34: Why Some Women Say No to Mammograms: The Hidden Dangers in Traditional Breast Cancer Screening

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Hello and welcome to the keeping Abreast with Dr. Jen podcast. This is a special edition and I AM your host, Dr. Jen Simmons. And today we're going to talk to you about something that is controversial. It's going to evoke some feelings in you guys. Some of you are going to be offended, some of you are going to be relieved, some of you are going to be enlightened, some of you are not going to know what to do with your feelings about today's podcast, because today we're going to talk about breast imaging. I have been diving deep into the data for the purposes of educating myself and for educating you because this is an area of our health care system which is enormous and where the vast majority of people who are participating in this arena are uninformed or under informed. And that's a big problem, especially in today's society where we talk about informed consent and knowing and understanding what we're doing and what we're getting into. And the fact that we don't have this informed consent in this area is really troublesome. And so I wanted to make sure that we talked about it, that you understand about breast imaging, that you understand the purpose, that you understand the possible outcomes, and that you make an informed decision as to what is right for you. And I'm going to focus a lot on the data that comes from around the world where there isn't as much political influence on their decision making. There's not as much commercial influence on their decision making because that commercial aspect, that financial aspect, has a lot of influence on what the decisions are that are being made in this country with regard to imaging. And they are Directly affecting you in so many ways. So let's get into it. First of all, I want to say that the mammographic screening program, which started in the 1970s, started with the very best of intentions. And the mammographic screening program was built on a premise. The premise was that breast cancer growth is both linear and predictable. And if you are to find a breast cancer when it is small, it means that that breast cancer is early and that it would require less treatment and be easier to cure. And that premise is logical, it's believable, it just doesn't happen to be true. Unlike colon cancer, which has a very predictable growth pattern. So we have a colonoscopy program that finds polyps when they're small and early. Sometimes they've even transformed to be malignant. But if you find this process early, you can actually halt this process in colon cancer. That is not true of breast cancer. So breast cancer growth is neither linear nor predictable. So breast cancer doesn't start off small and grow to some predictable size, at which point it would be more likely to metastasize. And if you find a breast cancer before that point, you significantly change the trajectory of the disease for that person. Again, it's a very logical theory. It just doesn't happen to be true. Because in the world of breast cancer, there are very small breast cancers that have very aggressive biology, very large breast cancers that don't have aggressive biology and everything in between. And so talking about breast cancer in terms of size and time is not a meaningful discussion because it doesn't predict outcome. The only thing that predicts outcome with breast cancer is biology, and that is not affected by mammographic screening. So that is the main problem with mammographic screening is that it simply does not help us to identify the people that are at most risk of dying of breast cancer. And we know that because no matter how many mammograms we do, every single year, the same exact number of women present with aggressive disease, no matter how many mammograms we do every year, the same exact number of women die of breast cancer every year. We are not impacting the bottom line, but here's where we are impacting. The mammographic screening program, when it started in the 1970s, started off with 2D mammogram, two dimensional mammogram, it was two views of each breast, an up and down view, we call that the CC or craniocaudal, and a side to side view, we call that the MLO or medialateral oblique. Now it's not straight side to side, it's kind of tilted side to side so that we can capture the tissue, the low lying tissues of the axilla and look at lymph nodes at the same time. That 2D mammogram had about the amount of radiation that you do get in a cross country airplane ride. However, that radiation is coned down and compressed to the area of the breast as opposed to the scatter that you get on an airplane. I know that that is always an argument of radiologists that mammograms don't deliver any more radiation than cross country travel. And we're not telling people not to travel cross country. Yes, that is true. That mammogram does have that same amount of radiation. However, we have to remember that scatter radiation and focused radiation are two very different things. When we look at breast cancer incidence, it was pretty much steady from 1999 till around 2012. In 2012, we introduced digital breast tomosynthesis, or DBT onto the scene. Sometimes it's called 3D mammogram. Essentially what it is is a CAT scan of the breast. It captures multiple images or slices in both directions. So the test is acquired in a very similar manner to a mammogram in that your breast gets smashed between the two plates and imaged. However, a digital breast homosynthesis will deliver somewhere between two to three