Mammography Is Dangerous Besides Ineffective, Warns Samuel S. Epstein, M.D.

Feb 06, 2002, 00:00 ET from Cancer Prevention Coalition

    CHICAGO, Feb. 6 /PRNewswire/ -- The following was released by Samuel S.
 Epstein, M.D., Chairman of the Cancer Prevention Coalition and Professor
 Emeritus of Environmental and Occupational Medicine, University of Illinois
 School of Public Health, Chicago:
 
     Recent confirmation by Danish researchers of longstanding evidence on the
 ineffectiveness of screening mammography has been greeted by extensive
 nationwide headlines.  Entirely missing from this coverage, however, has been
 any reference to the well-documented dangers of mammography.
 
     -- Screening mammography poses significant and cumulative risks of breast
        cancer for premenopausal women.  The routine practice of taking four
        films of each breast annually results in approximately 1 rad (radiation
        absorbed dose) exposure, about 1,000 times greater than that from a
        chest x-ray.  The premenopausal breast is highly sensitive to
        radiation, each 1 rad exposure increasing breast cancer risk by about
        1 percent, with a cumulative 10 percent increased risk for each breast
        over a decade's screening.  These risks are even greater for younger
        women subject to "baseline screening."
 
     -- Radiation risks are some four-fold greater for the 1 to 2 percent of
        women who are silent carriers of the A-T (ataxia-telangiectasia) gene;
        by some estimates this accounts for up to 20 percent of all breast
        cancers diagnosed annually.
 
     -- Since 1928, physicians have been warned to handle "cancerous breasts
        with care -- for fear of accidentally disseminating cells" and
        spreading the cancer.  Nevertheless, mammography entails tight and
        often painful breast compression, particularly in premenopausal women,
        which could lead to distant and lethal spread of malignant cells by
        rupturing small blood vessels in or around small undetected breast
        cancers.
 
     -- Missed cancers are common in premenopausal women owing to their dense
        breasts, and also in postmenopausal women on estrogen replacement
        therapy.
 
     -- Mistakenly diagnosed cancers are common.  For women with multiple risk
        factors including a strong family history and early menarche -- just
        those strongly urged to have annual mammograms -- the cumulative risks
        of false positives can reach as high as 100 percent over a decade's
        screening.
 
     -- The widespread acceptance of screening has lead to overdiagnosis of
        pre-invasive cancer (ductal carcinoma in situ), sometimes treated
        radically by mastectomy and radiation, and even chemotherapy.
 
     -- As increasing numbers of premenopausal women are responding to
        aggressively promoted screening, imaging centers are becoming flooded.
        Resultingly, patients referred for diagnostic mammography are now
        experiencing potentially dangerous delays, up to several months, before
        they can be examined.
 
     -- The dangers and unreliability of screening are compounded by its
        growing and inflationary costs.  Screening all premenopausal women
        would cost $2.5 billion annually, about 14 percent of estimated
        Medicare spending on prescription drugs.  These costs would be
        increased some fourfold if the highly profitable industry,
        enthusiastically supported by radiologists, succeeds in replacing film
        machines, costing about $100,000 each, with the latest high-tech
        digital machines recently approved by the FDA, costing about $400,000
        each, for which there is no evidence of improved effectiveness.
 
     The ineffectiveness and dangers of mammography pose an agonizing dilemma
 for the millions of women anxious for reassurance of early detection of breast
 cancer.  However, the dilemma is more apparent than real.  As proven by a
 September 2000 publication, based on a unique large-scale screening study by
 University of Toronto epidemiologists, monthly breast self-examination (BSE)
 following brief training, coupled with annual clinical breast examination
 (CBE) by a trained health care professional, is at least as effective as
 mammography in detecting early tumors, and also safe.  National networks of
 BSE and CBE clinics staffed by trained nurses should be established to replace
 screening mammography.  Apart from their minimal costs, such clinics would
 empower women and free them from increasing dependence on industrialized
 medicine and its complicit medical institutions.
 
     (For further details and supporting documentation, see "Dangers and
 Unreliability of Mammography:  Breast Examination is a Safe, Effective and
 Practical Alternative," by Samuel S. Epstein, Barbara Seaman and Rosalie
 Bertell, International Journal of Health Services, volume 31(3):605-615,
 2001.)
 
