Those people who know me and have followed our regular blogs will know I’ve always been a strong advocate for early intervention in breast cancer detection because I have always been convinced that it saves lives.
Now it seems that conventional science – the very same school of opinion that has always argued screening prior to age 50 (and then, more recently, 47) would make no tangible difference to cancer mortality rates – appears to agree.
The results of a study that started 30 years ago found that offering routine mammography screening to women from the age of 40 resulted in 70% fewer deaths.
We’ll get to whether mammography is the right screening tool in a little while, but first of all it’s worth sharing the statistics and facts that have come out of the study, which was run by a research group at Queen Mary University London (QMUL) who published their findings this week in The Lancet Oncology Journal (you can read the full study text here).
In total, 160,000 women, recruited between 1990 and 1997, took part in the research programme. In the context of medical research, this is not a small study group by any stretch definition, and its findings can therefore be reasonably considered to be robust.
In simple terms, the women – all aged between 39 and 41 – were split randomly into two groups.
One group was offered routine annual screening from around age 40, the second group waited until they qualified for routine annual screening from the NHS. At the time the study began, the age at which women became eligible for routine mammography was 50.
NHS screening eligibility was extended by six years in 2007 to allow for women aged between 47 and 73.
This review of the QMUL study has delivered very similar data to the last time an update on the research was published 15 years ago. It is interesting to note that even then – in the face of clinical evidence to the contrary, the British Journal of Cancer was still arguing that the risks of early screening outweighed the benefits.
The really significant element of this week’s news, however, lies in the mortality rates which, as I’ve said above, were 63% lower among the group who had been offered routine screening around the age of 40.
It is reasonable –to conclude that early intervention in the diagnosis of breast cancer has a significant and demonstrable positive impact on mortality rates.
The question, now, is what represents the best screening method – and in my opinion that is not mammography alone.
The debate around mammography screening is peppered with questionable claims as to its effectiveness and an absence of any reference to risk-benefit balance. Moreover, there is some published evidence that exposure of a pre-menopausal woman’s breasts to radiation at mammography increases risk of breast cancer by 1% for each exposure.
The first thing to say is something I have repeated over and over again for years: at its absolute best, a mammogram is on average accurate only 60-70%% of the time.
Even if it were 100% accurate, the very best outcome it will ever offer any woman is confirmation that she already has the disease.
But then we come to overdiagnosis, which is the discovery of non-harmful cancers. At an early stage, it is impossible to tell benign cancers 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.
Based on current data, roughly 1 life is saved for every 10,000 mammograms performed. But here’s the kicker: current data also suggests the impact of screening those 10,000 women would mean between 120 and 140 of them being over-diagnosed and given unnecessary treatment.
Put simply, what that means is there is a greater chance of a mammogram leading to an unnecessary and potentially life-altering treatment than to the early detection of a tumour requiring intervention.
As stated above, evidence also suggests irradiation from screening can increase cancer risk. Other studies show that the regular aggressive ‘crushing’ of breast tissue between mammography screening plates can be a trigger for abnormal breast health, which may lead to cancer developing.
There’s a great deal of evidence out there that should give pause in the argument for mammography as a single and safe form of screening, and together my many blogs about breast cancer over the last three years have chronicled that evidence.
But if we either don’t understand or refuse to recognise the limitations of mammography, how can we ever hope to ensure that women are given the balanced information they need to make an informed choice about their breast health.
There are other scanning 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.
No-one is necessarily arguing that mammography should be discontinued (though this is a decision made by the Swiss government six years ago for screening mammography and an option still being considered by the French).
But mammography is now old technology. Over the last 30 years since the QMUL study started, the world has moved on, both in terms of medical knowledge and technology and also in public attitudes to healthier living.
It is beyond time for alternative approaches to cancer diagnosis and care to become part of a wider debate that seeks to empower rather than limit women in the choices they make with regard to protecting and managing their health.
If you’d like to learn more about our non-invasive ThermoCheck© scanning, please contact us for a confidential, informal and no-obligation discussion.