The fury that has been triggered by the ongoing breast cancer screening scandal may have been unrelenting in its ferocity, but it also serves to obscure the uncomfortable truth – that all evidence shows that mammography does not save lives.
News that a computer error led to nearly half a million women missing out on a final mammogram check over a nine-year period has prompted all manner of outrage and, with it, some questionable estimates around the number of women whose lives were shortened as a result.
The Health Secretary, Jeremy Hunt, told the Commons the number of women mortally affected by the failure was somewhere between 135 and 270.
But the apparent public shock at that figure, and the notion that such a catastrophic error could be allowed to happen, is based on the false premise that mammography saves lives and is oblivious to other, more profound facts and figures.
Let’s look at the evidence in a context which, with the exception of a handful of respected doctors who wrote to the national media over the weekend to highlight the flawed thinking and advice around mammography screening, the wider medical community seems reluctant to give.
The broad landscape to the issue of mammography screening is one of dubious claims over its effectiveness and the absence of any awareness of risk-benefit balance.
Current Government advice claims screening reduces the risk of dying from breast cancer by around 35%. Yet when we interrogate that number with a little more due diligence, what we learn is that in order to prevent 3 or 4 deaths, an estimated 10,000 women would have to be screened.
The immediate and understandable response to that would likely be that a single life is worth saving. But if we look at the negative impact of screening those 10,000 women, we discover that between 120 and 140 of them would be overdiagnosed and given unnecessary treatment.
Overdiagnosis is the discovery of non-harmful cancers, and the problem here is that at an early stage it’s impossible to tell the benign from the malignant, leading to the possibility that women with tumours that pose no significant threat to life or health are put at risk of harm through unnecessary treatment.
In fact, according to New England Journal of Medicine research reported by Practice Update, there’s a greater chance of a mammogram leading to an overdiagnosis than to the early detection of a tumour requiring intervention.
There are further issues that highlight the shortcomings of mammography as a prevention tool. There is now evidence that suggests continued regular exposure through irradiation screening actually increases cancer risk. Other studies show that regular aggressive ‘crushing’ of breast tissue between the screening plates can itself trigger abnormal breast health, which may lead to cancer developing.
There are other facts and figures.
A representative survey of 5,000 medical professionals in nine European countries discovered that 92% overestimated the extent to which mammography screening could prevent death.
For many years now, it has been my belief that one of the biggest obstacles to prevention of breast cancer is the medical world’s reliance on, and apparently unquestioning belief in, mammography as the only way to deal with it.
So, if those involved in either delivering the screening or treating those cases that result from it don’t understand mammography’s limitations, then it’s simply not conceivable that women are being given the balanced information they need to make an informed choice.
For years it seemed mine was a voice in the wilderness, yet the scandal of the past fortnight has driven those in the medical establishment to speak publicly about their concerns over the effectiveness of screening.
Writing to The Times, 15 respected doctors, including Susan Bewley, professor of women’s health at King’s College London, and Michael Baum, one of the architects of breast screening in the run-up to its public launch in 1988, urged women aged 70 to 79 who were offered catch-up checks to “look this gift horse in the mouth” and turn down the appointment, whilst also advising them to seek help if they find a lump or other symptoms.
They have since been joined by Kailash Chand, honorary vice president of the British Medical Authority who, writing in The Guardian, said he feared ‘most doctors and patients do not understand the medical evidence’ surrounding mammography.
All of them have my support, although I wouldn’t restrict the shortcomings of catch-up mammography screenings to those aged 70 to 79.
As I keep saying, at its absolute best, a mammogram is on average accurate only 60% of the time. And even if it were 100% accurate, the very best it can possibly hope to offer any woman is confirmation that she already has the disease.
So, if mammography carries a potential risk of human cost, if it is not accurate enough, if it has the potential to trigger or accelerate the disease it is supposed to guard against, then what is the point of it?
It’s a question the Swiss medical authorities asked in 2014 before taking the formal position that it would no longer recommend screening mammography. The problem here, of course, is that the total and sole reliance on it means the NHS has nothing to replace it with.
There are other screening options, though, which include the ThermoCheck computer-assisted breast thermography we offer here at The Natural Doctor and which carries no risk, is suitable for women of all ages and highlights abnormalities in breast tissue temperature to detect possible cancer risk with up to 95% accuracy.
A study by the Nordic Cochrane Collaboration discovered that mammography overdiagnosis increases the number of cancers diagnoses and, condequently, unnecessary biopsies, by 50%, leading the Collaboration’s co-founder, Peter Gotzche to observe: “It’s ironic that the best way to avoid becoming a breast cancer patient is to say no to screening.”
The evidence may question the value of a mammogram, but it also suggests the time has come for a proper dialogue over harnessing expertise and technology inside and outside the NHS to tackle breast cancer prevention and diagnosis
For more information about mammography and the other options available for monitoring breast health and cancer risk, you can watch my video and subscribe to our YouTube channel to stay up to date with the latest news in natural medicine.