Breast Cancer – We Deserve Better Detection Methods

The most popular question I receive is, “Is should I have an annual mammogram? Breast cancer is the number one killer of women between the ages of 35 and 54. According to the latest statistics on the Canadian Cancer Society website 21,200 new cases will be diagnosed and 5,300 women will die from the disease this year. In the U.S. 192,700 will be newly diagnosed and 39,600 will die this year.

My grandmother died of breast cancer but not until the disease had ravaged most of her gastrointestinal tract. With a family history, one of the many risk factors for developing breast cancer, I have been determined to learn as much about detecting and preventing this cancer in order to protect myself and my daughters.

Every time I read an advertisement encouraging women to “prevent” breast cancer by having your annual mammogram I sadly shake my head. Mammogram does nothing to prevent breast cancer. It is a diagnostic tool, albeit, as we are discovering, not a very effective method. Mammogram, the “gold standard” for early detection has over the last few years been called into question. The controversy is raging since Danish researchers reviewed seven randomized, controlled mammogram trials which supported the benefits of mammography in reducing death from breast cancer. They found that of the seven trials five were so flawed they could review only two and even these two trials had problems. It was determined that mammogram had no effect on deaths due to breast cancer. This study received national headlines but it was not the first study to prove mammogram’s inadequacies. What else have we learned about mammogram over the years?

- The Journal of the National Cancer Institute (JNCI) states the chance of receiving a false positive is substantial (meaning you have been diagnosed with a cancer when there is none).
- Women having mammograms in their forties are at higher risk of false positives due to dense breast tissue.
- Women may also have a false sense of security as reported in the New York Times as mammograms miss breast cancer in 30 to 40 percent of those that actually have cancer.
- Another study published in 2000 in the JNCI found that mammograms do not reduce death rates from breast cancer any better than a simple breast exam. They followed over 40,000 women between the ages of 50 and 59 and found annual mammograms no more effective than breast exams.
- A study published in the Journal of the American Medical Association also found that women age 70 and older had little to no benefit from regular mammograms.
- The Lancet reported that breast compression, which occurs during mammogram, may cause tumors to rupture spreading cancer cells leading to metastases.
We know that repeated ionizing radiation from mammograms has been brought into question as to its safety and whether it increases the risk of breast cancer.

So what do we do?
Researchers reported at this year’s 39th Annual Meeting of the American Society of Oncology that Magnetic Resonance Imaging (MRI) offered – by – far the highest sensitivity for diagnosing breast cancer, and, at the same time, had the lowest rate of unnecessary biopsies. They found that MRI provided a 96.1% accuracy while mammography offered 42.8% and 41% with ultrasound. Dr. Kuhl, one of the researchers, stated MRI was better able to find breast cancers in younger women with dense, fibrous breast tissue and MRI does not use ionizing radiation like mammogram minimizing mutagenic effects. So why are medical doctors not recommending MRI instead of mammogram? The answer the technology is new and radiologists have to be specialized to read a breast MRI plus mammography is big business in North America even with all its risks and failures.

Every Canadian who has ever had to wait months for an MRI knows that our current medical system is not set up to use MRIs for breast cancer detection. Women in rural areas would have to travel to cities that have an MRI. So do we just continue to have a potentially dangerous substandard detection method? No. We start requesting a breast MRI until those that fund mammograms recognize that women want a better method. We have to create a new “Gold Standard” in breast cancer detection, ¬≠one that works and has fewer side effects and we have to start adopting methods that truly PREVENT breast cancer. Read my newsletter issue number one for more information on preventing breast cancer.

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