times more radiation than a standard mammogram. Now that is for the average person. However, the algorithm of that device is such that the denser your breast tissue is, or the larger your breast is, the more radiation it will deliver. So some women are getting 10 times the radiation of a standard mammogram with digital breast tomosynthesis. So when we look at breast cancer incidents starting in 2012, it really begins to rise and it's been on a steady climb since then. Now, I am not denying that there are other things in our environment that are causing more breast cancer. There certainly are. We are living with more chemicals and more toxins than ever. We are not living on our grandmother's earth. We're not even living on our mother's earth. That the the number of chemicals and additives and things that we are exposed to on a daily basis is exponentially more than our mothers and grandmothers. That is for sure true. However, we are also being exposed to exponentially more radiation. If we are getting screening mammograms every year, and if we're getting screening mammograms every year, at least 25% of us, and maybe closer to 50 or 60% of us, depending on where you're getting image, are getting called back for additional views. So those additional views are delivering even more radiation, making that exponential number even higher. The amount of radiation that we are being exposed to is not insignificant. And we know that radiation is a known carcinogen. So let's specifically talk about the problems with mammogram pain, compression, trauma. Those are obvious, right? But if that's all that it was. Women are tough. We can handle things if we know they're for the good. But what if they're not for the good? What if the fact that we've been told time and time again that mammograms save lives isn't true? Because it isn't. You would have to, you would have to image with mammogram thousands of women to save one woman's life. And in the course of imaging thousands of women, you're going to cause many, many, many more breast cancers than the life that you saved. So the balance is way off in terms of benefit. And there are more harms than just causing breast cancer in the population. Mammograms lead to a lot of over diagnosis, which leads to a lot of over treatment. Now this is going to be another thing that's tough for people to hear, but just stay with me. When we screen a population with mammogram, we are going to identify lesions that may or may not have progressed and become clinically relevant. If they progress and become clinically relevant in that if they, if they grow, if they're going to turn into life threatening disease, yes, they certainly need treatment. But a large percentage of these cancers that we're identifying would have never become a clinical issue. However, once they're identified, people need to undergo breast cancer treatment. And breast cancer treatment is not benign. In fact, we know that women who are treated for breast cancer are two to three times more likely to die of heart disease than women who were not treated for breast cancer. Now, that issue is twofold. First, the same inflammation that leads to breast cancer will eventually lead to heart disease. And the way that we treat breast cancer in this country is that we only focus on the tumor. And when you focus on the tumor, you never acknowledge or remediate why you got the tumor in the first place. So you never identify the source of the inflammation, you never get rid of the source of the inflammation, and you never restore balance because into the body, which is what is needed. So the inflammation is still there and yes, can lead to heart disease. However, the treatments for breast cancer Also lead to heart disease. So chemotherapy leads to heart disease. The aromatase inhibitors, tamoxifen, not tamoxifen as much, but the aromatase inhibitors certainly lead lead to heart disease. And radiation accelerates heart disease by both affecting the vessels in the heart and affecting the heart muscle itself. So when we treat women for breast cancer, we are, for the most part, getting rid of the breast cancer, but we're also creating a whole host of other problems for them. We, we already talked about heart disease. It also leads to brain disease and brain deterioration. Alzheimer's, dementia, depression, anxiety. There are all of these dysfunctions in the brain that happen as a result of the treatment for breast cancer. It also leads to osteoporosis and issues with fractures. And it's important to note that as many women die every year as a complication of a fracture as do die of breast cancer. So this is a statistic that we need to pay attention to. We need to pay attention to the fact that the number one threat to a woman's life, Even with a breast cancer diagnosis, isn't breast cancer, it's heart disease. And so if we are using a treatment that causes an even more fatal disease, we need to be mindful of that. So when we use widespread screening mammography and identify these people with these insignificant breast cancers and then commit them to treatment for breast cancer, this actually shortens their life instead of lengthening it. So we need a better way. There are other issues that go along with screening mammography. Over diagnosis is one of them, and over treatment the other. And of course, the fact that the radiation itself is causing breast cancer. So some of the breast cancers that we're seeing Are as a result of our screening mammogram program. Again, I know this is really hard to hear, and I know that this is not what you were told. You were told that mammograms save