Mammography seeks to diagnose breast cancer earlier with the hope that more- timely initiation of treatment will lead to better outcomes. All this makes sense, but there are facts about mammography that do not make it the no-brainer many doctors and researchers would have us believe.
Claims are often made that mammography saves lives. However, research published in March 2010 in the British Medical Journal found that reductions in death rates on the introduction of mammography were actually smaller than those in areas where mammography was not offered to women.
The implication is that reductions in death on the introduction of mammography had nothing to do with mammography but were due to other factors such as improvements in breast cancer treatment.
There’s something else that women need to know about mammography: It very often leads to the detection of lesions that turn out to be nothing as well as cancers that would not have troubled the women over their natural lives.
As a result, many women are subjected to stress and unnecessary investigations and treatments. Sometimes, these treatments cost women their lives. This is most certainly not a trivial matter.
In recent years, some researchers and doctors have been keen to provide some balance to the mammography debate. They have called for women to be given both sides of the mammography story. They want mammography deficiencies and pitfalls to be explained to women so that they can make more-informed decisions about whether to have the procedure.
However, proponents of mammography have generally responded with intransigence, restating the supposed benefits of the practice despite the concerns about it.
The ante was upped again on the publication of a paper in September’s Journal of the Royal Society of Medicine. The article is written by two mammography researchers who point to evidence that mammography’s true ability to save lives is dubious at best.
The paper is critical of scientists attached to the NHS (National Health Service) Breast Screening Program in the U.K. The claim is that they are clinging to beliefs formed 25 years ago despite good evidence coming to light that shows these beliefs to be scientifically untenable.
The paper also points out that new evidence regarding the ineffectiveness of mammography and the problem of overdiagnosis have not been reflected in an information leaflet for women published last year.
Professor Peter Gotzsche, the paper’s lead author, claims in an article on Sept. 1 in The Independent: “Senior researchers who are affiliated with the U.K. screening program continue to distort the facts even though we, and others, have pointed out their errors.
“I can only speculate why, but when you have believed in something for a long time and your career is built on that belief, it is very difficult to change. These people, in a scientific sense, are behaving outright dishonestly and doing women a great disservice.”
Yet, the Breast Screening Program here in the U.K. is set to be expanded.
On Jan. 2, 2011, an article in Science Daily highlighted the fact that more than half of American women do not have scheduled mammograms. I speculate that at least some of these women have weighed the facts (found on the Internet, most likely) and decided it’s just not for them.
Despite the intransigence of the British government and many of the scientists advising it, I wouldn’t be surprised if we see a similar trend in the U.K.
Dr. John Briffa is a London-based physician and author with an interest in nutrition and natural medicine. His website is DrBriffa.com