Causes of Breast Cancer may Include Mammograms / Environment News Service

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Environment News Service: Avoidable Causes of Breast Cancer May Include

Mammography[Paranormal_Research] Causes of Breast Cancer may Include

Mammograms / Environment News Service

 

 

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Avoidable Causes of Breast Cancer May Include Mammography

 

WASHINGTON, DC, February 20, 2002 (ENS) - Mammography centers around

the country have been scaling back operations and closing their doors for the

past two years because of inadequate insurance reimbursements. The trend comes

at a time when a growing population of older women is increasing the demand for

the radiological breast exams. But a prominent cancer prevention physician warns

that mammography is a risky, unreliable, profit driven technology.

 

Breast cancer is the second most common cancer affecting women in

the United States, with over 200,000 new cases diagnosed each year.

 

Currently, the average cost of a mammogram is between $90 and $100,

and Medicare only reimburses $82 for the procedure. The private insurance

reimbursement rate is somewhat lower. According to the American College of

Radiology, nearly 400 mammography programs nationwide have been forced to close

since March of last year, 40 of them in New York State.

 

 

 

New York Senator Chuck Schumer (Photo courtesy Office of the

Senator)

" Thousands of women across Westchester County could be forced to

wait months for mammograms because there aren't enough radiology centers that

can afford to screen them, " said New York Senator Chuck Schumer, a Democrat.

The New York senator is co-sponsoring legislation with Senator Tom

Harkin, an Iowa Democrat, that would raise Medicare reimbursement rates to more

accurately reflect the cost of the procedure. " The bottom line is that we need

to raise reimbursement rates, which would keep mammography centers open and

provide incentives to attract the next generation of radiologists, " Schumer

said.

 

But cancer prevention physician Dr. Samuel Epstein, professor of

environmental and occupational medicine at the University of Illinois-Chicago

School of Public Health, says mammograms are at best ineffective in detecting

cancers, and at worst, may themselves trigger cancers. The safe, effective, low

cost route to cancer prevention, he says, is monthly breast self examinations

(BSE) coupled with annual clinical breast examinations (CBE) and education about

the avoidable causes of cancer.

 

" Mammography poses a wide range of risks of which women worldwide

still remain uninformed, " warns Dr. Epstein who is chairman of the Cancer

Prevention Coalition.

 

 

 

Dr. Samuel Epstein (Photo courtesy Naturally Healthy)

In a September 2001 article published in the International Journal

of Health Services, Dr. Epstein claims that radiation from mammography " poses

significant cumulative risks of initiating and promoting breast cancer. "

" 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 radiation absorbed dose (rad) - the routine

practice of taking four films for each breast results in some 1,000 fold greater

exposure, one rad, focused on each breast rather than the entire chest, " Dr.

Epstein writes.

 

Premenopausal women who get annual mammograms for 10 years are

exposed to a total of about 10 rads for each breast, " each rad of exposure

increasing breast cancer risk by one percent, " he writes.

 

New experimental findings reported this week by Lawrence Berkeley

National Laboratory cell biologist Mary Helen Barcellos-Hoff support Dr.

Epstein's warnings.

 

Barcellos-Hoff showed that exposure to ionizing radiation creates a

microenvironment in the tissue surrounding breast cells that can cause even

nonirradiated cells and their progeny to become cancerous. " Radiation exposure

can cause breast cancer by pathways other than genetic mutations, " said

Barcellos-Hoff who presented her study in Boston this week at the annual meeting

of the American Association for the Advancement of Science.

 

Barcellos-Hoff and her team focused on the signaling - crucial to

normal functioning - that takes place between a cell and the microenvironment of

its surrounding tissue. The director of Berkeley Lab's Life Sciences Division,

Mina Bissell, has shown that breakdown in these communications can initiate the

cancer process.

 

" Our data is pointing to the tissue surrounding breast cells as a

primary target of ionizing radiation damage, " Barcellos-Hoff said.

 

Radiation damage to this surrounding tissue generated signals that

changed how the breast cells' genomes were expressed. A new cell type was

created with physical characteristics that were cued to act cancerous by the

signals coming from outside the cell.

 

 

 

A normal breast as it appears in a mammogram (Photo courtesy McGill

University School of Medicine)

The discovery suggests new and possibly more effective means for

preventing breast cancer. " Repairing damaged tissue so that it once again

suppresses instead of promotes carcinogenesis is a simpler strategy for stopping

the cancer process, compared to trying to repair individual damaged cells, " says

Barcellos-Hoff.

