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Today’s Debate Over Mammography?
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Today’s Debate Over Mammography?
I had never heard about Dr. Alice Stewart, I read about her the other day …in the 1950s, she asked an uncomfortable question.
When childhood leukaemia was rising, Dr. Stewart and her colleagues investigated the histories of children who had died from cancer. She discovered an association: children whose mothers had undergone diagnostic X-rays during pregnancy were more likely to develop childhood cancer.
She published the findings in The Lancet in 1956. But, her conclusions were challenged.
She lost her funding became difficult.
Her Oxford research unit received no further Medical Research grants, and she was unable to continue the work at Oxford.
That did not mean she stopped asking questions.
Eventually, medicine’s understanding of radiation saw routine prenatal X-rays disappeared.
This got me thinking about something that I see discussed often: mammography.
Recently the Swiss Medical Board concluded that on balance of benefits and harms when it comes to mamograms was unfavorable enough that it recommended against introducing new systematic screening programs and proposed eventually phasing out existing ones.
We should be willing to ask the same kind of questions Alice Stewart asked:
What does the evidence actually show?
What is the absolute benefit for a woman of this age and risk profile?
What are the risks?
How common are false positives?
How much overdiagnosis occurs?
What are the consequences of screening more frequently?
Are there circumstances where another imaging method is appropriate?
And most importantly:
Is the woman being given enough information to make that decision for herself?
That’s the connection between Alice Stewart’s story and the mammography debate.
The lesson of Stewart isn’t that radiation is always too dangerous to use.
It’s that medical practices involving radiation should never be placed beyond scrutiny simply because they are established practice.
The question shouldn’t be: Are you for or against mammography?
The better question is:
Do women have the evidence they need to make a genuinely informed choice?
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This discussion was modified 1 month, 2 weeks ago by IMA-HelenT.
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This discussion was modified 1 month, 2 weeks ago by
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13 Replies
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Can you please post a link to the Swiss study you cite? Thank you
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Here you go, a link to the analysis of the study by the New England Journal of Medicine https://www.nejm.org/doi/full/10.1056/NEJMp1401875, the orginal study is all in German
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The issue regarding mammography is that mammography has had NO EFFECT ON BREAST CANCER DEATH RATES. This is a big problem that is not going away. The easiest-to-read book on this important subject is “Conspiracy of Hope: The Truth About Breast Cancer Screening” by Renée Pellerin, a female journalist. The definitive medical critique on this subject is “Mammography Screening: Truth, Lies and Controversy” by Peter Gotzsche, M. D., Ph. D. Dr Gotzsche was one of the founders of the Cochrane Collection group, and was later fired by that group for telling the truth about mammography and other medical topics of great interest. (I believe Dr. Gotzsche is now in research at Stanford University.)
Also, the same problems are applicable to thermo-mammography because it also is mammography.
(Probably there are on-line sources of information about this which I don’t know about. I do know I am never getting another mammogram. and I do know that abbreviated breast MRI is the correct study (very informative and totally harmless) for finding out whether one has a breast cancer. My abbreviated breast MRI cost about $400.
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Thanks for the book recommendations, will get both of them.
I have been listening to a podcast called “Keeping Abreast” with Dr. Jenn Simmons, there is a two part episode on mammograms that I found very informative informative https://open.spotify.com/episode/5ughmVip1lPiGJ4xCVPW4D
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I am a 67 year old female and have never had a mammogram and never will. I made an informed decision many years ago not to irradiate my breasts, and instead have had ultra sounds every 3-4 years. I check my breasts regularly, have no family history of breast cancer and take many supplements. I have met at least 4 women whose breast cancer was missed with a mammogram.
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72 years old. Never had a mammogram. Still kickin’!
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Fantastic, and please keep kicking 😊
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There’s a great exposition on Dr Vinay Prasad’s channel in youtube.
Statistics indicate that there’s no difference in outcomes, so it’s unnecessary to push unto mammography as a routine or a schedule for cancer screening.
There’s a similar case to be made for the colonoscopy screening; statistics and a study don’t show significant benefit either.
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Thanks @julio bro the podcast I mentioned in an earlier response also mentioned this study about outcomes and say we need to focus on the mitochondria, understanding its health and therefore our risk of developing cancer or other chronic illness.
Yes, need to start a discussion about colonoscopies
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I am 65 years old I decided two years ago i no longer want to entertain mamograms
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Thanks @suealphabet … What made you decide that you were stopping them? Do you do any other screening or just self checks?
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Just some podcasts I’ve been listening too. I don’t have history of breast cancer in my family but my sister was just diagnosed with breast cancer and i believe it’s due to many covid 19 vaccines. As for mammograms I also decided the risk of radiation once a year is not worth it and squishing your boobs i don’t think is that healthy either. From what I heard if from a mammogram they suspect something they would order an ultrasound. Why not do ultrasounds then for women they are less abrasive. What do you think?
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I happen to agree, but have so many women I know that have mammograms because they are invited over and over again, and never offered alternatives. I just happen to be someone that hates being told what is good for them.
😅
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