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No matter how many different ways I questioned cancer screening, Mary (not her real name) continued to fall back on the often made statement that “mammograms save lives!” Mary is an intelligent, well-educated close friend and former co-worker who had a mammogram that revealed a tumor in her breast. She then made the decision to have a double mastectomy. Like many women, Mary was convinced that a mammogram and subsequent double mastectomy had saved her life.
Maybe the mammogram saved Mary’s life and maybe it didn’t. We will never know. The trouble with cancer studies is that they deal with anonymous, faceless groups. Mary is an actual person. A real, living breathing person. If a doctor tells you that you have cancer growing inside you, most people will take dramatic steps to remove the cancer completely including surgery, toxic chemotherapy and radiation.
I am a survivor of an “incurable” cancer and cancer coach. Personal experience and research has taught me that cancer management is about both conventional and evidence-based non-conventional therapies.
If you would like to look beyond conventional breast cancer thinking please scroll down the page, post a question or comment and I will reply to you ASAP.
“Conclusion Annual mammography in women aged 40-59 does not reduce mortality from breast cancer beyond that of physical examination or usual care when adjuvant therapy for breast cancer is freely available. Overall, 22% (106/484) of screen detected invasive breast cancers were over-diagnosed, representing one over-diagnosed breast cancer for every 424 women who received mammography screening in the trial.”
“After 50 years of being enthusiastically promoted and used, cancer screening has entered an era that is characterized by “skepticism,” according to a commentary published online August 18 in JAMA Internal Medicine…
“For years, cancer screening has been oversold,” he said, echoing a comment made by Otis Brawley, MD, chief medical officer of the American Cancer Society, in 2009, which caused a firestorm of controversy at that time…This declaration has become less controversial since a variety of commentators have described screening as being the subject of promotion instead of education.
“A substantial proportion of older people in the United States continue to undergo cancer screening, even though they are unlikely to benefit from it. A large population-based study that used data from the National Health Interview Survey (NHIS) found that more than half of all people 65 years and older who had a life expectancy of less than 9 years had received prostate, breast, cervical, or colorectal cancer screening…
“These results raise concerns about overscreening in these individuals, which not only increases healthcare expenditure but can lead to patient net harm,” the researchers write…People with a shorter life expectancy have less time to develop clinically significant cancers after screening tests and are more likely to die from other causes..”
“Overdiagnosis of breast cancer refers to the screen detection and diagnosis of breast cancer that would not have progressed to symptomatic cancer during a woman’s lifetime.
Screening mammography, like all screening tests, will result in some overdiagnosis that is attributable to competing causes of death occurring during the lead time (the time period between asymptomatic screen detection and clinical detection) and detection of very indolent cancer.
The primary harm of overdiagnosis relates to subsequent (unnecessary) treatment. Importantly, overdiagnosis concerns must be balanced with the lifesaving and morbidity benefits of screening mammography and the prevention of some invasive cancer by detection and treatment of ductal carcinoma in situ.
Reasonable estimates of overdiagnosis of women aged 40–80 years are in the order of 1%–10%, with lower values when overdiagnosis is restricted to invasive cancer and among younger women. Prospective identification of an overdiagnosed invasive cancer is not currently possible. Delaying screening until age 50 years or screening biennially rather than annually will not substantially reduce the amount of overdiagnosis of invasive cancer. The clinical significance of overdiagnosis will continue to be minimized as advances in personalized medicine further reduce treatment-associated morbidity.