But Senator Schumer says he is concerned for the health of New York

women who must wait as long as four or five months to get a mammogram. " Early

detection is the key to treating the disease effectively and routine mammograms

reduce the risk of dying from breast cancer by 40 percent. "

 

" These shortages are putting thousands of Westchester County women

at risk because delayed diagnoses often result in tumors being detected at less

treatable stages, " the senator says.

 

" We need to push this bill through Congress and get it to the

President's desk immediately because when it comes to treating breast cancer,

every day counts, " Schumer said of the Assure Access to Mammography Act, first

introduced in March 2001.

 

But mammography is " not a technique for early diagnosis, " says Dr.

Epstein, who points out that the radiological screenings miss many cancers, and

mistakenly diagnose other conditions as cancer, particularly in premenopausal

women.

 

" Overdiagnosis and subsequent overtreatment are among the major

risks of mammography, " he warns.

 

" Despite long-standing claims, the evidence that routine mammography

screening allows early detection and treatment of breast cancer, thereby

reducing mortality, is at best highly questionable, " writes Dr. Epstein. He

quotes a 1997 study by M. Napoli published as a monograph by the Journal of the

National Cancer Institute that concluded, " the overwhelming majority of breast

cancers are unaffected by early detection, either because they are agressive or

slow growing. "

 

 

 

This is a fine needle aspirate of a breast mass that contains both

benign (left) and malignant (right) cell clumps. The benign cells are small,

uniformly sized and shaped. The cancerous cells are larger and vary in size and

shape. (Photo courtesy University of Wisconsin-Madison, Dept. of Surgery, Dr.

William Wolberg Tutorial )

No nation other than the United States routinely screens

premenopausal women by mammography, although professional associations are

divided on the need to do so. The American Cancer Society acknowledged in 1985

that most breast cancers are found by the women affected. " We must keep in mind

the fact that at least 90 percent of the women who develop breast carcinoma

discover the tumors themselves, " the society said.

Effective self examination for breast cancers " critically depends on

careful training by skilled professionals, " and confidence is enhanced with

annual clinical breast exams by experienced professionals, Dr. Epstein

emphasizes.

 

A " large-scale crash program " for training nurses in how to perform

clinical breast exams and how to teach breast self examination is immediately

needed, particularly for underinsured and uninsured women in the United States

and in developing countries, he urges. Clinics offering this training " could be

established nationwide, and eventually worldwide " in schools, community

hospitals, churches, synagogues and mosques, he envisions.

 

These clinics could also serve as sources of reliable information on

how to reduce the risks of breast cancer. " From an environmental standpoint, "

says Dr. Epstein, " the most important thing is the contamination of animal and

dairy fats with carcinogenic industrial pollutants. That's a very major source.

Living near hazardous waste sites in another major thing, living near industry. "

 

" In your body fat and in my body fat, there's probably about 150 to

200 carcinogenic industrial pollutants, " he said. " And animal and dairy fats,

they concentrate the stuff. They are mainly chlorinated hydrocarbon pesticides,

PCBs, they're aldrin, dieldrin, chlordane, heptachor, DDT which have permeated

the totality of our environment, our air, our water, our workplace, in the North

Pole you find them. "

 

 

 

GE 800T mammogram system at Memphis, Tennessee's Delta Medical

Center (DMC) (Photo courtesy DMC)

In the senator's view, the problem is financial. " The average

increase in the Medicare rate - 1.5 percent per year between 1997 and 2000 - has

lagged far behind the medical inflation rate. Since other government insurance

programs and private insurers base their reimbursement rates on Medicare, low

Medicare rates create a ripple effect which lead mammography clinics to receive

insufficient reimbursements from private and government insurers alike, " he

said.

Dr. Epstein too acknowledges that the costs of mammography are high

and rising. " The dangers and unreliability of mammography screening are

compounded by its growing and inflationary costs, " he writes, citing an annual

cost of $10 billion if all women, both before and after menopause were screened

annually.

 

" Such costs will further increase some fourfold if the industry,

enthusiastically supported by radiologists, succeeds in its efforts to replace

film machines, costing about $100,000, with the latest high tech digital

machines, approved by the FDA [Food and Drug Administration] in November 2000,

costing about $400,000, " he writes.

 

But while the senator would fund the increasing costs of

mammography, the doctor would have women utilize low cost breast self

examinations supplemented by annual clinical exams and education about the

environmental factors that contribute to the disease.

 

 

 

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