31 Days of “Little Known” FACTS — For Breast Cancer Awareness Month — Day 20 — Misleading Statistics

Did you know…

Statistics are often used for breast cancer screenings and treatments that mislead the public into thinking the benefit is way better than it actually is.

“We often hear news reports that something has been found to reduce the risk of breast cancer, or reduce the risk of dying from breast cancer. These reports are often misleading because they use numbers representing relative risk reductions.  Absolute risk reduction is what really matters, which is often much lower, and often not reported. What is the difference?

Relative vs Absolute Risk

“Relative risk is used to compare risks between two groups, whereas absolute risk stands on its own. Here is an example: Say there is a clinical trial evaluating a new drug that will prevent breast cancer, and 200 women have signed up. In the control group, 100 women received a placebo pill and two developed breast cancer. In the treatment group, 100 people received the drug and only one person developed breast cancer. The two groups are compared – two developed breast cancer in the control group vs one in the treatment group. A 50% reduction in breast cancer! That sounds pretty good. People who want to avoid breast cancer might consider taking this drug, even if there are side effects. But the reality is that the absolute risk reduction was much smaller. If the risk of developing breast cancer at all was 2%, taking the drug may lower the risk to 1%. So a 1% change in absolute risk of breast cancer might not seem worth it if there are side effects to the drug.”

Below is an excellent video explaining how marketing messages may state “Mammograms reduce breast cancer death by 20%…”

But did you know…this translates into only 1 life saved out of 1,000 women…

See below “fact box” as another good example using absolute #s from Harding Center for Risk Literacy:

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31 Days of “Little Known” FACTS — For Breast Cancer Awareness Month — Day 19 — Celebrities & Mammography Advice

Did you know….

#1. Companies use celebrities to aggressively market 3D mammograms, although there’s no evidence they save lives.

In July 2016, Health News Review wrote:

Sheryl Crow hawks 3D mammograms with fear and false hope

“It may not be her favorite mistake, but it was a mistake nonetheless for the singer and breast cancer survivor Sheryl Crow to advocate in an aggressive, unbalanced way on behalf of a 3D mammography device.

That’s the takeaway of a number of breast cancer experts who’ve reviewed the content of the manufacturer-sponsored “education campaign” and Crow’s statements regarding breast cancer screening. They found blatant abuse of statistics and misleading guidance about the appropriate role of mammography screening in breast cancer prevention and treatment.

Fast forward to Oct 18, 2019, USA Today: Massive marketing muscle pushes 3D mammograms, despite no evidence they save more lives, investigation shows

“Yet newer tech isn’t necessarily better – and it can cause harm, said Dr. Otis Brawley, a professor at John Hopkins University. “It’s unethical to push a product before you know it helps people,” he said.

#2. Celebrities influence public opinion

Prevention.com did a good job calling celebrity chef Sandra Lee in Why Getting A Mammogram May Cause More Trouble Than It’s Worth:

“After a routine mammogram found that she had stage 0 breast cancer, TV chef and cookbook author Sandra Lee started soap-boxing.

“I don’t care if my niece is only 23,” she said on Good Morning America when she revealed her diagnosis and her plan to get a double mastectomy. “Girls in their 20s and 30s just have to know. If you’re sitting at home right now watching this… get your rear end in there and get a mammogram right now.”

This is singularly bad advice. There’s little evidence that all women need a mammogram right now. If you’re a woman under 40, in fact, getting a mammogram is far more likely to harm your health than to help it. That’s largely true for women between 40 and 49 as well. “

The problem is not when a celebrity makes a personal decision to have extremely aggressive treatments, it’s when a celebrity goes public and gives medical advice on TV and gets a film produced about her opinion on early detection — and is invited to speak at conferences and events.

While it’s great that Sandra Lee is happy with her double mastectomies for her DCIS, celebrities should not be giving medical advice on major TV news programs — especially without giving an alternative, less aggressive approach and perspective for this controversial topic.