lives. And that is a very convenient slogan, but it just doesn't happen to be true. Mammograms are costing lives in the way of causing breast cancer, in the way of over diagnosis, and in the way of over treatment. Treating women for breast cancer that don't need to be treated, and then they have other things that come about from the treatment of breast cancer that actually shorten their lives and change, that significantly change the quality of their lives. I mean, ask any woman on an aromatase inhibitor what her quality of life is like, and she will tell you about the bone pain, the joint pain, depression, the lack of libido, the dry hair, the hair falling out, the losing skin, the. The. The mood swings, the sleep difficulty. I mean, life is not great on an aromatase inhibitor. And there are so many compliance issues with aromatase inhibitors because life is not great on an aromatase inhibitor. And many women will say the same thing about tamoxifen or similar things about tamoxifen, because these drugs just don't make you feel good. And it's very hard to take these drugs that don't make you feel good, because if you don't have a life that feels worth living, you're not going to take this drug. So we don't want to commit women to, To a process that is not helping them and is only hurting them. And it all starts with mammography. And this is why countries like Switzerland have abolished their mammographic screening programs, because they don't work, because they don't save lives, because they cause additional complications. And, you know, Denmark looked at their study populations, and they look at the population that screens and the population that doesn't screen. So they have large, very large population studies. They all have the same access to medical care. And there are no more deaths from breast cancer in women who don't screen. So if you're not saving lives, which we're not, no matter how many women we screen every year, the same exact number of women die of breast cancer every year in the United States. 40,000 women are going to die of breast cancer every single year in the United States, no matter how many women we screen. If it's not saving lives, if it's causing more cancers, then we really need to reevaluate and think about this. And though you can ask any radiologist if radiation causes cancer, and they will say yes. And then you ask them if mammograms cause cancer, and they will say no. So how is it possible? How is it even possible? This is not my information. I am just the messenger. But this is important information that we're just not talking about enough. And nearly 40% of the population who is eligible to screen chooses not to screen for all of these reasons, because screening mammograms are free. So it's very unlikely to be an access issue. They are choosing not to screen. Some of them because they don't want the pain, Some of them because they don't want the trauma.

Some.

Some of them because they don't want the radiation. Some of them have been through this system and know that it doesn't work or it's unreliable, or it's painful. I mean, we have to remember that 40% of the population are women with dense breasts. And mammogram will miss 40% of cancers in the population that has dense breasts. So this is not a good or effective test for 40% of the population. These numbers are unacceptable for a screening program, for a screening test, for a screening tool. We can't have a screening tool that's going to harm women, cause the very disease that we pretend to want to prevent and miss cancers in 40% of that population. It's clear that we need to abolish the mammographic screening program. It is not helping anyone. It is only hurting people. And it's time to do something else. Now, MRI was once believed to be a solution, but for anyone who has had an mri, you know that it is far from perfect. And there are many reasons why MRI cannot be our screening solution. So MRIs are cumbersome, they're uncomfortable. That is not the reason why. They take a long time. That is an issue. But we could certainly get past that issue if it were a viable screening tool. Access for MRI is a huge problem, though. I am very fortunate to live in a city where there are lots of MRI machines. There are lots of places in this country and abroad where people don't have access to mri. So access alone prevents it from being a screening tool. And then beyond that, for it to have validity in the breast, it requires gadolinium. Now, gadolinium is a heavy metal. We are told that gadolinium is safe. But what we have to remember is it is a heavy metal that is stored in the body. And when it is stored in the body, it is stored at the expense of something else. And it's always going to have an effect on the tissues that it's stored in. We know that heavy metals are not safe. We know that heavy metals cause lots and lots of chronic disease and can even lead to organ failure. So having a gadolinium based study every year is not safe and it's not possible for a screening test. So MRI is not a viable option. But I know that women want to do something. I know that just, just sitting and watching and waiting is not what you want. And so I'm going to propose some options for you today. And you need to do what makes you feel comfortable and listen. At the end of today, if you believe that mammogram is the right thing to screen, then that's what you should do. I am telling you that from my perspective, I do not believe mammogram to be safe, accurate or useful. And in Fact, I think the harms of mammogram far outweigh the benefits. I believe in self exam. I think that self examination