Firing Back
Last week I pushed a hot button. Actually I pushed it twice, in the e-alerts “Easy as 123” and “And 4” (8/5 & 8/6).
It’s no surprise that members would have strong responses to the controversial realities of mammography – realities that fly in the face of the widely accepted “safety” and “necessity” of mammograms. Most importantly, in amongst the cheers and jeers I received, there was some very useful information for any woman who is weighing her options about breast cancer screening.
Do it yourselfbut with training
A member named Linda started with the basics in this e-mail:
“BSE (breast self-examination) is definitely a major tool in prevention of breast cancer, BUT, as you point out, only when you know what to look for.
“In the case of small tumors, if you don’t know ‘what’ to look for, it does no good at all. In my case, I didn’t have a clue. It was my doctor who discovered the lump during my annual physical. I have since had tumors removed twice, but still wasn’t clear on what to look (feel) for. Since becoming part of the S.T.A.R. (Study of Tamoxifen and Raloxifene) clinical trial however, I have been having my breasts checked every six months. Since each time was not always by the same person, I was able to see several different methods. One of the major problems with BSE is that women are not ‘trained’ in what to look for or more especially, what it might feel like if you do have a tumor. They need far more training sessions available (I couldn’t find any in my area to start with), on how to do BSE, along with ‘models’ that a woman can actually ‘feel’ what some of the tumors might be like.”
Linda makes an excellent point. BSE is far more effective when women receive very specific training in how to do it and then how to recognize potential problems. For information on BSE training in your area, check with your doctor, or contact a local hospital. But keep in mind that along with BSE training, they may also heavily promote yearly mammograms. So if you don’t want a mammogram, stand your ground!
The old guard
By and large the jeers were not many. The most articulate came from a member named David who shared the two e-Alerts with a friend of his (identified only as a woman “in the medical field” – we’ll call her Dr. W.), and he sent along her comments in his e-mail. I don’t have room for her entire response, but this sentence sums it up: “I would still STRONGLY urge you to advise all women close to you to HAVE A MAMMOGRAM.”
Dr. W. suggests a careful consideration of the studies I cited. She says, “After these ‘meta-studies’ came out, some of the leading cancer centres and medical journals put out their own literature refuting many of these claims. It has been since reported that mammograms ARE necessary and MAY save lives – I believe the discomfort in the short term is WELL worth it when one’s life is at risk.”
I agree that a careful consideration is in order when anyone (including me, of course) offers study results to emphasize a point. But Dr. W.’s assumption is that “leading cancer centres and medical journals” provide the last word on this issue. In fact, what they provide is the ingrained, mainstream attitude that refuses to waver from the misguided conviction that mammograms provide the gold standard when it comes to breast cancer exams.
Dr. W. shares two individual cases in which mammograms proved to be useful. And I agree; there are many such cases where mammograms have saved lives. But that doesn’t negate the fact that there are effective alternatives to the discomfort and danger of mammography and the needless rush to perform biopsies and begin therapies that often follow false-positive results of mammograms.
Pain & loopholes
A member named Zephyr wrote to offer one of the best reasons to use alternatives to mammography:
“My doctor did the “this is what we do & best choice of screening” routine on me just last month. I’ve not had a mammogram to date and plan not to have one if at all possible! I am not well endowed and an older cousin, also not well endowed, had her muscle tissue pulled away (ripped off more like it) from the bone during a mammogramthat, at least in my eyes, was an unnecessary occurrence for her!”
And another member, named Russell, has a couple of bones to pick with the mammogram-focused medical establishment:
“I work in the medical field and doctors are rewarded sometimes even with cash for every test or prescription that is done. When they recommend a test, they also recommend a clinic to do it. That clinic has a deal cut with the doctor. Technically this is illegal but they work through a loophole. 90%+ of the diagnostic imaging done is involved in this scheme. I also remember reading about a study done in Europe that proved that ionizing radiation increases your risk of Breast cancer.”
In addition to their health care duties, doctors are also required to be businessmen, and there’s nothing wrong with that. But in the business atmosphere that Russell describes, there certainly seems to be a powerful incentive for doctors to stick with the “this is what we do & best choice of screening” routine when it comes to recommending mammograms.
Laser tag
“Have you heard of Imaging Diagnostics Systems?”
This question comes from a member named Emyrram, who adds: “They have a new non-invasive laser procedure for breast examinations where they use lasers to produce a 3-d image. You can visit their website at imds.com. What is your knowledge regarding this technology? Are the lasers harmful?”
I took Emyrram’s advice and visited the web site, where I discovered another emerging alternative to mammograms. Imaging Diagnostic Systems, Inc. (IMDS), has developed a breast cancer exam method called computed tomography laser mammography (CTLM) breast imaging system. And Emyrran’s description of how it woks neatly sums up the technique for us in layman’s terms.
I also found a number of published articles about CTLM, including one in Scientific American that describes the process as a combination of laser light and thermal heat that uses no radiation and produces a full color, three-dimensional, cross-section view of each breast. The exam takes about 10 minutes, and – great news – it’s 100 percent painless.
But does it produce more accurate results than mammography? Time will tell. Right now CTLM is well along in the FDA’s multi-step approval process. So while it’s not yet available to the public, it is undergoing studies in four hospitals. I’ll keep an eye out for the results of those studies and for more information about CTLM. And I’ll let you know as soon as the FDA passes judgment – hopefully with a green light.
Sooner or later a breast cancer screening method will come along to knock mammography off its mainstream pedestal. That method could be CTLM, or it may be something we can’t even imagine right now. Nevertheless, it will happen. And that day can’t come too soon.
To Your Good Health,
Jenny Thompson
Health Sciences Institute
Sources:
“New Light on Breast Cancer” Kelli A. Miller, Scientific American, 8/5/02, sciam.com
“New High-Tech Mammogram Shows Promise” Jim Kling, WebMD Medical News, 12/3/02, webmd.lycos.com
