earlier, so her "increased survival time" was a mirage.

This may or may not be accurate, it's just my suspicion.

[Recursion]

70. Right, that's the article's point

"Increased survival time" on its own doesn't really tell us anything, but it's what Komen et al trumpet as the reason everyone needs mammograms.

[MannyGoldstein]

54. The former

It looks like a lot of the stuff detected early is actually not cancer. I heard part of a discussion with the fellow who ran the study.

[lostincalifornia]

6. Any women who has found a tumor by mammography, that could not be felt manually, I would say has

benefitted.

As with any procedure or test it is up to the patient whether he or she chooses to have it done.

They have made several similar statements regarding PSA testing and Colonoscopies.

The question is are the odds of beating a tumor today or letting it grow 3 years and then fighting it different?

All evidence has suggested that treating something early before it moves to an advanced stage is always more beneficial.

Does this contradict that?

[Recursion]

7. Yes, this seems to contradict that: earlier detection is not decreasing mortality

This was a study of 90,000 women. The ones who received mammograms died from breast cancer at the exact same rate as the ones who didn't.

[lostincalifornia]

8. I would want to know if the treatments that were applied were the most effective ones. It is well

known that if the cancer is localized and has not spread, it is easier to treat.

It reminds me of the Proscar/Avodart study which found that it reduces low grade prostate cancer in those who took Proscar/Avodart, but seemed to "increase" the incidence of aggressive prostate cancer in those who took the drugs. The problem with that conclusion was that they did not take into consideration the Proscar/Avodart shrink the prostate gland which would make it easier for a biopsy to detect a cancer, low or aggressive. Therefore by shrinking the gland, if there was already a high prostate cancer there, it would be easier to find.

Were the people reading the mama grams equally competent? In other words, were there specific standard in reading the protocols that were applied equally by the radiologists?

[Recursion]

9. This does seem to raise more questions than answers

And I'd have to see the crosstabs to make any sensible judgement (and I probably couldn't then, since I'm an electrical engineer rather than a pathologist).

Ohheckyeah, above, postulates that the mammogram itself worsens the cancers that do happen and so could wash-out any advantage from earlier treatment (I'm agnostic on that, and I know it's controversial; but it's clearly not on its face implausible that physical compression and radiation would make cancers worse).

I could also imagine an interpretation that while the mammograms themselves don't do that, the unnecessary treatments resulting from false positives do.

To make sense of this we need to sort out whether this is because of the ill effects of mammograms, the ill effects of unnecessary treatments, or whether it's simply because early detection doesn't actually improve mortality.

[lostincalifornia]

17. I agree. I added more comments to my post also, wanting to know the criteria used in reading the

mammograms was used among all the radiologist. In other words, did they use the same standards. Also, there are a lot of variables that are not mentioned, the least of which is density, and if a breast is too dense, they they should utilize an MRI to eliminate a false negative since too dense a breast would be difficult to read.

The age group includes both younger and older women are included in both groups, and that demographic would confuse the issue I would think. There are other factors also, heredity, i.e. does it run in a family, birth control pills, childless women, or women have children later in life, all could be factors also.

No competent physician would ever diagnosis breast cancer on a mammogram alone. It must be confirmed with a biopsy, and unless the biopsy showed a cancer, there would not be treatment. If there was, without a biopsy confirmation, that is malpractice.

The only unnecessary treatment from a false positive mammogram would be a biopsy, which could cause an infection. However, there would NOT be a treatment for a cancer unless the biopsy showed one.

As far as ill effect of mammograms, it is possible, however, one would except to see a significant increase in that, which has not been observed.

[Recursion]

19. A biopsy itself has contraindications

Everything has contraindications.

The only unnecessary treatment from a false positive mammogram would be a biopsy, which could cause an infection. However, there would NOT be a treatment for a cancer unless the biopsy showed one.

But tissue trauma (like a biopsy) is itself a risk factor.

[lostincalifornia]

26. the only way a firm diagnosis can be made is with a biopsy. If a mammogram shows a suspicious area,

the patient has a choice, do the biopsy or not

The trauma from a biopsy is less of a risk then potential infection, though both are low. If antibiotic prophylactic is administered for a few days before and after, that would reduce the risk of infection even more.

