I Get a Mammogram?
By Dr. Ben
I am scheduled for a mammogram in a few weeks. My GP and I are in
disagreement over mammograms - she feels that I definitely need
to have one whereas I try to avoid radiation as much as possible.
know there are other methods of breast screening out there but none
are available within this vicinity and come at a large cost when
they are available.
do self examinations regularly and my GP does an annual breast manipulation
and has found nothing of alarm.
I being paranoid about radiation and are my fears of creating other
issues (possibly caused by radiation) legitimate and/or well-founded?
knows - maybe it will 'surface' (sooner than later) that mammograms
ARE one of the causes of breast cancer. Even my Naturopath feels
I should have a mammogram.
to say, Dr. Kim, at the moment I am feeling pressured into having
advice and/or thoughts on this subject would be greatly appreciated.
It's been more than a couple of years since I last wrote about mammograms
and the effects of ionizing radiation on human health, so while
I empathize with Susan's angst, I welcome the opportunity to re-visit
this topic and highlight the latest relevant findings that have
been generated in peer-reviewed medical literature.
me, Susan's question boils down to this: Do the benefits of mammograms
outweigh their potential harmful effects?
answer this systematically.
are the benefits of having a mammogram?
the chief benefit is potential detection of a malignant mass. I
write potential detection because we know that in some
cases, mammograms miss malignant masses. Some studies indicate that
close to a third of malignant masses in women between the ages of
40 and 49 are missed with routine mammograms.
also mindful in writing "detection" rather than "early detection"
because it typically takes several years for a mass to become large
enough to detect via a mammogram; finding cancer with a mammogram
cannot be considered an effective screening measure to make an "early
are the potential harmful effects of mammograms?
mammogram screening typically involves shooting four x-rays, two
per breast. This amounts to more than 150 times the amount of radiation
that is used for a single chest x-ray.
John Gofman, Professor Emeritus of Molecular and Cell Biology
at the University of California in Berkeley, here's what we can
clearly state about x-rays:
decades, the scientific community has known that x-rays cause
a variety of mutations.
are known to cause instability in our genetic material, which
is usually the central characteristic of most aggressive cancers.
is no risk-free dose of x-rays. Even the weakest doses of x-rays
can cause cellular damage that cannot be repaired.
is strong epidemiological evidence to support the contention
that x-rays can contribute to the development of every type
of human cancer.
is strong evidence to support the contention that x-rays are
a significant cause of ischemic heart disease.
is not to say that you should never have an x-ray; this is to say
that getting exposed to ionizing radiation comes with real risks,
and these risks should be considered before consenting to any procedure
that leads to exposure.
in terms of ionizing radiation, what's the price that your body
pays for a routine mammogram?
the United States, the Food and Drug Administration mandates that
no more than 300 millirems (a unit used to measure doses of radiation
that are absorbed by the body) of radiation can be delivered per
film during a mammogram.
that routine mammograms typically involve taking four films, two
per breast, this amounts to up to 1200 millirems per mammogram.
to the physics department at the University of Richmond in Virginia,
the average American is exposed to approximately 360 millirems of
radiation each year - this exposure comes from the sun and other
natural elements, as well as from man-made devices.
provide some perspective on everyday events that can add up to 360
millirems of radiation over the course of a year, here is more data
from the University of Richmond:
of Radiation Absorbed (millirems)
trip from New York to Los Angeles
of x-rays for head and neck
scan (head and body)
body therapeutic thyroid treatment
annual dose per person per year
each time you receive a mammogram that involves four shots, you
may be exposed to about the same amount of ionizing radiation that
you're exposed to over the course of about three years and four
months. This is assuming that the maximum allowable dosage is used,
but even if less is used, it should be clear that the amount of
ionizing radiation that is involved with mammograms is significant.
highly respected physicians and scientists like Dr.
