October is Breast Cancer Awareness Month, and we’re inundated with pink ribbons, urging us to be “aware” of breast cancer and encouraging women to get mammograms. Personally, I didn’t need to be made aware of breast cancer. It devastated my family about 40 years ago, when my father’s eldest sister, who was more like a mother to him, died of it after a long and horrible illness. About 10 years later, another of his sisters began her long and painful struggle against the disease that eventually claimed her life. Recently, some of my friends have undergone mastectomies. It would hard for me to be more aware that breast cancer exists.
What infuriates me is that the attempts to raise “awareness” of breast cancer systematically fail to tell women the single most important thing they can do to reduce their risk of dying of breast cancer: correct their diet. Instead, it urges them to do something that might have little or no effect on their survival: get an annual mammogram. It would be as if the efforts to educate the public about lung cancer all failed to mention cigarettes but instead just urged everyone in the population to get an annual chest x-ray.
By the mid 20th century, European and U.S.-trained doctors who were practicing in Africa and Asia realized that breast cancer is rare to practically nonexistent in populations that eat a low-fat, plant-based diet. By the end of the 20th century, epidemiologists knew that breast cancer mortality is strongly linked to the amount of animal protein that a population consumes. The more animal protein a population eats, the more likely its women are to die of breast cancer. Vegetables had the opposite effect. The more vegetables a population eats, the less likely their women are to die of breast cancer.
The data on breast cancer mortality boil down to a simple lesson: if women ate low-fat plant foods instead of a fatty, animal-based diet (including meat, milk, fish and eggs), they could dramatically reduce their risk of dying of breast cancer–and colon cancer, and heart disease, and diabetes, and autoimmune disease, etc. etc. etc. They’d even reduce their risk of getting varicose veins! Even if a woman already has cancer, a switch to a low-fat, plant-based diet might improve her chances of survival.
Instead of being given advice that will actually prevent breast cancer, women in the United States are urged to get a routine annual mammogram. Unfortunately, mammograms do absolutely nothing to prevent breast cancer, and they may do little or nothing to keep most women from dying of breast cancer. Worse yet, routine mammography may lead to unnecessary surgical procedures in women who don’t have cancer.
The decision of who should undergo mammography and when they should undergo it is complicated. The next time you hear someone urging all women of a certain age to have annual screening mammograms, consider the following:
- Mammography involves exposing the breast to x-rays and thus might actually cause some cancers. The x-rays could pose a particular problem for young women and women with a genetic predisposition to breast cancer.
- The breast is typically squashed flat while the mammogram is being taken. Not only does this compression hurt, it could break up a precancerous lesion, turning it into a deadly invasive cancer.
- Mammography is less useful for finding cancers in the breasts of premenopausal women because their breast tissue is denser.
- By the time a cancer is large enough to be seen by mammography, it may already have spread.
- Mammograms often cause false alarms by bringing attention to harmless benign lesions, as well as to cancerous tumors that would have gone away by themselves if left untreated. Unfortunately, the woman has to undergo the pain and expense and risk of a surgical biopsy to find out whether the lesion is benign or not, and she’ll never know whether her body’s immune system would have destroyed a tumor before it caused any problems.
Many studies have failed to show that routine screening mammography provides any benefit in terms of saving lives. As a result, some experts argue that it is a pointless and cruel waste of medical resources to urge all women to have annual screening mammography. Even the value of routine breast self-examination has been questioned. Nevertheless, mammography could still be valuable for many individual patients, depending on the situation. The real question is when and how often and for whom it should be used.
Photo by maf04