Original Article Here.

In a dramatic break from enshrined medical dogma, the US Preventive Task Force revised their guidelines for breast cancer screening with mammography, published in the Annals of Internal Medicine. While previous guidelines started at age 40, the panel now advises against screening the 40-50 age group, because current science based medicine indicates more harm than benefit. The guidelines are now up to date with the European Guidelines which screen women age 50-69 every two years.

Setting Back Evidence-Based-Medicine with Fear Mongering

The mainstream media, government and corporate medicine have strongly opposed the revised guidelines with slick marketing techniques, and fear mongering with appeals to emotion rather than evidence based medicine. Kathleen Sebelius, for example, appeared on national television advising women to ignore her own Department's task force panel, and start mammogram screening at 40. The opposing criticism has at times been bizarre and comical, with one author claiming the new guidelines will cause 47,000 deaths. This would be a impossible, since this exceeds the 30,000 deaths annually before the screening era. These opposing views avoid the real problems with screening mammography.

The Basic Problem With Screening Mammography

The basic problem with screening for breast cancer with mammography is the "reservoir of silent disease". A series of autopsy studies show that indolent breast cancers are common in the population. These early cancers, called DCIS, are silent and rarely cause clinical disease. The most impressive study was from Denmark in 1987. The Danish group used specimen radiography on autopsy samples, which most closely approximates what screening mammography does, searching for and finding small clusters of calcifications.The Danish team found breast cancer in one out of five women, most of which was DCIS (ductal carcinoma in situ).

One out of 5 women show breast cancer at autopsy, yet only 2 to 3 women per 10,000 die from breast cancer annually. (20% vs .03%) This indicates a disconnect between the huge reservoir of silent and clinically insignificant disease, and the much smaller number of invasive breast cancer presenting clinically.

DCIS in 18% of the Population

Current screening mammography technology detects 60,000 cases of DCIS annually, and yet, this is only a small fraction of total DCIS present in one out of five women in the population. DCIS is ductal carcinoma in situ, an early form of cancer with a good prognosis, a 98% five year survival with no treatment. I expect future refinements in xray technology to allow detection of even greater numbers of DCIS cases which have small calcifications. Ultimately the technology will catch up and replicate the Danish autopsy findings.

Do we really want to be detecting DCIS in one out of five women, and submit all these women to biopsy and lumpectomy? This is exactly what is advocated by the corporate-government-media sponsored mammography screening programs.

Just Stop Calling It Cancer

Recently, an NIH panel asked pathologists to stop calling DCIS cancer. Here is the NIH Consensus statement: "Because of the noninvasive nature of DCIS, coupled with its favorable prognosis, strong consideration should be given to elimination of the use of the anxiety-producing term “carcinoma” from the description of DCIS. "

Less is Better

I beg to offer a differing opinion more in line with the US Preventive Task Force revisions. The detection of massive numbers of cases of DCIS results in harm from over-treatment of the population with little benefit in terms of reduced mortality from breast cancer. This opinion is echoed by Dr Laura Essermanin a recent JAMA article on the limitations, and disappointing benefits of screening mammography.

Twenty Years of Data

We now have twenty years of breast cancer data during the screening era, and Dr Laura Esserman concludes, the incidence of early stage breast cancer has decreased due to mammography, yet the incidence rates for advanced cancers have not declined as expected. She says:

"One possible explanation is that screening may be increasing the burden of low-risk cancers without significantly reducing the burden of more aggressively growing cancers and therefore not resulting in the anticipated reduction in cancer mortality."

This means we are finding the DCIS cases with mammography, with little impact on overall mortality numbers. In other words, the bulk of our mammography screening efforts are going towards detecting and treating relatively benign lesions which are very common in the population. Critics might call this a fraud and a scam. Our corporate sponsored media calls this good medical care.

Many aggressive cancers are detected clinically between screenings because of rapid growth, making screening superfluous. Some very aggressive cancers, even though detected by screening, are so invasive and aggressive that any form of treatment proves futile.

The Solution, Cancer Prevention With Iodine Supplementation

The discovery of a large reservoir of silent disease is a wake-up call that something is dreadfully wrong. Rather than screen the population for small calcifications, called DCIS, generating massive numbers of lucrative procedures with biopsies and lumpectomies that have little impact on overall mortality, I suggest a better approach.

The evidence is overwhelming that Iodine deficiency causes breast cancer, and Iodine supplementation prevents and treats breast cancer. Iodine supplementation is a less expensive and more effective alternative to the runaway train called mammogram screening. Iodine tablets are available OTC on the internet without a prescription.

For more information on screening mammography see my recent article:

Rethink Pink October Breast Cancer Mammogram by Jeffrey Dach MD

Radiation Exposure Causes BreastCancer

Another frequently overlooked problem with screening mammography is the radiation exposure. Radiation is a known carcinogen, and exposing breast tissue to radiation causes breast cancer. Dr Berrington's paper in the 2005 issue of BJC estimated that radiation exposure from screening mammography causes one death for every 2000 women screened. This number is virtually identical to the numbers cited by the US Task Force for lives saved. The US Preventive Task Force estimated that 1,900 women in their 40's would be exposed to 10 years of radiation from mammograms to save one life. This survival benefit equals the mortality from radiation exposure.

Harm From Over-Diagnosis and Unnecessary Biopsies

How do we measure the harm resulting from missed diagnosis, over-diagnosis and unnecessary treatment arising from screening mammography? In a BMJ editorial, Dr Gilbert Welch says the following:

One in 1,000 women annually screened for 10 years will avoid dying from breast cancer.

Two to 10 women will be over-diagnosed and treated needlessly.

Ten to 15 women will be told they have breast cancer earlier than they would otherwise have been told, but this will not affect their prognosis.

One Hundred to 500 women will have at least one "false alarm" (about half of these women will undergo a biopsy).

For References and Links see Original Article Here.

Author-Jeffrey Dach MD is a Board Certified Diagnostic Radiologist with 25 years reading mammograms.

Disclaimer: The reader is advised to discuss the comments on these pages with his/her personal physicians and to only act upon the advice of his/her personal physician. Also note that concerning an answer which appears as an electronically posted question, I am NOT creating a physician -- patient relationship. Although identities will remain confidential as much as possible, as I can not control the media, I can not take responsibility for any breaches of confidentiality that may occur.

Author's Website: www.jeffreydach.com

Author's Bio: Jeffrey Dach MD is founder of TrueMedMD a clinic in Hollywood Florida specializing in Bioidentical Hormones, natural medicine, and natural thyroid. Location: 4700 Sheridan Suite T, Hollywood, Florida 33021, telephone 954-983-1443 http://www.jeffreydach.com

www.opednews.com/articles/Mad-Over-Mammogram-Guideli-by-Jeffrey-Dach-091126-560.html