[Recursion]

27. The risk of driving to the clinic is greater than both

It's kind of a problem we have with diseases that aren't normally distributed. We're always talking about tail-heavy processes, and we don't really have the tools to deal with that, mentally or emotionally. I don't know. I hope posting this didn't consign me to being "anti-mammogram"; I just literally don't know now what the right policy determinations are.

[lostincalifornia]

29. It is a question of risk verses reward. People need to make their own informed decision. The most

important thing is that they have all the facts.

Discussions like this are good.

[Recursion]

30. I do agree patient choice needs to be front and center here

But then again informed choice has to be based on accurate popular medicine and science reporting...

[AngryAmish]

75. It is my understanding that many times when any tumor is removed this promotes metastication

Wouldn't that also be true of a biopsy? Your are cutting into the cancer. (Let me add here this is not my field and am quite ignorent about cancer other than it sucks.)

[hedgehog]

50. As far as unnecessary treatment goes, there is some concern that we are finding and treating

"cancers" and "pre-cancers" that would never progress to actual cancer. If I understand correctly, these are anomalous cells that look like cancer cells to us, but which the body itself has spotted and walled off.

There is a similar issue with prostate cancers. Again, if I understand correctly, some are very aggressive and will metastasize while others are indolent and will never spread. Again, if I understand correctly, the odds are that if you get prostate cancer before a certain age, it is the aggressive type. If you get it in old age, it is the indolent type or it will metastasize so slowly that you won't live long enough to be harmed by it. Some doctors do not want to test for prostate cancer after a certain age because in this situation, ignorance is bliss; leave the cancer untreated and the patient and his family worries. Treat the cancer, and the side effects make the patient's life miserable.

[lostincalifornia]

66. There is no rule that if you are at a certain age it will be aggressive. The only way to determine

that is through a biopsy, and the only way to justify a biopsy, is various diagnostics to determine if it is necessary

The reason some doctors do not want to test for prostate cancer after a certain age is because they are making the assumption that if the patient is too old, the odds are he will most likely die of something else. What is too old? Is it 70? 80?

There are plenty of people in their 70's and 80's going through major suffering from cancer that has been ignored

What is changing in Prostate Cancer, and now being considered for breast cancer is Active Surveillance. This means not ignoring the cancer, but monitoring it actively, and if something changes, then decide on treatment.

The use of "Watchful waiting" in most cases is replaced with "Active Surveillance".

[hedgehog]

68. The issues you raise are very valid and the reason for intense scrutiny of

current practices. I like your phrase "active surveillance".

[lostincalifornia]

69. We are on the same page

[pnwmom]

15. Yes, this research does contradict that prior belief.

They are saying that the women who are "saved" as a result of early diagnosis of tiny cancers generally had very slow growing tumors that might never have killed them at all -- and even might have gone away on their own.

They are saying that many of the women in this category went through unnecessary treatment with significant adverse effects. (For example, radiation to the left breast has been shown to carry a risk of damage to the heart. )

You are right that the situation with breast cancer research is similar to that of prostate cancer research -- that early diagnosis based on the available tests, and treatment, don't seem to decrease mortality. It increases the survival rate -- meaning that you get to live with the cancer diagnosis for a few extra years because it's discovered earlier -- years when otherwise you would have felt perfectly fine. Instead, you undergo treatment that doesn't decrease your chance of dying from the disease.

Doctors have already changed their recommendations about prostate cancer. The question is if they will do the same for breast cancer.

Colonoscopies are in a different category. From everything I've read, removing precancerous colon polyps have been a success story, like treating early cervical cancer.

[Jesus Malverde]

24. Thanks for the explanation it finally makes sense..nt

[lostincalifornia]

31. Actually that is NOT true with prostate cancer. If a prostate cancer is found, and it is localized

and low grade you have several options, one of which is Active Surveillance. Which is where the biggest change in prostate cancer is occurring, but they are still using PSAs, and every major medical institution and experts in prostate cancer still recommend it.

In addition, It has been shown in studies exceeding 10 years that if surgery or radiation therapy is used, the person has a greater than 90% chance of being cancer free after 10 years. That includes intermediate and high risk cancers, as long as they are localized.