is probably one of the best ways for you to know your body, understand your body, and to be in tune with what's happening with you. Self exam means that you know what your breasts look like, you know what your breasts feel like, you know what your normal is, and then you'll be able to recognize what is abnormal. I recommend doing self examination once a month. Self examination means that you are looking at your breast, you are feeling your breast, and it is something that timing matters in certainly in the premenopausal population. So if you're still getting your cycle, you should do your examination day seven of your cycle. So day one is whenever it started. And one week later is when you should examine your breasts. That's when they are the least stimulated. And so that is when the exam will be the, the easiest to do and the least confusing, let's say it like that. So I recommend that you stand in front of a mirror with your arms down by your sides and look at your breasts. You're looking for redness, dimpling, change in size, shape. And then I want you to put your arms up over your head and look again and again you're looking for redness, dimpling, change in the size or shape of the breast. Especially when you move your arms up. If you see something pulling the tissue in, that is what you're looking for. And then depending on the size of your breasts, some women can examine themselves when they're standing up. Other women can examine themselves in the shower or other women need. If you have larger breasts, you need to be lying down. And you lie down, you raise your arm over your head on the side of your, of this breast that you're examining. And you just go around your breast in a radial fashion. And I want you to use your fingertips. And they are the most sensitive part of your hand. And you're literally just going to move your fingertips around the breast in a radial fashion and go all the way around from outside to in. And you're looking for a bump in the road. And if you feel a bump in the road, that is a lump in the breast. And that is something that needs to be evaluated. Now, when I said that I don't think anyone should ever have a screening mammogram again, I don't mean that you're never going to have a mammogram again. Because if you find something in your breast that needs further evaluation, you need diagnostic studies. You need studies to tell you what is happening in your breast. And so in that case, I do recommend a mammogram. I recommend a diagnostic mammogram where they will isolate that area and look to see what it is they are probably going to add on an ultrasound, which increases the sensitivity of the testing. But that is an appropriate study, a diagnostic study. I do want to be clear that I recommend a lot of antioxidants before anyone gets radiation. So in general, I recommend melatonin, vitamin C, vitamin E, the tocopherols. So I actually I have a link to a protocol that I will make sure to post in the show notes so that you all can have access to it. But I never recommend a radiographic study, an X ray, a mammogram, a DEXA scan, a CAT stick scan, a PET scan. I never recommend undergoing a radiographic study without premedicating with antioxidants to try to bind up the free radicals that happen, the cellular damage that happens when you have a study. So back to when you find something. I agree you should go have diagnostic studies. I just don't agree with screening mammogram. So self examination is one option and I think that everyone should be doing that anyway. I know that the United States Prevention Task Force said that self examinations or the American Cancer Society said that self examinations are not necessary or not helpful. I don't believe that to be true at all. I think that they are very helpful and I think that if things are going to be clinically relevant, you are most likely going to be able to identify them on a self exam. Now, for some people, they want to do more and I get it, they want to do more. There's a lot of talk about thermography and there is actually a wonderful documentary called Boobs the Documentary. It's by a woman named Megan Smith. She totally unintentionally made this documentary. When in the course of making another documentary, you can google it and find it, we can try to put one of the links to it in the show notes. Don't google boobs. You will not be happy with what comes up. But if you google boobs the documentary or search whichever search engine you want to use Boobs the documentary, you can find it and watch that. It is further evidence on the problems with screening mammogram. But it also introduces thermography and ultrasound. Now, thermography gets a little bit of a bad rap because people advocate for it. For breast cancer screening. I want to be clear, thermography is not a screening tool for breast cancer, period. Thermography is not a screening tool for breast cancer. I know it is touted as one. It is not. Thermography is powered to find inflammation. Now, in some people, are inflammation and breast cancer associated? Yes, they are. But there are also people with slow growing breast cancers who do not have a significant inflammatory response and thermography will miss those. I believe in thermography, I think it's a really valuable test. I think you should know if you have inflammation happening in your body. I think it's an important way to maintain and promote your health. If you are going to use it as a breast cancer screening, you have to use it alongside another study like ultrasound. So I think that thermography has its values without question. It's just not a standalone