                     MAKE YOUR OPINION COUNT -  Click Here
                http://tbutton.prnewswire.com/prn/11690X87658688
 
 

SOURCE Cancer Prevention Coalition
    CHICAGO, Feb. 6 /PRNewswire/ -- The following was released by Samuel S.
 Epstein, M.D., Chairman of the Cancer Prevention Coalition and Professor
 Emeritus of Environmental and Occupational Medicine, University of Illinois
 School of Public Health, Chicago:
 
     Recent confirmation by Danish researchers of longstanding evidence on the
 ineffectiveness of screening mammography has been greeted by extensive
 nationwide headlines.  Entirely missing from this coverage, however, has been
 any reference to the well-documented dangers of mammography.
 
     -- Screening mammography poses significant and cumulative risks of breast
        cancer for premenopausal women.  The routine practice of taking four
        films of each breast annually results in approximately 1 rad (radiation
        absorbed dose) exposure, about 1,000 times greater than that from a
        chest x-ray.  The premenopausal breast is highly sensitive to
        radiation, each 1 rad exposure increasing breast cancer risk by about
        1 percent, with a cumulative 10 percent increased risk for each breast
        over a decade's screening.  These risks are even greater for younger
        women subject to "baseline screening."
 
     -- Radiation risks are some four-fold greater for the 1 to 2 percent of
        women who are silent carriers of the A-T (ataxia-telangiectasia) gene;
        by some estimates this accounts for up to 20 percent of all breast
        cancers diagnosed annually.
 
     -- Since 1928, physicians have been warned to handle "cancerous breasts
        with care -- for fear of accidentally disseminating cells" and
        spreading the cancer.  Nevertheless, mammography entails tight and
        often painful breast compression, particularly in premenopausal women,
        which could lead to distant and lethal spread of malignant cells by
        rupturing small blood vessels in or around small undetected breast
        cancers.
 
     -- Missed cancers are common in premenopausal women owing to their dense
        breasts, and also in postmenopausal women on estrogen replacement
        therapy.
 
     -- Mistakenly diagnosed cancers are common.  For women with multiple risk
        factors including a strong family history and early menarche -- just
        those strongly urged to have annual mammograms -- the cumulative risks
        of false positives can reach as high as 100 percent over a decade's
        screening.
 
     -- The widespread acceptance of screening has lead to overdiagnosis of
        pre-invasive cancer (ductal carcinoma in situ), sometimes treated
        radically by mastectomy and radiation, and even chemotherapy.
 
     -- As increasing numbers of premenopausal women are responding to
        aggressively promoted screening, imaging centers are becoming flooded.
        Resultingly, patients referred for diagnostic mammography are now
        experiencing potentially dangerous delays, up to several months, before
        they can be examined.
 
     -- The dangers and unreliability of screening are compounded by its
        growing and inflationary costs.  Screening all premenopausal women
        would cost $2.5 billion annually, about 14 percent of estimated
        Medicare spending on prescription drugs.  These costs would be
        increased some fourfold if the highly profitable industry,
        enthusiastically supported by radiologists, succeeds in replacing film
        machines, costing about $100,000 each, with the latest high-tech
        digital machines recently approved by the FDA, costing about $400,000
        each, for which there is no evidence of improved effectiveness.
 
     The ineffectiveness and dangers of mammography pose an agonizing dilemma
 for the millions of women anxious for reassurance of early detection of breast
 cancer.  However, the dilemma is more apparent than real.  As proven by a
 September 2000 publication, based on a unique large-scale screening study by
 University of Toronto epidemiologists, monthly breast self-examination (BSE)
 following brief training, coupled with annual clinical breast examination
 (CBE) by a trained health care professional, is at least as effective as
 mammography in detecting early tumors, and also safe.  National networks of
 BSE and CBE clinics staffed by trained nurses should be established to replace
 screening mammography.  Apart from their minimal costs, such clinics would
 empower women and free them from increasing dependence on industrialized
 medicine and its complicit medical institutions.
 
     (For further details and supporting documentation, see "Dangers and
 Unreliability of Mammography:  Breast Examination is a Safe, Effective and
 Practical Alternative," by Samuel S. Epstein, Barbara Seaman and Rosalie
 Bertell, International Journal of Health Services, volume 31(3):605-615,
 2001.)
 
                     MAKE YOUR OPINION COUNT -  Click Here
                http://tbutton.prnewswire.com/prn/11690X87658688
 
 SOURCE  Cancer Prevention Coalition