On February 9, the Food and Drug Administration announced that it would take stringent action to regulate "the most potent forms of medical radiation," particularly those from increasingly popular CT scans. The FDA is to be commended for warning that such radiation is unsafe and equivalent to that about of 400 chest X-rays, 0.4 rads (radiation absorbed dose), and "can increase a person's lifetime cancer risk."
However, the FDA remains strangely unaware that radiation from routine premenopausal mammography poses significant and cumulative risks of breast cancer. This is also contrary to conventional assurances that radiation exposure from mammography is trivial, about 1/ 1,000 of a rad, and similar to just that from a chest X-ray. However, the routine practice of taking two films of each breast results in exposure of about 0.4 rads, focused on the breast rather than on the entire chest. Thus, premenopausal women undergoing annual screening over a ten-year period are exposed to a total of at least four rads for each breast, at least eight times greater radiation than FDA's "cancer risk" level. Such high radiation exposure approximates to that of Japanese women living approximately one mile away from the site of the Hiroshima atom bomb explosion.
This alarming information is not new. In 1972, the prestigious National Academy of Sciences warned that the overall risks of breast cancer increase by one percent for every single rad exposure. This totals a 10 percent risk from 10 years annual premenopausal mammography. This warning was emphasized in my 1978 The Politics of Cancer, "Whatever you may be told, refuse routine mammograms, especially if you are pre-menopausal. The x-rays may increase your chances of getting cancer."
A 1993 Swedish study involving 42,000 women showed that those under the age of 55 who received regular premenopausal mammography experienced a 29 percent greater risk of dying from breast cancer. Based on a detailed review of these and a wide range of other such studies, the late Dr. John Gofman, the leading international authority on medical radiation, published an analysis in his classic 1995 book, Preventing Breast Cancer. He stressed that medical radiation is probably the single most important cause of the modern breast cancer epidemic.
These warnings were further detailed in a 2001 article, with some 50 scientific references, "The Dangers and Unreliability of Mammography: Breast Self Examination As A Safe Effective and Practical Alternative," published in the prestigious International Journal of Health Services. This was co-authored by Dr. Rosalie Bertell, a leading international expert on the dangers of radiation, the late Barbara Seaman, founder and leader of the women's breast cancer movement, and myself. An analysis of several 1993 studies showed that women who regularly performed monthly breast self-examination (BSE), particularly following training by qualified nurses, detected their cancers much earlier than those who failed to do so. That most breast cancers are first recognized by women themselves was even admitted by the American Cancer Society (ACS) as early as 1985. "We must keep in mind that at least 90 percent of women who develop breast cancer discover the tumors themselves."
The International Journal of Health Services article further stressed that cancer risks from mammography are up to fourfold higher for the two percent of women who are silent carriers of a gene known as the A-T (ataxia-telangiectasia), and highly sensitive to the carcinogenic effects of radiation. This accounts for up to about 20 percent of all breast cancers diagnosed annually.
These wide range of concerns on the still unrecognized dangers of routine premenopausal mammography are critical, especially in view of the current high incidence of breast cancer. Disturbingly, this has increased by about twenty percent since 1975 in spite of routine premenopausal mammography, and its multi-billion dollar insurance costs. Such funds should instead be directed to establishing BSE training clinics nationwide.
Five radiologists have served as presidents of the ACS. In its every move, the ACS promotes the interests of the major manufacturers of mammography machines, particularly the latest digital machines. These are four times more expensive, but no more effective than the film machines.
The mammography industry conducts "research" for the ACS and its grantees, serves on its advisory boards, and donates considerable funds. In virtually all its actions, the ACS has been and remains strongly linked with the industry. An ACS communications director admitted the obvious in a 1999 article published by the Massachusetts Women's Community's journal Cancer. "Mammography today is a lucrative [and] highly competitive business."
Not surprisingly, the prestigious Chronicle of Philanthropy, the nation's leading charity watch dog, has warned the obvious. The ACS "is more interested in accumulating wealth than saving lives." A national boycott of the ACS is well overdue.
Samuel S. Epstein, M.D.
Professor emeritus Environmental & Occupational Medicine
University of Illinois Chicago School of Public Health
Chairman, Cancer Prevention Coalition
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