Originally published May 14 2007
American College of Physicians warns women in their 40s about dangers of mammograms
by Staff writer
The American College of Physicians has recommended women in their 40s consult with their doctors before undergoing routine annual mammography screening. An expert panel from the American College of Physicians (ACP), which represents 120,000 internists, made this recommendation in the April 3rd issue of the journal Annals of Internal Medicine.
After reviewing 117 studies conducted between 1966 and 2005, the panel found the data on mammography screening for women in their 40s are so unclear that the effectiveness of reducing breast cancer death could be either 15 percent or "...nearly zero."
The panel pointed out that benefits must be weighed against the harmful effects of mammograms, including exposure to radiation and unnecessary biopsies, surgery, and chemotherapy.
Dr. Amir Qaseem, lead author of the ACP guidelines, stated "It is important to tailor the decision of screening mammography by discussing the benefits and risks with a woman, addressing her concerns, and making it a joint decision between her and her physician." The ACP noted cancer risk varies from woman to woman, and decisions about annual mammography screenings are best made on a case-by-case basis.
The ACP pointed out for women who have a known high risk of breast cancer (family history or early menarche, for example) annual screenings are appropriate.
The group is not opposed to mammography, but rather questions the efficacy of annual mammography exams commencing at age 40. "We agree that mammography can save lives," said Douglas K. Owens of Stanford University, who chaired the committee that wrote the guidelines, "But there are also potential harms. We don't think the evidence supports a blanket recommendation."
The dangers of mammography are recognized in the medical field. According to Dr. Samuel Epstein of the Cancer Prevention Coalition, "Screening mammography poses significant and cumulative risks of breast cancer for pre-menopausal 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 pre-menopausal 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.'"
The coalition reports women who carry the A-T gene are especially prone to risk from early mammography 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."
"Mammography is used primarily as a tool to recruit new patients into conventional cancer treatments, regardless of whether they would actually benefit from such treatments," said Mike Adams, author of Natural Health Solutions and the Conspiracy to Keep You From Knowing About Them. "The breast cancer industry harms ten women for every one it helps. It is an industry of greed, profits, and scare tactics," Adams added.
At the heart of the current blanket recommendations to begin annual mammography exams at age 40 is the American Cancer Society (ACS). Robert A. Smith, director of cancer screening at the ACS, responded to the new recommendations stating, "The danger here is that some women will elect not to get screened. Mammography is the single most effective way of finding breast cancer early, and when we find breast cancer early, women have the greatest chance of successful treatment." Just last month the ACS advised women who are at a perceived "high risk" of breast cancer to also undergo annual MRIs.
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