Which is the whole point of detecting it early.

The USPSTF which recommended against PSA screening did NOT have ONE urologist in that group, which begs one to question their expertise in Prostate Cancer.

PSA is still being used, not on a single reading, but a trend, along with velocity, free PSA, Color Doppler MRI, and DRE, along with other diagnostics to determine if a biopsy is indicated.

Any doctor who does not order a PSA or do a DRE during a physical for any male over 50, is ignoring the advice of experts in the field.

As someone posted below in a response below, the study had some very questionable methodology:

http://www.bostonglobe.com/lifestyle/health-wellness/2014/02/11/study-questions-value-mammography-reduce-breast-cancer-deaths/fQGBGHqCOZSKFRGhPgjULK/story.html

[pnwmom]

34. The point is that "active surveillance" is now an option in many low grade and small cancers,

which has not been the case for breast cancers.

[lostincalifornia]

40. agreed. As usual, I jumped to the wrong conclusion. Thanks

[PotatoChip]

63. I don't know for sure, but to me

it sounds as if they are saying that mammograms cost more than 'they' think should be spent.

Here is what I mean. Many times a mammogram will pick up something very small but suspicious looking. Something that would not have been detected by a manual self or even doctor's exam, unless or until it grew much larger. The finding will then set in motion the costly process of the patient having to go through a biopsy only to find that the suspicious spot/tiny lump is benign. I know this because it's happened to me. Twice.

And my guess here is that it happens quite frequently. Far too many benign biopsy findings.

Now, I realize that there obviously have been cases of very tiny, suspicious looking mammogram detected cancers. But unless they are one of the more rare, extremely aggressive type of cancers, (which really do need to be found super-early), the cancer would eventually have been found w/out a mammogram, yet within plenty of time to successfully treat.

In other words, too many benign early mammogram findings leading to too many associated costs to justify finding the few much more rare but very aggressive types of cancer...

I hope I've explained what I mean articulately enough for folks to see what I'm saying here. And keep in mind that this is just supposition on my part. Furthermore, if I am correct, that in no way means that I agree with 'throwing the baby out w/the bathwater' (so to speak) just to save a few bucks.

I may be wrong, but this is the only way this new recommendation makes any sense to me.

[Starry Messenger]

10. I'm 43.

I just got health ins. I'm getting my first mammogram next week. I feel like there have been a sudden spate of articles like this, is it because a sudden flood of people like me are suddenly getting free access to routine tests?

[Recursion]

12. It's been a low-level statistical inference war for about a decade now

I honestly don't know what's behind it, or how to read these data. (I'm an electrical engineer; give me a capacitor and I can tell you about it....)

[pnwmom]

16. No. This isn't a sudden spate of research. This 90,000 subject study has studied these

women for 25 years to find out what the long term outcome of their treatment would be.

[REP]

22. Talk to your doctor

My doctor is very up on the research on mammograms, and has discussed with me why I'm on the schedule I'm on, which is a number if things that puts me in a high-risk group. If I had fewer of these, I'd be scanned less often. You may be in a risk group that is safer is scanned less often or more often - ask your doctor.

[Jesus Malverde]

25. That has got to be frustrating.

Do some research and take your time.

[alarimer]

42. No, this evidence has been building for some time.

It stems from the fact that many of the things detected by the scans do not actually need to be treated, but will be anyway. (It's impossible to tell the difference at this point, however). That extra treatment is not risk-free. There is a small, but non-zero rish of death or injury for every biopsy, for instance. Things that are done as a precautionary measure but that won't (statistically, at least) reduce overall mortality from breast cancer, because they are treating things that won't actually develop further.

I think the push for mammograms every single years is misguided at best. A needless expense that may in fact may cause more harm than good.

[ohheckyeah]

43. We now have safer means of

early detection but the infrastructure for mammograms is already in place and very profitable, so the newer means are being ignored. Check out thermography and ultrasound for breast cancer detection.

[alarimer]

44. Unfortunately (and I am no expert) it seems to take a long time for new methods to be accepted

For whatever reason, changes seems to be incremental at best. At least when it comes to the insurance companies covering innovations.

