Women between the ages of 20 and 39 who have no symptoms of breast disease should have a clinical breast examination every 3 years. A physician, a nurse practitioner, a nurse, or a physician assistant can perform this examination. The health care professional will examine both breasts for discrepancies in size or shape. The examiner will also palpate (feel) each breast to detect any lumps or masses. The area under both arms will be examined as well, to check for enlargement of lymph nodes.
For as long as I can remember women have been steered to yearly mammograms as screening tools for early detection of breast cancer. However, what most women don’t know is that if a lump or tumor shows up on a mammogram, it’s been there for quite a while. Mammograms cannot detect breast lumps until they are about the size of an eraser on the end of a pencil. That’s big already! Furthermore, “For women under 50 with dense breasts, mammograms may miss a small percentage of in situ breast cancers.” Historically, mammograms did not have a very good track record. Why? Well, in the early years of mammography machines were not calibrated correctly, which caused excess radiation exposure, plus an increased risk of inducing breast cancers. Mammography actually lacked “quality control,” so …
in 1992, hearings held by the Senate Committee on Labor and Human Resources found numerous quality issues in the field of mammography.
Those hearings led to the Mammography Quality Standards Act (MQSA) on October 7, 1992, which became effective October 1, 1994, rather late in the field of mammography, I’d say. The U.S. FDA was tasked with setting mammography quality standards. Interestingly, in the first year of the FDA’s oversight, 26 percent of mammography facilities had significant violations, which apparently jeopardized women’s breast health, in my opinion. Many facilities had to close as a result of MQSA and the FDA standards. In 2003 a Harvard Law School course work requirement paper was published on the Internet that “…acknowledge[s] many of the current problems with mammography reflect deeply rooted historical problems with the delivery of health care and the regulation of medicine.” Also, “It acknowledges that the technological limitations of mammography techniques may be contributing to the physician interpretation problem.” Recognizing and trying to address some of the problems still plaguing mammography, Congresswoman Rosa L. DeLauro (D-CT-3) introduced H.R.3404, the Breast Density and Mammography Reporting Act of 2013 on October 30, 2013 that
amends the Public Health Service Act to require mammography facilities to include information regarding the patient's individual measure of breast density in both the written report of the results of a mammography examination provided to the patient's physician and the summary of that written report given to patients. Requires the summary to: (1) convey the patient's risk of developing breast cancer associated with below, above, and average levels of breast density; and (2) include language communicating that individuals with more dense breasts may benefit from supplemental screening tests and should talk with their physicians about any questions or concerns regarding the summary.
Breast density apparently is problematic for mammography and patients alike, since it determines exposure for readings. Here’s why, according to IAEA, the International Atomic Energy Agency:
Mammography screening is a profit-driven technology posing risks compounded by unreliability. In striking contrast, annual clinical breast examination (CBE) by a trained health professional, together with monthly breast self-examination (BSE), is safe, at least as effective, and low in cost. International programs for training nurses how to perform CBE and teach BSE are critical and overdue.
In the above paper, the authors discuss the dangers of mammography screening, which include: Radiation and Cancer Risks from Breast Compression, something women are not aware of but should know.
As early as 1928, physicians were warned to handle “cancerous breasts with care- for fear of accidentally disseminating cells” and spreading cancer. Nevertheless, mammography entails tight and often painful compression of the breast, particularly in premenopausal women. This may lead to distant and lethal spread of malignant cells by rupturing small blood vessels in or around small, as yet undetected breast cancers.
During mammograms, breasts are squeezed between plates to make them flat with a pressure that some say is as much as 50 pounds or more. That pressure can cause a rupture, as pointed out above. Knowing the above background information, let’s consider what a 25-year study published in the British Medical Journal in early 2014 revealed about mammography. But first, allow me to share with readers that in my 2012 book, A Cancer Answer, Holistic BREAST Cancer Management, A Guide to Effective & Non-Toxic Treatments, I devote two entire chapters to discussing mammograms in great detail. The BMJ study evaluated Canadian women ages 40 to 59 who: 1) had regular mammograms and breast exams by trained nurses, and 2) those who had breast exams alone. Surprisingly, the death rate from breast cancer was about the same in both groups. However, one in 424 women who had mammograms received unnecessary medical treatments, which included surgery, chemotherapy, and radiation. Needless to say, the Canadian breast cancer study has become a polarizing event in the divide between those in medicine who believe mammograms save lives and researchers who claim there is no evidence to that effect and only leaves the issue muddled. Furthermore, in light of the Canadian study, the American Cancer Society says it is rethinking its position on mammography and will be issuing revised guidelines sometime later in 2014. The BMJ study authors concluded that
…our data show that annual mammography does not result in a reduction in breast cancer specific mortality for women aged 40-59 beyond that of physical examination alone or usual care in the community. The data suggest that the value of mammography screening should be reassessed.
Readers ought to know that men also can contract breast cancer, which I discuss in another chapter in A Cancer Answer [available on Amazon.com], and undergo the same diagnostic procedures and treatments as women, which may include mastectomy. I once had a male client who had a double mastectomy. What conventional oncology overlooks and categorically does not utilize to diagnose breast cancer earlier than a mammogram can, is FDA-approved (1982) thermography, a non-invasive, radiation-free, infra-red photographic technique that photographs body heat, since cancer tissue gives off more heat than non-cancerous tissues. To help women make better informed choices about breast health issues, I devoted an extensive chapter in A Cancer Answer to thermography. Included in that chapter is an exceptional essay written by a Board Certified Thermologist medical doctor, who’s been a medical thermographer since 1982. Breast cancer can be found much earlier than before a lump or tumor becomes the size of a pencil eraser. Wouldn’t you consider that very early breast cancer detection? However, thermography for breast cancer detection is not covered by healthcare insurance plans, which is due to the politics of healthcare and apparent effective lobbying tactics employed by mammography equipment makers directed at the FDA and Congress. Apparently, money talks.