Logic vs Medicine

During a conversation with my wife, the topic of routine screening mammograms as a means of prevention of breast cancer came up.  I am a logical person and not at all averse to defying conventional wisdom when it flies in the face of logic.  For me logic wins every time, there is simply no contest.

Back to the topic of this post.  In the USA The America Cancer Society recommends “Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health”.  Various other people, much more learned than I, disagree with this timeline.  This includes USA based organizations like The U.S. Preventive Services Task Force – though mammograms are generally recommended, their frequency is generally reduced from once a year to once every two to three years.

Conventional wisdom would seem to indicate that if mammograms detect cancer then get them done often, since early detection is key to defeating cancer.

Logic calls foul.  First, let us look at what a screening mammogram actually is.  Simply put, the breast is crushed between two plates until it is flat and dense, then it is irradiated by X-Rays.  This is done twice for each breast, with X-Ray pictures taken in the vertical and horizontal planes.

Sounds wonderful doesn’t it?   To me it sounds like detection is not only barbaric, but downright dangerous as well.  I wonder what happens to a benign tumor when it is crushed, then irradiated twice every year?  I can’t imagine it is anything good.

Although this primitive technology is capable of detecting breast cancer early, perhaps it is also capable of causing breast cancer by its invasive nature – logic certainly seems to warn of this danger.  (While “invasive” might not be the precisely correct word, X-Rays do penetrate the body.)

Am I recommending that women don’t get annual mammograms?  Absolutely not.  I am not a doctor so I am making no recommendation either way.

What I am recommending is you take conventional wisdom with a grain of salt.  If it seems to defy logic, it is probably worthy of deeper investigation.  If the conventional wisdom originates from people who will benefit financially from your listening to them (namely a doctor or radiologist), then perhaps you need to take a pinch of salt, and throw it over your left shoulder – right into their eye.

About C.G.Ayling

Born and raised in a country of five names, a citizen of the world. A thorny old man.
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