Consequences of False-Positive Mammogram Results

Consequences of False-Positive Mammogram Results
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Odds are most women will get at least one false-positive mammogram, but thankfully most women who are called back for further testing of a suspicious mammogram finding do not end up having cancer after all.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

In response to the Swiss Medical Board’s recommendations against women of any age getting routine mammograms, critics suggested that instead of phasing out screening programs completely, we should leave it up to each woman individually to make her own judgment, once she’s “fully informed” about the pros and cons. “On the basis of the same information, some women will choose screening, and others will not.” I agree—that’s why I’m doing this video series to lay out the benefits and the harms.

When it comes to medical treatments, I think most patients understand there are risks and benefits: drugs can have side effects; surgeries can have complications. So, you can make your decision based on whether you think the benefits outweigh the risks. But, “patients have been taught to think differently about screening.” What’s the harm? Who wouldn’t want to know if you have cancer? It’s a no-brainer. But, “[i]n reality, the truth is more nuanced. There are benefit and harms to consider in screening—just as there are in treatment.”

In the case of mammograms, “the most frequent harm is a false-positive result,” where they think they see something on the scan, but after further testing—more X-rays, ultrasound, or a biopsy—it turns out to be nothing. Phew. As you can imagine, this can cause a “roller coaster of emotions.” “Experiencing a false-positive result can [be an] agonising experience…,” sometimes “profoundly” affecting a woman’s life. Some women then can get depressed, anxious, and lose sleep over it, even months later. Even after getting the all clear, breast cancer worries can persist, even a year or more later. And, beyond psychological effects, if you have to go in for a biopsy, they obviously use local anesthesia during the procedure, but the pain afterwards can sometimes persist for days or weeks.

“These adverse consequences would be less concerning if false-positive mammograms were…uncommon event[s].” Unfortunately, most women will get “at least one false-positive mammogram within 10 years” of annual screening, though the chances that a single mammogram will produce a false positive is only about 10 to 14%.

But, that’s way more than over in Europe, for example, where it’s only like one in 20, or one in 50. That’s thought to be because American radiologists are so afraid of being sued for malpractice that the bar they use is much lower. And, that’s fine for a lot of women. Even if 10,000 women have to go through false positives, many feel it would be worth it to save a life—even many women who have themselves experienced a false-positive result firsthand, so they know what it’s like. Most women don’t even “want to take false positives into account when deciding about screening,” but some women do.

For some, going through a false alarm is no big deal, but for others, it can be really scary. Some women interviewed going through the process were described as being in a state of “[e]motional chaos” facing a possible cancer diagnosis. “Waiting for [the] results” was particularly hard for some women; it was constantly on their minds. But after it was over, many women were able to just brush it off, whereas others had persistent anxiety, even though they were given the all clear.

Studies have noted increased anxiety, on average, even months later, after being called back for a suspicious mammogram that turned out to be nothing. Or, even years later. A study of hundreds of women who experienced a false positive, and some appeared to be suffering the consequences— even years later. They were followed out for three years, and the experience still seemed to haunt them. So, maybe we shouldn’t just dismiss these false alarms.

Regardless, “women should be informed of the [possibility], and reassured that most women who are recalled” back for further testing of a suspicious mammogram finding “do not end up having cancer” after all, so as to put their mind at ease a bit as they go through the process, and wait for the final results.

Please consider volunteering to help out on the site.

Image credit: Bill Branson via Wikimedia. Image has been modified.

Motion graphics by Avocado Video

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

In response to the Swiss Medical Board’s recommendations against women of any age getting routine mammograms, critics suggested that instead of phasing out screening programs completely, we should leave it up to each woman individually to make her own judgment, once she’s “fully informed” about the pros and cons. “On the basis of the same information, some women will choose screening, and others will not.” I agree—that’s why I’m doing this video series to lay out the benefits and the harms.