In 2015, Celebrity chef Sandra Lee was told by her doctors she was “a ticking time bomb.  I was inspired to write a response:

DCIS is NOT a “Ticking Time Bomb” — What Women Really Need to Know

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31 Days of “Little Known” FACTS — For Breast Cancer Awareness Month — Day 18 — Fear vs Facts

Did you know…

Your breasts might kill you?

That’s the message put forth by the video below… urging women to get a mammogram every year starting at 40. This advice tells women to ignore the scientific evidence and guideline recommendations from the U.S.Preventative Services Task Force

Where is the information about the risks, harms and limitations of mammography?

Watch Donna Pinto’s story in this ABC investigative report.

Donna created #BeW I S E — a woman’s health initiative with an urgent public health mission — to ensure all women are properly informed about serious potential harms of breast cancer screening.

Review Be WISE information and videos.

Make your own informed choice.

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31 Days of “Little Known” FACTS — For Breast Cancer Awareness Month — Day 17 — Radical Remission

Did you know…

Over 1500 cases of “radical remission” have been analyzed and documented by Dr. Kelly Turner, author of New York Times bestseller, Radical Remission: Surviving Cancer Against All Odds.

“Radical remission” is a term that refers to remission that occurs either without conventional medical treatment, after conventional treatment has failed to work, or when conventional and complementary methods are used in conjunction to overcome a dire prognosis.

Hear the story behind the book:

What is the Radical Remission Project?

The Radical Remission Project was born out of Dr. Kelly Turner, PhD’s dissertation research on Radical Remission (RR). As Dr. Turner began to research RR as part of her PhD from the University of California at Berkeley, she realized that the opinions of two groups of people were typically missing from the 1,000+ cases of RR published in medical journals – 1) the survivors themselves, and 2) alternative healers. Because Western doctors do not currently have an explanation for why RR’s occur, Dr. Turner decided to ask these two ignored groups what they think can lead to a Radical Remission. Her dissertation research involved a year-long trip around the world during which she traveled to 10 different countries in order to interview 20 Radical Remission survivors and 50 alternative healers about their techniques for healing cancer. Since then, her research has continued, and Dr. Turner has now analyzed over 1,500 cases of Radical Remission.

Find Radical remission stories or share your story

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31 Days of “Little Known” FACTS — For Breast Cancer Awareness Month — Day 16 — Dairy May Increase Breast Cancer Mortality Risk

Did you know…

Studies have linked dairy products to an increased risk of breast cancer mortality.

“Dairy cheese contains reproductive hormones that may increase breast cancer mortality risk.”

That’s the warning label the Physicians Committee for Responsible Medicine—a nonprofit with more than 12,000 doctor members—is petitioning the Food and Drug Administration to require cheese manufacturers to prominently display on all dairy cheese products. See petition at PCRM.

“It doesn’t matter if it is organic, grass-fed or not fed with hormones. When we’re consuming dairy, we’re getting estrogen and other sex steroids.” – Oncology dietitian Alison Tierney, RD

Listen to Alison on The Exam Room™ podcast and hear why the hormones, fat, and proteins found in milk can be triggers for cancer.

Physician’s Committee for responsible Medicine states: “Eating a low-fat diet rich in fruits, vegetables, grains, and beans—while avoiding meat and fatty animal products—promotes breast health.” – Fight Breast Cancer with a Plant-based Diet

The collected data from other researchers and our own data are indicating that the presence of steroid hormones in dairy products could be counted as an important risk factor for various cancers in humans. – Hormones in Dairy Foods and Their Impact on Public Health – A Narrative Review Article

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31 Days of “Little Known” FACTS — For Breast Cancer Awareness Month — Day 15 — Toxic “Forever Chemicals” in Pink Post-It Notes May Increase Breast Cancer Risk

Did you know…

PFAS are called “forever chemicals” because they don’t break down, and evidence shows that even very low levels of PFAS exposure is not safe for human health.

