The Mammogram Debate: A Campaign of Fear

From the May 2004 edition of Dr. Fuhrman's Healthy Times:

More than a decade ago, the American Cancer Society recommended that women get a baseline mammogram at age thirty-five, followed by annual screenings beginning at age forty. The campaign to position mammograms as the key weapon in the fight against breast cancer was initiated by the American Cancer Society, with a number of medical groups joining the fray. Instilling fear about breast cancer was a campaign strategy. To achieve this, the American Cancer Society used greatly exaggerated numbers and faulty math to overstate breast cancer risk. They admitted they did this—and continue to do it—to promote mammograms.1 They still trumpet the claim that women face a one-in-eight chance of developing breast cancer during their lifetimes.

Where does this one-in-eight figure come from? It is a cumulative probability derived from adding up all the chances a woman has of developing breast cancer between birth and age 110. Since women do not generally live that long, this figure is not based on reality. More sophisticated risk assessment gives the actual risk of being diagnosed with breast cancer before age sixty as about one in 500. Even women in their eighties do not face a one-in-eight chance of developing breast cancer. For example, at the age of seventy, the risk of developing breast cancer during the next ten years is one in twenty-three. In their zeal to help women, the American Cancer Society and other groups have created an epidemic of fear. Unfortunately, that fear has not been used to direct women to prevent breast cancer—by avoiding the causes of breast cancer. Rather, it has been used to convince women to think that using mammograms to find cancer after it already has developed is their best hope for survival.

For more on The Mammogram Debate check out these posts:
1. Blakeslee S. Faulty Math Heightens Fears of Breast Cancer. New York Times March 15, 1992, Section 4, page 1.
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Kirsten - January 1, 2007 5:30 PM

As someone rapidly approaching 35, I wonder if this means Dr. Fuhrman would not recommend the baseline mammogram at 35? I am happily working to reduce my risk for cancer by eating to live as much as possible (a work in progress), but is the mammogram invasive enough to avoid until later?

Jim - January 2, 2007 10:58 AM

Whatever your decision (to mammogram or not, and how often), in addition to your decision to 'eat to live', be sure to take into account (* honestly *) any additional personal circumstances.

You could be on your way to 'eating to live', but maybe there are other family or personal traits that still make you more susceptible (even as your work to 'eat to live'), especially in combination with characteristics outside of diet.

As an example, for me and my personal circumtances, I believe my being an introvert with my feelings is going to affect my lifespan more than my diet (even though my diet is vegetarian since '88 / and near vegan beginning in '06). So I think that, beyond diet, meditation will give me the most bang-for-my buck in terms of lifespan.

If you or your family have other traits that heighten your propensity toward cancers (and which might not be addressed in one generation by diet alone, even as powerful a tool as is diet), just be sure to take those factors into account in your decision to mammogram or not, when, and how often.

Furthermore, it could very well be the * honestly * part that trips me/you/everyone up. To take into account family or personal characteristics which might be uncomfortable is a difficult prospect for everyone. Over the past year, I've learned that even as capable and honest as I believe myself to be in evaluating myself, there is no substitute for honest feedback from an outside observer as to what traits, both familty and personal, might impact my life negatively.

It is then up to me to decide what, if anything, I want to do to lessen the impact of those traits on my lifespan.

My layman's two cents.

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