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TO NATIONAL AND MEDICAL EDITORS:
Mammography Is Dangerous Besides Ineffective, Warns Samuel S Epstein, M.D.
CHICAGO, Feb. 6 /PRNewswire/ -- The following was released
by Samuel S. Epstein, M.D., Chairman of the Cancer Prevention Coalition and
Professor Emeritus of Environmental and Occupational Medicine, University of
Illinois School of Public Health, Chicago (and also a NEWAYS Personal care, skin
care & cosmetic line Endorser):
Recent confirmation by Danish researchers of longstanding evidence on the
ineffectiveness of screening mammography has been greeted by extensive
nationwide headlines. Entirely missing from this coverage, however, has been any
reference to the well-documented dangers of mammography.
-- Screening mammography poses significant and cumulative risks of breast cancer
for premenopausal women. The routine practice of taking four films of each
breast annually results in approximately 1 rad (radiation absorbed dose)
exposure, about 1,000 times greater than that from a chest x-ray. The
premenopausal breast is highly sensitive to radiation, each 1 rad exposure
increasing breast cancer risk by about 1 percent, with a cumulative 10 percent
increased risk for each breast over a decade's screening. These risks are even
greater for younger women subject to "baseline screening."
-- Radiation risks are some four-fold greater for the 1 to 2 percent of women
who are silent carriers of the A-T (ataxia-telangiectasia) gene; by some
estimates this accounts for up to 20 percent of all breast cancers diagnosed
annually.
-- Since 1928, physicians have been warned to handle "cancerous breasts
with care -- for fear of accidentally disseminating cells" and spreading
the cancer. Nevertheless, mammography entails tight and often painful breast
compression, particularly in premenopausal women, which could lead to distant
and lethal spread of malignant cells by rupturing small blood vessels in or
around small undetected breast cancers.
-- Missed cancers are common in premenopausal women owing to their dense
breasts, and also in postmenopausal women on estrogen replacement therapy.
-- Mistakenly diagnosed cancers are common. For women with multiple risk factors
including a strong family history and early menarche -- just those strongly
urged to have annual mammograms -- the cumulative risks of false positives can
reach as high as 100 percent over a decade's screening.
-- The widespread acceptance of screening has lead to overdiagnosis of
pre-invasive cancer (ductal carcinoma in situ), sometimes radically treated by
mastectomy and radiation, and even chemotherapy.
-- As increasing numbers of premenopausal women are responding to aggressively
promoted screening, imaging centers are becoming flooded.
Resultingly, patients referred for diagnostic mammography are now experiencing
potentially dangerous delays, up to several months, before they can be examined.
-- The dangers and unreliability of screening are compounded by its growing and
inflationary costs. Screening all premenopausal women would cost $2.5 billion
annually, about 14 percent of estimated Medicare spending on prescription drugs.
These costs would be increased some fourfold if the highly profitable industry,
enthusiastically supported by radiologists, succeeds in replacing film machines,
costing about $100,000 each, with the latest high-tech digital machines recently
approved by the FDA, costing about $400,000 each, for which there is no evidence
of improved effectiveness.
The ineffectiveness and dangers of mammography pose an agonizing dilemma for the
millions of women anxious for reassurance of early detection of breast cancer.
However, the dilemma is more apparent than real. As proven by a September 2000
publication, based on a unique large-scale screening study by University of
Toronto epidemiologists, monthly breast self-examination (BSE) following brief
training, coupled with annual clinical breast examination (CBE) by a trained
health care professional, is at least as effective as mammography in detecting
early tumors, and also safe. National networks of BSE and CBE clinics staffed by
trained nurses should be established to replace screening mammography. Apart
from their minimal costs, such clinics would empower women and free them from
increasing dependence on industrialized medicine and its complicit medical
institutions.
(For further details and supporting documentation, see "Dangers and
Unreliability of Mammography: Breast Examination is a Safe, Effective and
Practical Alternative," by Samuel S. Epstein, Barbara Seaman and Rosalie
Bertell, International Journal of Health Services, volume 31(3):605-615, 2001.)
CONTACT: Samuel S. Epstein,
M.D., Professor Emeritus Environmental and Occupational Medicine, and Chairman,
Cancer Prevention Coalition, University of Illinois at Chicago, School of Public
Health, +1-312-996-2297, fax, +1-312-413-9898
SOURCE Cancer Prevention Coalition 02/06/2002
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