Mammografieën??
Sinds dat de Deense onderzoeker Dr. Peter Gotzsche vorig jaar oktober in The Lancet vraagtekens plaatste bij de resultaten van allerlei wetenschappelijke onderzoeken naar mammografieën onder een half miljoen vrouwen, gaan steeds meer wetenschappers vraagtekens plaatsen bij het nut van mammografieën. Zo lijken vrouwen in de leeftijd van 40 tot 50 jaar, die regelmatig mammografieën laten doen een twee keer zo’n hoge kans te hebben dood te gaan aan borstkanker dan vrouwen in die leeftijd die geen screenings laten doen. In 30% van de gevallen wordt bij vrouwen in deze leeftijd ook nog eens ten onrechte geen kanker vastgesteld. (Trouwens doorgaans duurt het 8 jaar voordat een borstkanker met een mammografie kan worden vastgesteld.)
Volgens de op dit terrein bekende Engelse professor, Michael Baum hebben de nadelen van mammografieën de voordelen al ingehaald. De enorme druk die op de borsten tijdens het onderzoek wordt uitgeoefend kan aderen doen beschadigen waardoor volgens vele wetenschappers eerder uitzaaiingen van kanker kunnen ontstaan. Belangrijk is als vrouw zelf regelmatig borstonderzoek te doen en bij constateren van een onregelmatigheid dan een mammografie laten doen.
About
mammography
What's
a "sacred cow"? One is a medical belief that's been etched in stone
for years. For instance, to question the value of cholesterol lowering drugs is
like damning motherhood. Or to challenge the belief that mammography does not
save many lives may condemn you to hell. But everyone should be asking probing
questions about the sacred cow of mammography.
Dr.
Peter Gotzsche, 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 Gotzsche and his colleagues analyzed international studies
on half a million women.
Dr.
Michael Baum, professor of surgery at University College, London, England says,
"The latest evidence shifts the balance towards harm and away from benefits".
Today,
women, health care professionals and the media all focus on the benefits of
regular mammograms. Mentioning their negatives is considered unethical. But
there is bad news and it's unethical not to publish it.
Many
women are unaware that mammograms may do more harm than good. For example, if
women between the ages of 40 and 49 have regular screening, three years later
these patients have 2X the death rate from breast cancer than unscreened women!
The
cruel truth is that whatever way you slice the cake the decrease in cancer
deaths by mammography is modest. Experts say that you have to screen 2,000 women
for 10 years for one benefit. That's why some authorities argue women should not
be exposed to radiation for such poor results. Or expose them to worry.
I've
seen first-hand the profound anxiety of the patient whose report states more
x-rays must be taken because of a questionable first result. Then real fear sets
in when the second report can't separate a cancerous lump from a benign one.
More sleepless nights follow while waiting to have a breast biopsy and further
delay for the result. Even if the final report is good, many worry that doctors
might still have missed the cancer.
This
is not a minor happening. Women who have regular mammograms for 10 years have a
49 percent chance of being recalled at some time for a biopsy. These terrible
odds are much worse than Las Vegas.
Mammograms
can, on the other hand, also provide a false sense of security. Studies show
that they miss 30 percent of cancers in women 40-to 49 years of age.
Another
concern is that squeezing breasts during mammography causes more than pain. Some
authorities say this pressure may also rupture blood vessels in or around a
tumour causing the cancer to spread.
I
think the larger question is whether breast cancer screening should be continued
since the benefits are so small. Or only used when manual breast examination
detects a questionable area.
Unfortunately
women die of breast cancer for one prime reason. There is no way to diagnose it
early.
The
Cancer Society and others have lead women to believe mammography results in
early diagnosis. This is a lie. It takes eight years before a lump is large
enough to detect which provides time for cancer cells to spread to other areas.
This is not early diagnosis. One critic said it well, "Finding a cancer
this way is damage control, not prevention".
The
debate about mammography will continue as economics plays a role. To deny its
benefits means a huge economic loss to everyone involved in the procedure. And
who wants to admit they've been wrong about the benefits of mammography after
stressing its need for so many years?
What
is rarely mentioned by anyone is the risk of radiation. In the U.S. women are
advised to have a mammogram starting at age 40 as breast tissue is dense at this
age which makes breast lumps less visible. In Canada the generally accepted age
is 50. This involves a considerable number of x-rays by 70 years of age. And
since women are often called back for additional mammogram studies, more
radiation is needed.