I’ve taken a strong, and in some cases
controversial position on mammography, and I’m particularly leery of the newer 3D tomosynthesis mammography, which is touted as being so much better but in
reality may simply compound the same problems associated with regular
mammography, as it increases the
amount of harmful (and cancer-causing) ionizing radiation you’re exposed to.
Dr.
Northrup agrees, calling 3D tomosynthesis “a better mouse trap.”
“I keep going back to the work of Gilbert Welch
from Dartmouth. I believe it is the most important paper to come out about
breast cancer almost in my entire career,” she
says. “Gil wrote a book called 'Should I Be
Tested for Cancer? Maybe Not and Here’s Why.' That was in 2004. Now he comes
out with a paper that has everyone riled up. It’s called 'The Effect of Three
Decades of Screening Mammography on Breast Cancer incidents'1[published
in the prestigious medical journal New England Journal of Medicine]. He
says: 'With the assumption of a constant underlying disease burden, only eight
of the 122 additional early-stage cancers diagnosed were expected to progress
to advanced disease.
After excluding the transient excess incidence
associated with hormone-replacement therapy and adjusting for trends in the
incidence of breast cancer among women younger than 40, we estimated that
breast cancer was overdiagnosed (i.e., tumors were detected on screening that
would never have led to clinical symptoms) in 1.3 million U.S. women in the
past 30 years. We estimated that in 2008, breast cancer was overdiagnosed in
more than 70,000 women; this accounted for 31 percent of all breast cancers
diagnosed.'”
So in 30-year’s time, an estimated 1.3 million women were
diagnosed with what amounts to “ductal carcinoma in situ,” also known as stage
zero cancer—or cancer you may die with but
not from. It’s essentially
harmless...
“[Gilbert Welch] pointed to a study [from] way
back, of women who died in car accidents in their 40s. They sectioned their
breast tissues and found that 40 percent of them – this is
normal healthy women dying in car accidents – had evidence of ductal carcinoma
in situ that was never going to go anywhere. This is the big dilemma,” Dr. Northrup says.
