There is a better way to screen for breast cancer. Vitamin D screening, at least at a level of 40-60 ng/ml, can prevent many disease cases. Studies have shown that this target level far outweighs the benefits of early detection in patients with breast cancer. Implementing Vitamin D screening and targeting this level could save 225,000 people from the trauma of breast cancer each year!
Main Takeaways
● Among 1,000 women who begin screening at age 50 and are screened for 20 years, 2 to 3 will avoid dying from breast cancer, 200 will have at least one false positive result, 30 will undergo a biopsy, 3 will be diagnosed with an interval cancer, and 15 of them will be over-diagnosed.
● Approximately 4.1 billion dollars are wasted yearly on excess testing and overtreatment following a false positive diagnosis.
● Assuming an 80% decreased incidence risk, getting everyone's vitamin D level up to at least 40-60 ng/ml would prove a safe and cost-effective breast cancer intervention. Around 225,000 people would be spared from the trauma of breast cancer and treatment each year.
The Maurer Foundation's data shows that, while breast cancer rates have stayed the same for women under 50 since 1985 and for those over 50 since 2003, African American women have a 41% higher mortality rate from breast cancer than non-Hispanic white women by 2007.
We’ve all been witness to the excessive amount of pink during October for breast cancer awareness, but has it done anything to help prevent or reduce cases of breast cancer?
Does Early Detection Save Lives?
Despite all our efforts to raise awareness and pink-ify October and Breast Cancer Awareness Month, breast cancer incidence rates have not changed much in the last several decades. Even with increased awareness, the statistic of 1 in 8 women being diagnosed with breast cancer a some point in their lifetime has remained stable.
The US Preventive Services Task Force recommends a mammogram every two years for women 50-74 years of age. A mammogram once every two years roughly translates to about 13 mammograms for every woman, most often performed on patients showing no symptoms of the disease. So the question is, does early detection really save lives, or are we just overdiagnosing and overtreating breast cancer?
Are these types of early screenings worth it?
False positives and overdiagnosis are a huge problem with breast cancer screenings. Patients are often given inadequate information on mammogram screenings , and as a result, many women choose to undergo additional screenings and treatment that they may not have needed otherwise. In the paper, Benefits and harms of mammography screening, by Loberg et al. concludes that among 1,000 women who start screening at age 50 and are screened for 20 years, 2 to 3 will avoid dying from breast cancer and 200 women will have at least one false positive test, 30 will undergo a biopsy, 3 will be diagnosed with an interval cancer, and breast cancer will be overdiagnosed in 15.”
False positive – an identification of a breast tumor when there is none. Data suggests that in a 10-year period, 30% of women in the US will receive a false positive results, and 50% of women will receive a false positive at some point in their life. It can take up to 2 years for many of these false positive to be cleared, after which psychological harm, stress, and financial burden have already been inflicted on the patient.
False positive with biopsy – the removal of tissue to be examined for cancerous cells due to a false positive. A breast biopsy is an invasive procedure that can cause anxiety and stress, as well as physical pain and scarring.
Interval cancer – cancer that is detected between screenings that could have been overlooked or are rapidly growing tumors.
Overdiagnosis – a diagnosis of cancer in an individual who would never have experienced symptoms or died from the disease. This can apply to both in situ and invasive cancers. Figure 2 from Loberg’s paper (below) most adequately explains over-diagnosis and identifies four different possibilities, none of which prolongs life.
Do mammograms prevent death?
Loberg gets to the meat of the issue with the final figure of the paper:
Examining where the dark green area (representing all deaths) meets the pale green area (alive) – we see that they remain in the same place. Therefore mammograms did little to prevent breast cancer in any substantial way. The only difference, Loberg concludes, is whether you died of breast cancer or other causes (as you see there is more light pink area along the top of the graph in the non-mammography chart).
What is the financial impact of all this testing and overtreatment?
In Cost of Breast-Related Care in the Year Following False Positive Screening Mammograms by Chubak et al. (2010), an estimated additional cost of $503 in health care costs per year were attributed to false positives.
Here is how the cost is broken down:
| 308 million | population of US in 2010 |
| 156,464,000 | Women in the US (50.8 % – source: Women’s Health USA) |
| 54,136,544 | Women 50 or older – (34.6 % source: Women’s Health USA) |
| 27,068,272 | # Mammograms in the US a year. Assume every woman over 50 is following the suggested guideline of a mammogram every two years. |
| 8,120,482 | False positives per year. (Loberg et al. – 30% false positives) |
| $ 4,084,602,245 | Cost per year of false positives. (Chubak et al. – $503 additional cost for a false positive) |
A very rough estimate of… $ 4.1 BILLION!
How do we truly affect change in breast cancer?
Vitamin D Depending on the study referenced, between 50-80% reduced risk of breast cancer incidence. GrassrootsHealth and the Helen Knoll Foundation recommends maintaining a vitamin D3 level of at least 40-60 ng/ml (100-150 nmol/L) to help prevent many diseases, including cancer. Getting your vitamin D levels tested anually is critical to see where you are and make sure you are achieving these levels.
According to breastcancer.org, an estimated 287,850 new cases of invasive breast cancer and 51,400 cases of non-invasive breast cancer are expected to be diagnosed in the United States in the year 2022, up from 281,550 and 49,290 respectively.
If everyone could get their vitamin D3 levels up, assuming an 80% reduced risk of incidence, that would be around 225,000 people who would be saved from the trauma of breast cancer this year.
Vitamin D is critical for good health, and maintaining optimal levels can help prevent many diseases. Join us in advocating for Vitamin D testing and supplementation for everyone to reach healthy Vitamin D levels.
Join us today!
1. Get your vitamin D level checked and maintain 40-60 ng/ml (100-150 nmol/L).
2. Tell your friends, like our facebook page and share our information.
3. Donate to GrassrootsHealth – as we enroll 1,000 more women in our Breast Cancer Prevention project.
4. Donate to the Helen Knoll Foundation to help us raise awareness about D3 and help us hold more D3 drives across the country.
Keeping Up with Your Vitamin D is an Essential Part of Staying Healthy
Having and maintaining healthy vitamin D levels and other nutrient levels can help improve your health now and for your future. With GrassrootsHealth, you can choose to measure your vitamin D, omega-3s, and essential minerals including magnesium and zinc, by creating your custom
home test kit today.
Take the steps necessary to improve your health today and track your own intakes, symptoms, and results to see what works best for YOU.
Enroll and test your levels today, learn what steps to take to improve your status of vitamin D (see below) and other nutrients and blood markers, and take action!
By enrolling in the GrassrootsHealth projects, you are not only contributing valuable information to everyone, but you are also gaining knowledge about how you could improve your own health through measuring and tracking your nutrient status and educating yourself on how to improve it.
References
Benefits and harms of mammography screening
Magnus Loberg et al.
Breast Cancer Research
May 2015
Read Paper
Cost of Breast-Related Care in the Year Following False Positive Screening Mammograms
Chubak et al.
Medical Care
September 2010
Read Paper
An Open Letter to the New York Times
Cedric Garland
December 2009
Read Letter (scroll down page)
The Problem with National Breast Cancer Awareness Month
Women’s Health
Robin Hilmantel
October 2015
Read Article
The Big Squeeze
A Social and Political History of the Controversial Mammogram
Handel Reynolds, MD
Cornell University Press
2012
Read Part of Book