[ohheckyeah]

47. Women need to know their options

and demand what THEY want, not what the insurance company or doctor wants.

[LisaL]

11. There was some interesting design in that study.

“The principal investigator set out to prove that all you needed to do was a physical examination,” said Dr. Daniel Kopans, director of breast imaging at Massachusetts General Hospital, in an e-mail responding to the new study finding. “The nurse examiners were highly trained while the radiologists and technologists [who performed the mammograms] had no training.”
http://www.bostonglobe.com/lifestyle/health-wellness/2014/02/11/study-questions-value-mammography-reduce-breast-cancer-deaths/fQGBGHqCOZSKFRGhPgjULK/story.html

[Recursion]

13. OK, that's a pretty huge issue there

See, this is why I miss being in grad school and being able to actually read studies themselves rather than journalists' abstracts...

[LisaL]

14. Appears to be a number of issues with the study, from reading that article.

[Recursion]

18. So why aren't mortality rates lower among those who have received mammograms?

Should someone do another study with better trained radiologists?

[lostincalifornia]

21. That is one thing, or at least set up consistent standards, but you can't just mixed different age

groups, young and old in the groups without any kind of control. As people get older, they are more at risk for breast cancer than when they are younger. Mixing the two groups together skews the result, unless you factor that in, and I do not see that being done.

[LisaL]

23. Well,

"The work was immediately criticized. The American College of Radiology and Society of Breast Imaging called it "an incredibly misleading analysis based on the deeply flawed and widely discredited" study. Mammograms typically find far more cancers than this study did, suggesting the quality was poor, the groups contend."

http://abcnews.go.com/Health/wireStory/study-disputes-routine-mammograms-22480463

[lostincalifornia]

28. The biggest problem with mammograms are women with dense breasts. Those women should request an MRI

since a mammogram would be very difficult to read if it was too dense

[Brainstormy]

57. Well, of course

they would criticize the study. Mammograms are the bread and butter of radiologists. I tried to have a conversation on this subject with a radiologist about a year ago. He became so defensive he was spitting and blubbering.

[lostincalifornia]

20. Wow, that says everything, and was one of my very questions. Did the radiologists all adhere to the

same standards?

I was also concerned with the conclusions, because the are mixing both older and younger women together, and that could definitely alter the results.

The main thing that bothers me is the conclusion. That if you find a tumor early, verses finding one three years later it makes no difference, and that flies in the face of all experience. The whole philosophy is that localized cancers have a much better chance of being contained than those that have spread.

I am also concerned by the sudden studies that suggest pap smears, PSA tests, colonoscopy, and mammograms "do more harm than good". I may be cynical, but this sure feels like a cost saving mechanism, and strongly believe that if the paradigm changes where people stop having these diagnostics, the death rates of those diseases will increase significantly.

[Le Taz Hot]

32. And if you have large, dense breasts,

all the technician can see is black. But if you want an ultrasound, you have to pay for it yourself because insurance, most times, won't cover it.

[flamingdem]

37. Is ultrasound effective for finding cancer?

Is that the same or different than thermal imaging that's being mentioned here?

thanks

[Le Taz Hot]

39. I have no idea.

I'm hoping a medical person might jump in here and help out.

[Ruby the Liberal]

52. Mine was caught by ultrasound

And could not be felt by medical personnel. It was the biopsy that was ordered because of the ultrasound that was the actual diagnosis though.

[bemildred]

33. If you are one of the small percentage of women who get breast cancer,

then having mammograms will likely extend your life by finding it earlier.

If you are one of the majority of women who will not get breast cancer, the small risks associated with the tests multiplied by the large number of women tested balances out the higher risk for cancer patients and the much smaller numbers of them.

My own conclusion, long since, is we need better tests.

[phylny]

35. I was just diagnosed with DCIS (Ductal Carcinoma in Situ) via a mammogram.

The radiologist didn't like the array of the microcalcifications in my right breast. Had ultrasound, stereotactic biopsy, and MRI. I'm due to have a lumpectomy. The breast surgeon said, "You are the poster patient for early detection."

Cancer runs in the maternal side of my family - it's our "disease of choice" as I put it.