Please consider joining Breast Cancer Action in their campaign to call out corporate giant 3M for pinkwashing while continuing to produce and use toxic PFAS. 3M says their pink products are a “reminder of a good cause” even though their toxic “forever chemicals” may increase the risk of breast cancer. This hypocrisy is called pinkwashing.

Read Kara Kenan’s story. She was exposed to toxic PFAS for much of her life and diagnosed with breast cancer at age 35.

Please consider this easy way to take action — Tell 3M to stop producing, using, and selling PFAS!

Thank you Breast Cancer Action for making a difference with your mission, vision and values

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31 Days of “Little Known” FACTS — For Breast Cancer Awareness Month — Day 14 — Some Doctors are Paid $$$ for Persuading Women to Get Screening Mammograms

Did you know…

Some doctors are given cash bonuses for persuading women to get screening mammograms.

One ethical doctor published a paper in the British Medical Journal, April 3, 2019:

Helen Salisbury: Should I persuade patients to have mammograms?

“Our practice has recently been invited by the local clinical commissioning group to take part in a quality improvement scheme aimed at increasing the uptake of cancer screening. We are offered support from Cancer Research UK to make an action plan to improve rates of bowel, cervical, and breast cancer screening. We’re incentivised with payments for engaging in the process and for any increase in the proportion of our patients screened.”

Response from Michael Baum, Prof emeritus of surgery:

“Dr. Salisbury is to be congratulated on her honesty. No GP should be put in this position of being rewarded for meeting targets of compliance with screening, whilst denying the patient the right of informed choice. The NHSBSP management must shoulder this responsibility by setting out the pros and cons of screening for breast cancer without making any covert coercion. As chance would have it I’m off to Lugano in two weeks to be interviewed on Swiss TV in a programme that celebrates the de-implementation of screening by mammography in Switzerland.”

More insightful responses:

“Helen Salisbury is quite right. We do not know if the benefits of screening mammography exceed the harms. The problem is though that to the public the “catch it early” slogan is divine truth. The public does not know what “it” and “early” are. “It” may be a harmless in-situ carcinoma or benign microcalcification, and “early” may be a small tumour that has metastasized widely. Fortunes are being wasted on screening and many lives are being devastated.” – Re: Helen Salisbury: Should I persuade patients to have mammograms? The “catch it early” myth, Roger H Armour, Retired consultant surgeon

“Back in 2012, despite increasing evidence of breast screening harms and lack of benefit, GPs were being paid to encourage women to participate in the programme as part of ‘local enhanced services payments’ if a health authority deemed recruitment was getting too low. Such payments were not ethical then; in light of today’s knowledge, are they not destined to invite litigation?” – Mitzi A J Blennerhassett, medical writer/author, bmj patient reviewer

“The short answer to the title question is “No! Definitely not.”

A trusted doctor should be one who guides his/her patient to reliable information and encourages them to contribute to a well-considered shared, but individual decision that respects BOTH party`s rights to self-determination according to their own values, individual circumstances and preferences. No interference of State!

The limited consultation time is short enough anyway: it should not be used by the doctor to promote public health issues: a reversal of a true doctor-patient relationship. His/her patient will have taken the initiative to make the appointment and should be free to raise those issues which concern them, without imposition of public health promotion. Especially where the conscience of the doctor is troubled, both by being offered a payment to raise a Public Health Authority issue that is directed at citizens, not patients, and especially when they are uncertain of the value of the intervention – in this case the harm benefit ratio of breast screening? The power of Public Health to blackmail by payment incentive and override the judgement of individual doctors is insidiously corrupting the Profession, crushing its judgement and professionalism, as Seamus O`Mahony has so eloquently written about. Overdiagnosis with resultant wastage of resources stem from this reversal; a sad consequence of this uncalled for activity.” – Hazel Thornton, Honorary Visiting Fellow, Department of Health Sciences, University of Leicester

Thank you Dr. Salsbury and all who wrote responses.

For more responses to Dr. Helen Salsbury’s BMJ article, see rapid responses

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