By Valerie Consoli

Hello Roderick, 

For decades we have been told that annual mammogram screenings are necessary after the age of 40. Hundreds of thousands of women have followed this advice, with no questions asked. Early prevention is key, more lives are being saved we're told. But how true is this really? Are yearly mammograms simply a way to make more money, or do they truly live up to the benefits they claim? 

My mother was diagnosed with breast cancer when she was 36. I was five years old. Over the years I saw her go through hell, I watched her life change as she had a double mastectomy. I remember the huge hole in her chest from the radiation that made me not want to hug her too tightly, because I thought it might hurt. I remember her taking over 80 pills a day at one point. I wonder now if she had been over-treated by doctors. I wonder how much of cancer treatment and so-called prevention is really that, or do these processes simply exist to fuel the huge money making process that is supposed to cure and prevent cancer? 

The value of annual mammograms was questioned in 2009 when the US Preventative Services Task Force recommended that routine screening for women with an average risk of breast cancer should start at 50, not 40. 

Have we been frightened into having more mammograms than we actually need to detect these cancers? Are we ultimately harming ourselves more by having more frequent mammograms than we really need? 

Let's look at the facts, do the benefits of annual mammograms outweigh the risks? Many studies say NO. 

The cancers found by mammograms are nearly all slow-growing cancersCancers that would normally be caught by doing a self-exam, or an exam at the doctors. In fact, mammograms are not very good at detecting the more lethal forms of breast cancer. 

Normal breast tissue can hide a true breast cancer so that it doesn't show up on the mammogram. This is what is called a false negative. Along the same lines, a mammogram can identify an abnormality that looks like a cancer, but that turns out to be normal. This is called a false positive. This sort of a diagnosis happens more often than a true cancer diagnosis. 

> According to some doctors, too much screening can actually raise a woman's risk of developing cancer because of radiation. 

> A UCSF study has indicated that over half of the women screened annually will get a false positive result within ten years of their first mammogram. This applies to women whether they begin to have mammograms in their 30's or 40's. 

Annual mammograms for women in their 50's may detect cancer, but they only reduce the risk of dying from the disease over the next ten years by .07% of a point. From .53% to .46%. Reductions for women in their 40's are even smaller; from .35% to .3%. 

According to a survey of randomized clinical trials involving 600,000 women around the world, for every 2,000 women screened annually over ten years, one life is prolonged, but ten healthy women are given a breast cancer diagnosis and are unnecessarily treated, often with therapies that themselves have life-threatening side effects. 

Dr. John D Keen states that the premise of a new universal life-saving benefit from finding pre-symptomic breast cancer through mammography is false. He explains that statistically, the chance that a mammogram will save a life, is very slim. His experience has shown that women under the age of 50 who have a mammogram are ten times more likely to be misdiagnosed and over-treated. 

Dr. Karster Juhl Jorgensen states that mammograms offer only marginal benefits and serious harms. Suggesting that a decision not to get screened can be as sensible as the decision to get screened. 

Dr. Gilbert H Welch gave the following estimates for mammogram screening of 2500 women, beginning at age 50 and continuing for ten years: 

1100 false alarms 

> 1250 biopsies 

> 5-15 women would be over-diagnosed and needlessly treated with surgery, radiation, chemotherapy or a combination of those. 

> Through all these statistics, only one life would actually be saved. 

Screening annually for women over 65 doesn't catch any more early tumors, but it does lead to more false positives. These findings are based on more than 140,000 older women across the US. According to Dr. Otis Bramley, chief medical officer of the American Cancer Society "This study clearly tells us that's screening every two years may be more appropriate than screening women every year." 

Dr. Dejana Braithwaite states that studies show that there is very little benefit, in fact, there is no benefit with annual mammograms and there is additional harm of having an increased probability of a false positive. 

Dr. Karla Kerlikowse, UCSF professor of epidemiology and biostatistics tells us that there is plenty of data out there that shows no added benefit of yearly mammograms, but definitely more harm. Our study really quantifies the harm and the harm is pretty large. She also adds that the study showed that 7-9% of women were told to get a breast biopsy, but ultimately were not diagnosed with breast cancer, thus leading to unnecessary pain and scarring, scarring which makes future mammograms more difficult to read. 

Says Dr. Kerlikowsske "Until there is a screening developed that carries less risk of harm, the study encourages that annual screenings do not have any measurable improvement over the likelihood that cancer will be detected." 

My mother would have been 77 today. She was only 53 when she finally lost her battle. Back then, no one questioned the treatments or the diagnosis, and unfortunately that hasn't changed much 24 years later. Remember the wise words of Dr. Karster Juhl Jorgensen- "A decision not to get screened can be as sensible as the decision to get screened." Speak to a doctor you trust about your mammograms and any diagnosis. Don't just follow blindly. Use your voice and speak up. I believe more women speaking up and talking openly with their doctors can have a far more dramatic advantage in cancer prevention than an assembly-line of women going for a mammogram every year without questioning

Best wishes,

Valerie Consoli