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Avoidable Exposures: Patients


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Dangers of Mammography

Mammography poses a wide range of risks of which women worldwide still remain uninformed. Read “Mammography’s Mixed Blessings” by Seaman and Epstein

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Radiation Risks
Radiation from routine mammography poses significant cumulative risks of initiating and promoting breast cancer (1– 3). Contrary to conventional assurances that radiation exposure from mammography is trivial— and similar to that from a chest X-ray or spending one week in Denver, about 1/ 1,000 of a rad (radiation-absorbed dose)— the routine practice of taking four films for each breast results in some 1,000-fold greater exposure, 1 rad, focused on each breast rather than the entire chest (2). Thus, premenopausal women undergoing annual screening over a ten-year period are exposed to a total of about 10 rads for each breast. As emphasized some three decades ago, the premenopausal breast is highly sensitive to radiation, each rad of exposure increasing breast cancer risk by 1 percent, resulting in a cumulative 10 percent increased risk over ten years of premenopausal screening, usually from ages 40 to 50 (4); risks are even greater for "baseline" screening at younger ages, for which there is no evidence of any future relevance. Furthermore, breast cancer risks from mammography are up to fourfold higher for the 1 to 2 percent of women who are silent carriers of the A-T (ataxia-telangiectasia) gene and thus highly sensitive to the carcinogenic effects of radiation (5); by some estimates this accounts for up to 20 percent of all breast cancers annually in the United States (6).

Cancer Risks from Breast Compression
As early as 1928, physicians were warned to handle "cancerous breasts with care— for fear of accidentally disseminating cells" and spreading cancer (7). Nevertheless, mammography entails tight and often painful compression of the breast, particularly in premenopausal women. This may lead to distant and lethal spread of malignant cells by rupturing small blood vessels in or around small, as yet undetected breast cancers (8).

Delays in Diagnostic Mammography
As increasing numbers of premenopausal women are responding to the ACS's aggressively promoted screening, imaging centers are becoming flooded and overwhelmed. Resultingly, patients referred for diagnostic mammography are now experiencing potentially dangerous delays, up to several months, before they can be examined (9).

REFERENCES

1. Gofman, J. W. Preventing Breast Cancer: The Story of a Major Proven Preventable Cause of this Disease. Committee for Nuclear Responsibility, San Francisco, 1995.

2. Epstein, S. S., Steinman, D., and LeVert, S. The Breast Cancer Prevention Program, Ed. 2. Macmillan, New York, 1998.

3. Bertell, R. Breast cancer and mammography. Mothering, Summer 1992, pp. 49– 52.

4. National Academy of Sciences– National Research Council, Advisory Committee. Biological Effects of Ionizing Radiation (BEIR). Washington, D. C., 1972.

5. Swift, M. Ionizing radiation, breast cancer, and ataxia-telangiectasia. J. Natl. Cancer Inst. 86( 21): 1571– 1572, 1994.

6. Bridges, B. A., and Arlett, C. F. Risk of breast cancer in ataxia-telangiectasia. N. Engl. J. Med. 326( 20): 1357, 1992.

7. Quigley, D. T. Some neglected points in the pathology of breast cancer, and treatment of breast cancer. Radiology, May 1928, pp. 338– 346.

8. Watmough, D. J., and Quan, K. M. X-ray mammography and breast compression. Lancet 340: 122, 1992.

9. Martinez, B. Mammography centers shut down as reimbursement feud rages on. Wall Street Journal, October 30, 2000, p. A-1.

Excerpted from “Dangers and Unreliability of Mammography: Breast Examination is a Safe, Effective and Practical Alternative”, in
International Journal of Health Services, Volume 31, Number 3, Pages 605– 615, 2001 2001, Baywood Publishing Co., Inc. See the entire article



 


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