There is no doubt that the present climate regarding routine mammography is that both patients and physicians demand them or feel guilty if for whatever reason they are not riding the periodic mammogram bandwagon.
Once mammography received FDA approval and support of the National Cancer Society, the average primary care physician became a pawn for the burgeoning cancer industry under the assumption that the very best scientific minds had come up with the very best recommendations. Who were we to argue?Despite my 23 years of clinical practice as a family doctor ( retired 1994 ) with Board certification in both family practice and preventive medicine, I didn't know these figures. Once you read them and look at his resources and documentation there can be no argument. Now my only question is how can one put the brakes on this rapidly rolling juggernaut?
You may recall my aphorism, "figures don't lie but liars figure". Think about this when you read the following statement: "1 in 9 women will get breast cancer".. Innocent enough - right? In what way could this be a lie? The media says it repeatedly, the mammography industry quotes it almost daily and even medical articles refer to it as the lifetime risk for women. I cannot think of a better scare tactic to drive women into mammography screening centers.
The reality is that this simple statement is grossly misleading - not technically a lie but far, far removed from the truth. This is like questioning a child on his way to become a lawyer about the empty cookie jar. "Did you steal the cookies? The child says, "No", then afterwards explains, "I just borrowed them."
Now let us examine the true picture of Doctor Kauffman's presentation, a must read for every doctor and a sobering education. If 1,000 women of ages 40-50 had periodic mammograms what would be the impact, the true effect on public health, the real results? We know from years of observation and statistics that 8 of these women will actually have breast cancer. Seven of these positives will be found by mammography. The other will be missed. Of the 992 women who do not have breast cancer, 70 will be identified as falsely positive.
Of the total of 77 "positives" discovered by our much touted, periodic mammography program, only 9 will be correct. Applying the legal term of "Res ipso loquitor", if one but just looks at the figures "the thing speaks for itself". This is the test now firmly entrenched in American society. It is truly mind-boggling to try to fathom how this has come about. Read on. Kauffman's story is a true public service.
Duane Graveline MD MPH
Former USAF Flight Surgeon
Former NASA Astronaut
Retired Family Doctor