When it comes to medical treatments, I think most patients understand there are risks and benefits: drugs can have side effects; surgeries can have complications. So, you can make your decision based on whether you think the benefits outweigh the risks. But, “patients have been taught to think differently about screening.” What’s the harm? Who wouldn’t want to know if you have cancer? It’s a no-brainer. But, “[i]n reality, the truth is more nuanced. There are benefit and harms to consider in screening—just as there are in treatment.”

In the case of mammograms, “the most frequent harm is a false-positive result,” where they think they see something on the scan, but after further testing—more X-rays, ultrasound, or a biopsy—it turns out to be nothing. Phew. As you can imagine, this can cause a “roller coaster of emotions.” “Experiencing a false-positive result can [be an] agonising experience…,” sometimes “profoundly” affecting a woman’s life. Some women then can get depressed, anxious, and lose sleep over it, even months later. Even after getting the all clear, breast cancer worries can persist, even a year or more later. And, beyond psychological effects, if you have to go in for a biopsy, they obviously use local anesthesia during the procedure, but the pain afterwards can sometimes persist for days or weeks.

“These adverse consequences would be less concerning if false-positive mammograms were…uncommon event[s].” Unfortunately, most women will get “at least one false-positive mammogram within 10 years” of annual screening, though the chances that a single mammogram will produce a false positive is only about 10 to 14%.

But, that’s way more than over in Europe, for example, where it’s only like one in 20, or one in 50. That’s thought to be because American radiologists are so afraid of being sued for malpractice that the bar they use is much lower. And, that’s fine for a lot of women. Even if 10,000 women have to go through false positives, many feel it would be worth it to save a life—even many women who have themselves experienced a false-positive result firsthand, so they know what it’s like. Most women don’t even “want to take false positives into account when deciding about screening,” but some women do.

For some, going through a false alarm is no big deal, but for others, it can be really scary. Some women interviewed going through the process were described as being in a state of “[e]motional chaos” facing a possible cancer diagnosis. “Waiting for [the] results” was particularly hard for some women; it was constantly on their minds. But after it was over, many women were able to just brush it off, whereas others had persistent anxiety, even though they were given the all clear.

Studies have noted increased anxiety, on average, even months later, after being called back for a suspicious mammogram that turned out to be nothing. Or, even years later. A study of hundreds of women who experienced a false positive, and some appeared to be suffering the consequences— even years later. They were followed out for three years, and the experience still seemed to haunt them. So, maybe we shouldn’t just dismiss these false alarms.

Regardless, “women should be informed of the [possibility], and reassured that most women who are recalled” back for further testing of a suspicious mammogram finding “do not end up having cancer” after all, so as to put their mind at ease a bit as they go through the process, and wait for the final results.

Please consider volunteering to help out on the site.

Image credit: Bill Branson via Wikimedia. Image has been modified.

Motion graphics by Avocado Video

Doctor's Note

You can check out my Doc Note under the first video in this series to get a sense why I chose to spend so much time on this topic. This is the fifth in a 14-part series on mammograms. In case you missed the first four, here they are:

Stay tuned for:

If you can’t wait and want to watch the entire series right now you can stream it for a donation to NutritionFacts.org by going here.

If you haven’t yet, you can subscribe to my videos for free by clicking here.

65 responses to “Consequences of False-Positive Mammogram Results

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  1. That is interesting that we might do more testing as well as more false positive test results here because Doctors might be afraid of being sued. Yes, a false positive test, even if the person later finds out it is negative, can be emotionally traumatizing.

    1. I wonder if a woman can sue (and win) for the emotional trauma caused by a false positive? After all, it is a “mistake”. That may balance out the bias in setting the threshold too low. An interesting legal question to ponder.

      1. Darwin, it is an interesting question to ponder. I’m not sure if it would work in raising the bar. I think it could make it easier for a doctor to be sued either way., creating a ‘damned if you do, damned if you don’t’ kind of environment for doctors.

        1. What happened to the Hippocratic oath, that basically begins, “First of all, do no harm” that doctors used to swear to ?

