Jenn Simmons, MD argues that current imaging-based cancer screening (mammography for breast cancer, screening for prostate cancer) rests on a false, linear-growth model. She states breast cancer growth is neither linear nor predictable, so imaging preferentially detects indolent, non‑life‑threatening cancers while missing biologically aggressive disease. Simmons advocates focusing on tumor biology and inflammatory markers (she cites use of the ARIA test) and using clinical exam alongside biologic tests. She offers a ‘safe and effective breast cancer screening’ guide on request.
Chapters
President Biden's recent diagnosis of metastatic prostate cancer is the perfect example of how our screening program is not doing what we think it's doing. And this is especially true in the area of breast cancer. Using mammogram to screen. We think that breast cancer growth is both linear and predictable. So that a breast cancer starts as something that's really small and it grows to some critical size, at which point it is more likely to metastasize. So if you screen and you find it before it reaches that critical size, you can save lives and save breasts. It's a very logical theory, and the same thing is being applied in the world of prostate cancer. But like prostate cancer, and like breast cancer, this theory is simply not true. It's very logical, it's very believable. It just doesn't happen to be true. Breast cancer growth is neither linear nor predictable. So it is all about biology. And a breast cancer is what it is from the very beginning. So if you catch it when it's really small, if it's an aggressive process, it doesn't matter. And the only thing that mammogram is good at catching are cancers that are not aggressive and not life threatening. So we need to relearn this paradigm and we need to focus on biology. That is why I don't use imaging alone to screen for breast cancer, and I don't rely on imaging alone to help me make my decisions. That is primarily why I certainly use physical examination, because clinically positive disease is meaningful when you can feel it. But I use the ARIA test because that is talking about biology that is measuring markers of inflammation. And we know very, very early, before a tumor would even develop if the inflammatory precursors of breast cancer are there. So if you want to learn about how to screen safely and effectively, comment safe in the comments and I will send my safe and effective breast cancer screening guide because what we're doing now is not working.
