Routine mammograms are far less effective at preventing breast cancer deaths and far more expected to cause unnecessary procedures, over-treatment and ultimately accelerate death.
A routine mammogram screening typically involves four x-rays, two per breast. This amounts to more than 150 times the amount of radiation that is used for a single chest x-ray. Bottom line: screening mammograms send a strong dose of ionizing radiation through your tissues. Any dose of ionzing radiation is capable of contributing to cancer and heart disease.
Screening mammograms increase the risk of developing cancer in premenopausal women.
Screening mammograms require breast tissue to be squeezed firmly between two plates. This compressive force can damage small blood vessels which can result in existing cancerous cells spreading to other areas of the body.
Cancers that exist in pre-menopausal women with dense breast tissue and in postmenopausal women on estrogen replacement therapy are commonly undetected by screening mammograms.
For women who have a family history of breast cancer and early onset of menstruation, the risk of being diagnosed with breast cancer with screening mammograms when no cancer actually exists can be as high as 100 percent.
In 1974, while mammography was in its infancy, the National Cancer Institute was warned by Professor Malcolm C. Pike at the University of Southern California School of Medicine that a number of specialists had concluded that "giving a women under age 50 a mammogram on a routine basis was close to unethical". This warning was ignored.
Also in the 1970's, the Director of Biostatistics at Rosewell Park Memorial Institute for Cancer Research, Dr. Irwin Bross, headed a study involving data from 16 million people. This ground breaking study found that the main cause of the rising rates of leukemia was medical radiation in the form of diagnostic medical X-rays. Applying his findings to the breast cancer screening program, Dr. Bross later elaborated that "women should have been given the information about the hazards of radiation at the same time they were given the sales talk for mammography."
One of the largest mammogram studies ever initiated had to be cancelled because the mammogram group of women developed more cancer than the non-mammogram control group. This study is dismissed now because it was done in the early 70's and radiology has greatly progressed since then [they say].
In the early 1980's as the mammogram began to be rolled out to women across the country in the face of this research, the NCI and ACS jointly urged annual breast X-rays for women under age 50. Doctors assumed there was good evidence supporting the recommendations and became enthusiastically ordered mammograms for all their female patients, even though they should have know better.
In 1985, the Lancet, one of the five leading medical journals in the world, published an article condemning the mammography recommendations under which "Over 280,000 women were recruited without being told that no benefit of mammography had been shown in a controlled trial for women below 50, and without being warned about the potential risk of induction of breast cancer by the test which was supposed to detect it.
The U.S. Preventive Services Task Force's panel last fall recommended against routine screening for women in their 40s. Thousands of scientists and medical professionals are unconvinced from conclusions of the new study and maintain that extreme caution is necessary before recommending a mammogram at any age.
Dr. Jeanne Mandelblatt, a Georgetown doctor who headed six research teams for the government panel, said the new study "does not balance the benefits against the harms," as the panel sought to do.
The new study looked at Sweden's mammography program. Since 1986, the country has required that screening be offered to women over 50 but left it up to each county to decide whether to offer it to younger women. About half of counties did, and researchers compared breast cancer death rates in areas where it was and wasn't offered.
They counted breast cancer deaths of women who had been diagnosed in their 40s and died within 16 years of followup. They compared two groups, one where screening was available and one where it was not.
The number of women in each group studied and the amount of time they were followed differed. Researchers did not express the results in terms of death rates, which would have made comparing these groups much easier.
Researchers did not have information on, and the study therefore could not account for, any differences in general health and other factors that could have affected the number of deaths.
"This is a very unscientific study based on findings and conclusions which completely ignore the potential risks and dangers associated with mammorgrams," said Dr. Kimberely Schor, a panelist who examines medical research.
If mammograms result in unnecessary procedures and over-treatment of what are actually harmless cancers that would go away by themselves, as the panel says, what is not being clearly stated is how many women die from or are seriously harmed by complications from biopsies and chemotherapy. Every surgical procedure carries risk, and women are being regularly subjected to those risks unnecessarily because of a faulty (yet very profitable) tests. Cancer treatment is of course known to carry very real risk, including a non-significant risk of death from the treatment, yet women are being unnecessarily subjected to that too (also very profitable).
In addition, anyone who has experienced a false positive knows just how many subsequent diagnostic mammograms you are then subjected to, which one can only conclude involves a non-trivial amount of radiation (far more than what you receive in a simple screening mammogram).
The research, published in New England Journal of Medicine, is the latest to show that the benefits of mammography are limited and will reignite the debate over the treatment.
The Norwegian research team said inviting women aged 50 to 69 to have routine mammograms and offering them better care from a team of experts cut the breast cancer death rate by only 10 percent, a highly controversial figure.
But the death rate in women over 70 - a group that also got better care but were were not urged to have mammograms - fell by 8 per cent, indicating that the mammograms only produced a slight benefit. The researchers had expected a 30 per cent reduction.
'There is a reduction in mortality, but it's lower than we anticipated,' said lead researcher Dr Mette Kalager of Oslo University Hospital.
Some 2,500 women would have to be regularly screened over 10 years to save one life from breast cancer, Dr H Gilbert Welch of Dartmouth Medical School noted in an accompanying editorial.
Yet as many as 1,000 will be told that doctors have seen something suspicious, around 500 will be subjected to a biopsy, and between 5 and 15 women will be treated unnecessarily for a condition that was never going to bother them.
'It's not the great lifesaver that people think it is. It's not a magic bullet,' said Dr Jeanne Mandelblatt of Georgetown University, who is shaping new mammogram guidelines for a U.S government task force.
If mammograms are both useless and dangerous, why then does the medical community continue to use it and other "heroic" cancer practices? The answer as to why they behave so caustically toward patients has been given many times in the history of medicine with the only difference now being that they have legally suppressed a citizen's right to choice in health care.
Before you decide to have a mammogram make sure you have been told of the risks in advance. Get the facts (the truth is out there) and then make your own conclusions.