By Dr. Bruce West
The uproar over the change in recommendations for mammograms has been predictable, unreasonable, political, and financial. It all happened after a well-respected organization, the U.S. Preventive Services Task Force (USPSTF) broke ranks with the medical establishment and sided with Health Alert and others. They recommend that mammogram screenings begin at age 50, instead of age 40, and that they be done every other year instead of yearly. What followed was shock, horror, anger, resentment, blustery political posturing that used the new guidelines for political gain, and more.
To date, all the women’s groups, mammography groups, most medical groups, (including the American Cancer Society and the American College of Obstetricians and Gynecologists), congressmen, and even the President’s office have distanced themselves from these new meaningful and evidence-based recommendations. Even Rush Limbaugh has ridiculously called the new recommendations an insult to women and the first of the new onslaught of “rationed care.”
The truth is exactly the opposite! The evidence to start mammograms was based on one study back in the 1970s! That study showed that mammograms could result in a 30% reduction in breast cancer deaths in women over age 50, but no benefit for women in their 40s. The clinical trial, for the Health Insurance Plan of Greater New York, followed women for 3 to 5 years, and did not even bother to follow them after that time. These study results were picked up by all the medical groups who sought to lower the age for first mammograms to 35. The American Cancer Society (ACS) agreed, and mammograms were started at age 35! The ACS quietly rescinded the age 35 recommendation in 1992, but the practice continued for 10 years anyway.
Over-treatment
The truth is that mammograms do not save lives. Even The Lancet reported in 2001 that mammography screening resulted in overtreatment without reducing mortality. To date, the Cochrane Collaboration continues to monitor mammography research. According to the Chochrane analysis of all the research, mammograms detect tiny cancers. One in three of these are meaningless and will not cause a problem. But there is no test that can sort out the potentially lethal cancers from those that are meaningless. Therefore, virtually all cancers are treated aggressively with biopsies and radiation, and even chemotherapies, surgeries, and more. Some women have even undergone double mastectomies because of these findings when they didn’t have a real problem at all! In the medical research world, this is simply referred to as over-treatment.
In the end, mammographic screening for breast cancer results in the overtreatment of huge numbers of women-all for no benefit. The screening does not affect overall mortality (deaths from all causes), and the benefit for breast cancer mortality (the number of women who would die from breast cancer) is small to insignificant. And this is for all women who start mammography at either age 50 or 40! In fact, the USPSTF, after examining the real statistics, concluded only 1 in 1,900 women who undergo mammography for 10 years would avoid a breast cancer death!
So a smart group has finally called for a reduction in a procedure that can result in overtreatment that can maim, injure, and even kill women-a procedure that offers little statistical benefit, even when started at age 40. But everyone is horrified, the politicians are distancing themselves because they want to pass “health care reform,” and the doctors and medical groups, who will lose business, are up in arms.
Over the years, women have been sold a bunch of lies-lies for money, politics, power, vanity, paybacks to special interests, and worse. It is all sickening and still going on. The mammography debacle is having a light shined on it. In addition, these same “experts” also caused, at the very least, 20,000 cases of invasive breast cancer a year for 25 years with estrogen prescriptions. This practice continued even though lots of people like myself begged them to quit. Quite frankly, all these medical “experts” owe an apology-on their knees-to the collective female population over the age 35! Instead, women get even more confusion because their doctors and the medical groups in whom they have placed their trust, are “angered,” “shocked” and in “horror” over the new mammography recommendations. In fact, the USPSTF and all non-biased medical scientist agree that these recommendations are the only ones that really make any sense.
Who was that Health Alert guy who was condemned for saying the same thing for years!?