tool. It's never a standalone tool unless all you're looking for is inflammation. But in general, what you would need is something in addition to that to help you identify what the consequences of that inflammation are or what the, what the root of that inflammation is. So it is a very valuable tool when used appropriately, not alone for breast cancer screening. And again, if you watch Boobs, the documentary, the documentary, it gives a great explanation of all of that. But I think all of this is going to be moot because the only thing that is for certain is change. And change is upon us. If you follow me, if you have been listening to me, you know that I'm talking about something called QT imaging. So QT is a novel way of imaging the breast. It is unlike anything else that is out there and it uses sound waves, circumferential sound waves, to create a three dimensional image of the breast that has 200,000 times more data points than MRI. It has 40 times the resolution of MRI and is fast, it's safe, it's radiation free, it's compression free and it will replace mammogram, MRI and anything else for breast cancer screening. They are not readily available yet, but they will be shortly. So just keep that on your radar and know that that is going to revolutionize breast cancer screening. Some people have asked me what is different than ultrasound and there's really no comparison between the studies. Whole breast ultrasound is a way to screen. Now, whole breast ultrasound will miss things like dcis, ductal carcinoma in situ. I am not certain that that is a downside, but the resolution of whole breast ultrasound and the resolution of ultrasound in general is so far below what QT's resolution is that you can't really compare the two. And the most Fascinating thing about QT is that it's a functional test. And what I mean by that is that if QT finds a lesion and it's not an obvious cancer.

You can.

Go back in 60 days. So a short interval study and have another scan and the cells can be counted. It has the resolution to count the cells and a doubling time can be measured. And we know that cancers have a doubling time of less than 100 days. And things that are benign or things that are inconsequential have a greater doubling time, a doubling time of greater than 100 days. So if you identify a lesion in the breast that has a doubling time of 200 or 300 days, you know that that's nothing to worry about and you just go again in another year for another study. Whereas if you have, if you have something that doubling time is less than 100 days, you know that that needs treatment and then you're sent for appropriate treatment. And that, that 60 days does not make any difference in terms of treatment or outcome or anything like that. So it's an inconsequential time for people who have an ambiguous lesion. If QT finds a cancer, you get recommended to go have treatment. Now, that may involve getting imaged all over again and again. I am not saying that no one will ever have another screening mammogram again. You may very well have diagnostic studies. I just. Oh, I'm, I'm sorry, I mixed that up. I am saying that you never need another screening mammogram again, but you may very well have diagnostic studies. So not only does QT prevent you from over treatment, but it's also saving women from being biopsied when they don't need a biopsy. Because if you know that you have something that is not going to affect you, that is not going to become a problem or be a problem, then you don't need a biopsy. So I, I know that QT is going to revolutionize breast imaging. You're going to be hearing more and more about it. Please send me your questions. I want to address them. I want to address any concerns that you have. I understand that people are afraid of new technology, but what I need you to know is you should be more afraid of the current technology, which is actually harming you. It's harming you and it's doing irreparable damage to thousands and millions of women. And it's time to stop this runaway train. It's time to stop causing the very disease that we pretend to want to prevent. It's time to start stop hurting the women that we pretend to care about, and it's time to start doing the right thing for patients instead of the right thing for industry. So I hope that this was informative. I hope that this was helpful. I'm sorry if this was disturbing, but it is disturbing and we have been operating under a system that doesn't work, that is very broken. And the time to stop is now. Send me your questions, send me your comments and I'll see you real soon. It's Dr. Jen. Bye for now.

Thank you for joining me on this episode of the Keeping abreast podcast with Dr. Chen. I hope you found the discussion informative and empowering. Remember, rest, health is health, so by staying informed and taking proactive steps, you have the power to optimize your well being. My team and I encourage you to apply the knowledge gained from today's episode to make positive changes in your life and share what you've learned with others. If you enjoyed this episode, please subscribe to our podcast and leave us a review. Your feedback and support mean the world to us and help us to reach more people who can benefit from these conversations. Stay connected with me on social media where I share additional resources, advice, updates and announcements related to breast health. You can find me on Facebook, Instagram and YouTube. Dr. Jenn Simmons and remember, my Jen has two ends, so until next time, remember to stay proactive, informed and confident in your breast health journey. The key to your health is you.