“Gifford-Jones, They Don’t Want To Hear That!”

Several years ago a friend asked if I’d talk to a women’s organization about breast cancer, how mammography could detect malignancy in its early stages. But when I gave her a short version of what I intended to say, she remarked, “But they would not like to hear that!” End of the talk. So what do women not want to hear?

Anytime I’ve questioned the use of mammography, it’s been like damning Motherhood and apple pie. Now, a blue ribbon panel of experts reports that women under 50 years of age should not have mammograms. And that postmenopausal women should submit to this procedure only every two or three years, rather than annually. The blunt fact is that if mammography had been a drug it would have been removed from the market long ago due to its ineffectiveness. For instance, Dr. Peter Goetzsche, a leading Danish researcher, claims there is no convincing evidence that annual mammograms decrease the risk of death from breast cancer. To reach this conclusion, Goetzsche and his colleagues analyzed international studies on half a million women. But how could a procedure that costs half a billion dollars every year in Canada be such a loser? There’s an easy explanation. We could wipe out cancer of the cervix if all women had a Pap smear at regular intervals. That is because this test is a “cellular diagnosis.” It obtains cervical mucous and is able to detect pre-cancerous cells years before they cause a malignancy. But mammography is a “lump diagnosis”. There’s no way to obtain cells from breast tissue.

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So for years it’s been stretching the truth to tell women mammography results in early diagnosis of breast cancer. How could it, when it takes about six or more years for cancer to be large enough to be detected by mammography? This provides time for malignant cells to metastasize to other areas. Another untruth is the number of women’s lives saved by mammography. The cruel truth is that whatever way you slice the cake the decrease in the number of cancer deaths is modest. Experts agree that 2,000 women must be screened for 10 years to get one benefit! One can always argue that saving one life is worthwhile. But wouldn’t it be better to use the funds saved from 20,000 inefficient mammograms to find a more efficient way to either diagnose or prevent breast cancer?