Samuel Epstein have comprehensively analyzed this and other
available data, and contend that every 1000 millirems of exposure
increases a person's risk of developing some types of breast cancer
by 1 percent.
not sure how accurate anyone can be about these numbers, but there
is credible evidence to suggest that going for a mammogram every
year over decades can significantly increase your risk of developing
those who support going for annual mammograms acknowledge that the
overall net benefit is itty bitty at best; the numbers indicate
that two thousand women have to be screened for ten years for just
one woman to experience benefit to her lifespan.
of the most comprehensive studies of routine
mammograms conducted on women aged 40 to 49 found that:
who went for annual mammograms developed breast cancer at a
clip that was 22% higher than that of women who relied just
on self breast exams.
who went for annual mammograms had twice as many cases of metastatic
cancer compared to the group that did not receive mammograms.
let's step back a bit from epidemiological data and put our focus
know that if you get a mammogram, you're not preventing
anything. You're screening for abnormal masses.
the medical professional who performs and interprets your mammogram
deems you to have an abnormal mass, you're likely to receive a biopsy.
And if your biopsy reveals a malignant mass, chances are good that
your physician will refer you to an oncologist who will prescribe
treatment, most likely a mix of surgical excision, chemotherapy,
and perhaps a course of radiation.
point is, when medical professionals and studies talk about mammograms
saving lives, this has nothing to do with you preventing
or overcoming cancer.
are 100% unique in genetic composition, life history, and current
life circumstances, and most importantly, your chances of developing
and overcoming breast cancer have very little to do with survival
rates that are calculated for entire populations.
of the factors that determine your chances of developing and overcoming
any type of cancer are not accounted for when a physician tells
you that getting a mammogram can help save your life. These factors
you eat, how
you eat, your exposure to toxins,
your living and work environments, the states of your closest relationships,
fulfilled you feel.
all of this in mind, it should be clear that experiencing significant
over the decision to receive or decline a mammogram is in and of
itself a contributing cause of every health challenge that we know
of. Stress contributes to the development of disease, including
all types of cancer; never forget that your body and health cannot
be compartmentalized; every aspect of your life has some impact
on the health of every cell in your body.
a physician whom you respect strongly recommend a mammogram doesn't
make things easy, that's for sure. At the end of the day, I remind
myself that no one carries more responsibility for my health than
my health and life better than anyone.
when I need more rest than I'm getting.
when I need to eat more of certain foods and less of others.
when there is friction in an important relationship in my life,
and I know that transcending both pride and a desire for the other
party to apologize is a good path to erasing friction that hurts
when I have a guilty conscience and need to step up and do the right
that I can use all of my awareness and autonomy to screen my health
on my own with each passing day. Making the adjustments mentioned
above as needed is the best program of disease prevention that I
know of, and I put my confidence in this approach above all conventional
measures that come with significant risk.
another way, the best line of screening for dis-ease is your own
set of observations of how you feel physically and emotionally.
And the best line of preventing dis-ease involves living in a way
that optimally supports your innate self-healing mechanisms.
no question that some conventional medical tests provide immense
value in assessing our health and helping us make decisions on how
to approach various health challenges. The key is to make use of
the least harmful tests available, and only when deemed truly necessary
by our best instincts.
regard to specific medical screening procedures for breast cancer,
I feel that for the vast majority of women, regular self examinations
coupled with a manual exam by one's physician on an annual basis
is an effective approach that is virtually risk-free.
a person's medical history and/or a finding with a manual examination
indicate that it's prudent to investigate further, I feel that diagnostic
ultrasound and even magnetic resonance imaging (MRI) should be used
before mammograms, though the cost of magnetic resonance imaging
is significant. Thermography
is also a good option in some cases, though like all other screening
measures, it cannot detect every type of growth.
again, I feel that it's best to depend less on medical tests and
more on how we feel day to day to stay on top of our health, and
of course, to live as healthfully as possible. Why wait for a health
crisis to prompt us into doing what we know we should every day?
post note: Click here
to read how science was swept under the rug by the AMA as well as
the American Cancer Society in regard to findings contrary to mammogram
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