What Doctors Don’t Tell You About Breast Cancer: Half the time it’s not cancer at all

[Guest guest]

http://healthy.net/scr/column.asp?Id=609

 

What Doctors Don’t Tell You About Breast Cancer:

Half the time it’s not cancer at all

 

© What Doctors Don't Tell You ,

 

Breast cancer is the second biggest lady killer in the

Western world. Most experts believe the causes are

almost certainly to be found in the environment -

particularly with the latest disclosure that most

women with breast cancer have high traces of parabens

in their breasts (Horm Res, 2003; 60 [suppl 3]: 50).

 

Some of the highest breast cancer rates are found in

the US, where breast cancer strikes one in every nine

women, and 40,000 Americans die of it every year.

 

The bare statistics seem frightening, and have been

used by doctors to press-gang women into being tested

for breast cancer as early as possible. In the US,

screening for breast cancer has become a huge

money-making industry - but what if the figures are

wrong? What if medicine is seriously overdiagnosing as

cancer a condition that is essentially harmless?

 

During the last 10 years, breast screening has been

called into question largely over basic questions of

accuracy. In fact, a growing number of experts believe

that the advent of breast-cancer screening has created

a problem where none may actually exist, labelling and

treating many conditions as cancer which aren’t

serious or life-threatening.

 

The astonishing fact is that fully half of all cases

of so-called ‘breast cancer’ might not be cancer at

all, but a harmless abnormality that will never

progress to cancer. In some 40,000 cases in the US,

women could be being wrongly treated for cancer.

 

What is breast cancer?

Breast cancer is a growth of undifferentiated cells in

the breast area usually causing a lumpy tumour.

However, the overwhelming majority - some 80 per cent

of breast tumours - is not cancerous. The first stage

of one type of cancer is believed to be when a milk

duct or lobule is invaded by microscopic

calcifications. Most of these are so tiny that they

cannot be seen or felt, and are only detectable on a

mammogram. The calcifications are believed to be the

precursors of cancer, but they are not in themselves

cancerous. Nevertheless, they are somewhat

misleadingly called ‘carcinomas in situ’ (CIS), which

means ‘cancers in place’. Doctors refer to the

calcifications that occur in lobules as ‘LCIS’ and the

ones in ducts as ‘DCIS’, which is much the more common

diagnosis of the two.

 

Before mammography, DCIS was virtually unknown, but it

now accounts for up to 50 per cent of breast cancer

diagnoses. The conventional view is that identifying

DCIS is a good thing as it picks up cancer in the

early stages, thus enabling treatment to prevent the

cancer from developing.

 

At least, this is the message given to patients, but

some experts are beginning to question the whole

philosophy.

 

'Doctors should make it clear that DCIS is not cancer;

it is only a possible precancer,' says Dr Eric Wiener,

head of breast oncology at the Dana-Farber Cancer

Institute in Boston, Massachusetts.

 

The plain fact is that most DCIS does not become

cancerous - a finding made by pathologists doing

autopsies on women who had died of something else.

Post mortems show that many women may have DCIS

harmlessly in their breasts for years; it is only when

DCIS spreads out beyond the duct (it is no longer ‘in

situ’) that cancer might begin. The problem is that

doctors don’t know what types of DCIS break out and

become carcinogenic, or even how often DCIS turns into

cancer. If left untreated, some DCIS will break out

and cancer will develop. But these cases are by far

the minority. Most DCIS causes no problems at all.

Nevertheless, doctors almost universally recommend

treatment, arguing that it is always ‘better to be

safe than sorry’.

 

Cancer statistician Dr Donald Berry, head of

biostatistics at the M.D. Anderson Cancer Center in

Houston, Texas, labels this ‘knee-jerk’ medicine.

 

In the hard-hitting article ‘Epidemiology versus

scare-mongering’, UK cancer expert Professor Michael

Baum attacked health professionals for scaring women

into unnecessary treatment. Baum has 30 years of

experience as a breast-cancer surgeon at the Royal

Free Hospital and, in his view, if left untreated, as

many as 80 per cent of all DCIS cases will never

become cancerous (Breast J, 2000; 6: 331-4).

 

This is backed up by American research aimed at

quantifying the true risks of DCIS. Cancer

statistician Dr Virginia Ernster, at the University of

California at San Francisco, looked back over the

death statistics of about 7000 women who had been

diagnosed with DCIS, both before and after screening

had become widespread. She found that, before the

advent of screening, only 3.4 per cent of the women

died of breast cancer, with the figure dropping to 1.8

per cent after its introduction. In either case, the

'risk of death was low', commented Dr Ernster (Arch

Intern Med, 2000; 160: 953-8).

 

The usual treatment for DCIS is a combination of the

three standard anticancer weapons - surgery,

chemotherapy and radiation, often disparagingly dubbed

‘cut, poison and burn’ by their detractors. Although

DCIS is not breast cancer, its treatment regime is

similar to what is given for the full-blown disease.

Doctors will either recommend surgery to remove the

so-called diseased part (lumpectomy) or even to remove

the whole breast (mastectomy), followed by

chemotherapy and/or radiation (Am J Nurs, 2001; 101:

11).

 

Nevertheless, a recent review of the evidence by

cancer expert Maryann Napoli came to a stark and

dramatic conclusion: there is no benefit whatsoever

from any conventional treatment for DCIS. Napoli, who

runs the Center for Medical Consumers in New York,

surveyed the US mortality rates in women diagnosed

with DCIS, and found that just 1 per cent of them died

from breast cancer - whether their DCIS was treated or

not (Am J Nurs, 2001; 101: 11).

 

'Seventy per cent of women with a DCIS diagnosis are

being overtreated and getting all the downsides of

treatment - surgical scars, side-effects of surgery,

radiation and tamoxifen,' says Professor Susan Love,

cancer expert at the University of California at Los

Angeles.

 

Article supplied by What Doctors Don’t Tell You, a

subscription monthly newsletter and information

resource on health and medicine. Find out more by

visiting the website www.wddty.com.