Since my husband's aggressive prostate cancer was also caught 5 years ago by a routine PSA (after surgery, the doctor said "You would have been dead within two years without finding it&quot , I'm an advocate for early diagnosis and treatment. Yes, it's anecdotal, but it's also our truth.

[840high]

53. I had infiltrating

ductal carcinoma. Detected by routine mammo. My oncologist said the same thing to me. Best wishes to you.

[phylny]

61. And to you, hope you are well!

[840high]

65. Yes - thank you. Hugs to you.

[reformist2]

36. If true, it means modern medicine hasn't gotten anywhere in the war on cancer.

[leftyladyfrommo]

38. The problem with early detection

is that everybody has cancers in their body but our immune systems keep them under control.

Doctors don't know which cancers are dangerous and which are not so they try ti treat everything. And those treatments have some serious side effects.

Many women are being treated for cancers that won't ever amount to anything. They go through many unnecessary procedures that are expensive and really awful.

I don't do mammograms any more. I don't do any screenings any more. If I have symptoms then I go. That is just how I feel about it. Not saying that other people should do the same thing.

[scarletwoman]

45. I refuse to have my breasts smashed between two flat plates & irradiated ever again.

I had one mammogram some years ago. I thought it was one of the most ridiculous, barbaric things I'd ever been subjected to. Never again.

Frankly, I don't trust the medical profession to know what the fuck they're doing anyway.

[leftyladyfrommo]

48. I don't trust them, either.

I stay completely away if I can.

[AngryOldDem]

51. I'm getting sick of this bullshit, too.

I've been having them since my baseline at 35. At 50, I went to an annual exam. I just had one in January. I have no pronounced family history of either breast or ovarian cancer. I don't smoke, drink rarely, and exercise moderately and consistently at least five or six days a week. My weight is not an issue. It seems to me all of this should be mitigating factors in determining whether an annual mammo is called for. But my doctor insists on a yearly exam, which I come to dread around Thanksgiving, and then have to sweat out getting the results. Perhaps this is a phobia. But I am sick of this "damned if I do, damned if I don't" conundrum I find myself in every year, and I'm getting to be of the age where I'm just about to say fuck it, I roll the dice and see what happens.

I am coming to the conclusion that several factors are coming into play here:

1) The fear factor.
2) Hospitals having to gin up business to pay for these million dollar machines.
3) Society's fixation on breasts.

And I am just WAITING for the study that comes out and says that having a yearly mammography actually INCREASES the risk of cancer. With all the other conflicting studies that come out over this damned exam, would that really surprise anybody?

[Phentex]

55. I would not be shocked at all!

Do we NEED to undergo a mammogram every single year or are we causing more harm than good? It's very frustrating.

From what I can tell about my friends who had breast cancer, there is no rhyme or reason to why a person gets breast cancer. One is a marathon runner with little body fat. She eats healthy all the time and, in my opinion, is overly obsessed with it. Her husband is a doctor. She gets regular mammograms but it was a self exam where she found the lump herself. One interesting thing she mentioned when undergoing her treatments: In some cases, where the cancer was further advanced or the cancer was the more deadly kind, there were actually more successful treatments for that kind of cancer compared to other kinds. She said it was almost like the doctors were happier to treat certain kinds because the success rate was higher.

I'm not saying women shouldn't get mammograms. My information is anecdotal but you DO have to wonder what we are doing to our healthy bodies by testing this way every single year.

[leftyladyfrommo]

73. I think I read that most lumps are found by self exams.

I used to get mammograms every year because my mother had breat cancer. Then I found out that all those mammograms were a total waste of time and money because I had very dense tissue and the exams showed nothing.

[JenniferJuniper]

56. I'm 52 next week; never had one and never will

Routine screen, that is.

When I was 39 way back in 2001, The Lancet published the results of a massive Danish study conducted by researchers Olsen and Gotzsche. They came to the same conclusion - Routine mammography screenings do not save lives. After reading the entire study, I opted out of having one at age 40. The doctor I was seeing at the time treated me as if I were an imbecile and said he wasn't sure he could keep me as a patient if I refused to be screened. So I dumped him. The next doctor basically told me I was nuts for "risking my life" for no reason.

