Is breast cancer being over-diagnosed?

There is no question that the advent and spread of mammograms led to an increase in early detection of breast cancer, and that early detection and diagnosis of cancer has been proven to result in better treatment outcomes and longer survival times.

However, when reviewing statistical information for breast cancer something about the numbers doesn’t quite add up.

According to research published in the November 22, 2012 issue of The New England Journal of Medicine, screening mammography correlated with a doubling of cases of early-stage breast cancer detected each year (from 112 to 234 cases per 100,000 women). At the same time there was only an 8 percent decrease in the rate at which women are diagnosed with late-stage cancer (from 102 to 94 cases per 100,000 women).

There are only two ways to explain these numbers: either the incidence of breast cancer is growing at an alarming rate – which does not appear to be the case – or many women who do not have cancer at all are told they have it.

Researchers who conducted this study reached the conclusion that – assuming that the incidence of breast cancer is stable – women are being overdiagnosed with early-stage breast cancer by as much as 31%. In fact, only eight of the 122 additional women diagnosed with early-stage breast cancer every year as a result of mammograms actually have a form of breast cancer that could develop into the advanced disease.

This may reveal a weakness in the diagnostic process for cancer, which relies entirely on pathology reports to identify the presence of disease. It is known that cancer cells that look identical under the microscope can express different genetic traits that make them more or less likely to grow and turn into invasive and deadly cancer. Genetic testing of cancer cells that would identify these differences is not yet practiced on a general basis.

Read about this study here:

I am not discouraging women from having mammograms or saying that early diagnosis or pathology reports are of no value

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, but it may be useful to correlate results with new detection techniques, including certain emerging blood tests. One of these, called Cancer Profile, measures markers in blood that – if present – can indicate that a person has some form of cancer in his or her body, or that they are at increased risk of developing it.

The good news about this test is that the markers that are measured can be modified and even brought back into the normal range through simple interventions that include diet, supplements and lifestyle factors.

This test requires a simple blood draw and is not extremely expensive. I have been making it available to patients who request it for several years now. I’ve written about it before in my newsletter and you can find my article here: Beyond colonoscopies. You can also read about the test and the science behind it here:

If you or someone you know is interested in doing this test, do not hesitate to let me know. For anyone who has experienced a bout with cancer, or is at increased risk of developing the disease, screening once a year with this test is probably not a bad idea.

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