Mammograms don’t save lives, as I’ve always said

If you’ve been reading my Daily Dispatch and my Insiders’ Cures newsletter, this big announcement didn’t surprise you. You already knew all about the problems with mammograms. And you knew about them well before the news hit the mainstream press.

I have been warning you for years about ineffective cancer screening programs pushed by the government. And the beloved mammogram takes the cake. It’s the darling of the pink ribbon crowd. But according to the old data…and the new Canadian data, it shouldn’t be! In fact, the study’s lead author even brought up the idea of dropping it as a screening tool altogether.

The Canadian study began in 1980. At the outset, researchers recruited nearly 90,000 women ages 40 to 60 from clinics across the country. Then, they randomly divided the women into two groups. The first group received annual mammograms. The second group only received annual physical breast exams–not a single mammogram.

Twenty-five years later, the same number of women died from breast cancer in each group. In other words, the darling of the pink ribbon crowd didn’t save any more lives than a regular, physical exam.

However, one major difference did stand out between the two groups…

Over-diagnosis was a major problem among the mammogram group. Over-diagnosis is a clinical term that describes what happens when a screening tool falsely detects a “cancer” growth. This leads to unnecessary and sometimes harmful treatments. But the growth detected isn’t cancerous at all.

You see, mammograms can and do detect very small breast growths. But these small growths don’t spread. They don’t metastasize. And they could never cause death, even if left untreated. They are “harmless,” by definition. In fact, an expert panel recently put together by the National Cancer Institute (NCI) even admitted that we shouldn’t call these small growths “cancer.” They say it’s inaccurate and harmful. Not to mention a waste of billions of dollars.

In an interview last week, the study’s lead author, Professor Anthony B. Miller, brought up the idea of stopping the use of mammograms altogether. Miller is an international expert who has studied these problems for decades. I actually published a review of one of his textbooks several years ago. Miller said, “Stopping mammography screening will not result in lives lost, but lives lived with greater quality of that life.”

Of course, the National Cancer Institute doesn’t want to see mammograms go by the wayside. Nor does the American Cancer Society. Or the American College of Radiology.

They all insist that we are finding more “cancers,” earlier when they are smaller and more “treatable.” This keeps everyone in the cancer industry very busy (and very rich). And it creates the illusion that they’re doing something right.

Of course, now we know that many of these growths are not cancer at all. And they wouldn’t ever kill the patient, even if left untreated.

Do you see the trick now?

To claim a real victory against cancer, we need to see death rates from cancer actually decrease. That way, we know we are dealing with real cancer. And not made- up problems. (Of course, dealing with made-up problems is the government’s favorite pursuit.)

And remember, this isn’t the first time mammograms have come under fire. In 2009, the U.S. Preventive Services Task Force changed its recommendation on mammography. It said women 50 to 74 should only get mammograms every two years. And younger women, ages 40 to 49 years, should consult with a physician about whether they should get mammograms.

And more recently, Harvard doctors questioned whether older women should get mammograms at all. Given the typical characteristics of breast cancer at older ages and life expectancy.

Bottom line?

Many experts now realize mammograms should not be an “untouchable” topic. We need to reassess and debate their rationale. Debate is good. And healthy. And it will benefit the health of women.

In fact, last week on PBS, I watched a debate between a Dr. Gilbert Welch, a medical scientist from Dartmouth University School of Medicine, and Dr. Carol Lee of the Memorial Sloan-Center Cancer Center. Dr. Lee is also on the Breast Imaging Committee of the American College of Radiology. So you can guess which side she argued.

It was almost humorous, really, if not so sad for the patients and honest doctors caught in the crossfire. She looked like a deer caught in the headlights. And she used extraneous statistics to attempt to justify mammogram screenings.

But Dr. Welch of Dartmouth simply pointed out the straightforward arithmetic that showed the same breast cancer death rates, with or without mammogram. They remain the same whether broken down year-by-year, decade-by-decade, and over the whole quarter-century.

Simple arithmetic–no statistics required–clearly proves the point, as I often say.

The cancer industry can’t deny these numbers. But they don’t like them. So they do all kinds of extraneous statistical shenanigans to make mammograms appear more useful.

Today, we have these kinds of shenanigans to thank for the epidemic of over-diagnosis and overtreatment of breast cancer. As well as thousands of “false alarms” and needless “cancer scares.” And that’s something we really can live without!

Always on the side of science,

Marc S. Micozzi, M.D., Ph.D.


“British Medical Journal, published on-Line, 2/11/2014

“Annual Screening Does Not Reduce Death from Breast Cancer,” Medical News Today ( 2/12/2014