There's a reason alright.

As mammograms become more and more sensitive, more and more diagnoses of cancer or atypical cells are being made. That would be great if we could 1) find a way to determine whether these cancers or atypical cells will ever actually pose a health problem during a patient's lifetime (we don't live forever after all, only about 85 years), and 2) if we could actually save the lives of the women who have deadly cancers by finding them early.

Doctors can't do either of these things. So what they end up doing is finding and treating lots of slow growing and/or harmless cancers early and treating them - sometimes quite aggressively - and then patting themselves on the back for a job well done. Except little of this is actually saving lives and anyone who has gone through cancer treatment knows it's no walk in the park and can have adverse long-term health ramifications.

Women have been told a huge lie. Again and again and again. Any person or group who knew about the results of the Danish study in '01 (and it was all over the place; it totally freaked out the American Cancer Society and the Pink groups) and continued to publicly advocate for routine mammography screenings is complicit in a conspiracy. Early detection not only prevents nothing, it does more harm than good.

[madaboutharry]

58. The images have become so sensitive, especially now

with 3D imaging, that radiologist aren't even sure what they're looking at anymore. I had a mammography tech tell me this.

[flamingdem]

59. Do you have any links for these studies or basic articles

on the subject?

I read about this years ago and avoid getting them often. But that's also a bit scary so I'd like to really learn the opposing sides and see any studies to get a sense of risk.

[JenniferJuniper]

62. ‘Screening for breast cancer with mammography’

is the title of initial review. The authors are Dr Peter C Gøtzsche MD and Ole Olsen MSc.

Here's a 2011 article written by one of the authors that provides a general summary of the information first published in 2001 along with his current reflections.

http://www.cochrane.org/news/blog/mammography-screening-ten-years-reflections-decade-2001-review


His book, "Mammography Screening - Truth, Lies and Controversy" is also a fascinating, if pricey, read.

http://www.amazon.com/Mammography-Screening-Truth-Lies-Controversy-ebook/dp/B00GMOO7G6/ref=cm_cr_pr_product_top

[flamingdem]

71. Thanks for those

I'm reading everything I can the topic.

[leftyladyfrommo]

74. It's only scary because we have been conditioned to believe

that if we don't get mammograms we will die of breast cancer.

Huge fear factor at play here.

I think that women who really have deadly cancers die from them anyway.

[AngryOldDem]

60. I'm familiar with this study.

It weighs heavily in my growing opinion that, for the most part, mammograms are a huge medical scam that preys on the vulnerabilities of a lot of women, and helps line the pockets of a lot of people who are more than happy to exploit that vulnerability. These people -- doctors, Komen, American Cancer Society, whoever -- shout down these studies to the point where it all just becomes more confusing white noise -- until all you hear is, "Get a mammogram or DIE" and off you go to your nearest radiology department.

And I find it more than a coincidence too, that those who knock down these studies the loudest have the most to lose (financially) if people stop listening to the hype and start actually thinking about what they're doing and why they're doing it.

If anyone is in a high risk group for any disease, then by all means, take advantage of every prescreening test there is (within reason) to keep one step ahead of it. But if your odds of getting a certain disease are low, screenings should be done by taking into consideration the pluses and minuses of family history, lifestyle, etc.

There are more ways to manage risk than just accepting the status quo du jour. And to those who credit mammograms with saving their lives, I'm glad. But that does not mean these tests need to be looked at, and looked at hard, in light of all the conflicting opinions out there.

[Liberal_in_LA]

72. is that a fact? that we all have cancers?

[leftyladyfrommo]

76. That's what I've been reading.

Everybody has cancer cells but our own immune systems kill them.

[LiberalAndProud]

46. Deborah Rhodes: A test that finds 3x more breast tumors, and why it's not available to you

Working with a team of physicists, Dr. Deborah Rhodes developed a new tool for tumor detection that's 3 times as effective as traditional mammograms for women with dense breast tissue. The life-saving implications are stunning. So why haven't we heard of it? Rhodes shares the story behind the tool's creation, and the web of politics and economics that keep it from mainstream use.

http://www.ted.com/talks/deborah_rhodes.html