          From what I can see the “Hippocratic” oath has become the “Hypocritical” oath, that instead begins, “First of all, make sure you can not get sued.” And as far as the “do no harm” to your patients oath goes, feel free throw THAT one out the window.

      2. One can sue for anything. Success is however unlikely. One has to show negative intention, as in to save money or save time or some other cause for the negligent action.

        In this specific the intention is to provide better care as a response to litigation. Negligen intent int action is not present. The result has untoward effects but they are not intentional.
        So on several areas of concern this would fail the test of successful litigation.
        What are the consequences of a positive not found..likely death..The intention is to help not harm And it is the accepted standard of care.

        Probably many of our medical diagnostic procedures are in response to the threat of litigation. Some of them are unnecessary. But the consequences of not performing them are drastic.

        The intention here is to provide information so we the patients make the correct decision. We are rarely told these things. to sue to change this, is probably not possible. Defense of litigation involves money and quite customarily to prevent the actual litigations the costs anticipated are arrived at and then a settlement offer lower is made. By my guess though as it is standard practice standard of care even that would not happen.

        1. Standard of care is really the prime consideration here. These same perameters if used in the EU would probably be the basis for litigation.
          Here in the US any doc is just doing what basically all the docs do and are pretty much taught to do.
          A class action is the basis to change things within the system. But really here what is your class…all women who received a false positive?
          How many would sue on that basis for harm and what attorney would pursue it?

          Pain and suffering are always consequential to a known wrong act. Judgement is not given on the basis simply of pain and suffering being present. IN this specific we have no known wrong act…all docs do it.

        2. Hi Ron in New Mexico! I’m not a legal expert, but I’ve been around long enough to see how many legal things work. In civil law I think intention is required for punitive damages. I believe it’s in criminal law where intention is a requirement for a guilty verdict. The bar is higher in criminal law because liberty is at stake, whereas only money is at stake in civil law. The idea is that liberty lost is irretrievable whereas money lost can be replenished.
          Joseph in Missoula

          1. The presumption of innocence is present in criminal law and not in civil law.

            So the bar is much lower. That does not imply a bar does not exist. In this specific there is no wrong act. All docs are acting within the established standard of care in America.
            So how would one doc be at fault in applying the established standard of care to one of their patients?

            Who then does one sue…the medical community at large? No such entity exists. Standard of care is a present and existent thing. Any medical expert in testimony would verse that any doc or hospital performed this diagnostic procedure as it is normally a procedure any doc would do under this circumstance. So is any doc or particular hospital responsible for a established standard of care..not really. They follow it but do not generally establish it. A set of procedures is present in a hospital, and most docs act under the purview of a hospital as regards litigation. But the same standard is present in any hospital anyplace in the US. The hospital establishes their individual basis of standard of care or medical protocol on the basis of generally recognized common procedures producing expectant result. Unless they deviate from established standard of care there is not basis for a claim of error or fault.

            Pain and suffering claim in civil litigation must be as a result of error or fault.

            1. Intention is involved with error. There must be a cause to a error. Did a doc order a procedure as he needed some extra money and this produced that but it was not normally called for. Did a doc not perform a procedure as he was having to go on a golf game……things like that produce error.

              So there must be a intention for the error or cause. Die Walmart not provide a sign warning peoples of a slippery wet floor as they intentionally understaff janitorial personal to save money? Thing like that a cause for the error a intentional thing. AS opposed to just slipping on a floor marked as wet and roped off at Walmart…there then being no error nor fault..Intention provides the context for the error.

              Aside the fact here as no error occurs if standard medical procedure is followed. What Dr Greger is stating here is that this is the normal way things are done in the US.
              Is it producing harm probably. Can one change it through lawsuit…no. . Other means exist to change established standard of medical care.

              1. Actually this here, publication, is the best way to change this specific standard. If everyone knows about it and it is producing harm eventually the standard will change. It has to. Docs will not generally do things which may harm patients. Even in response to the potential of litigation.

    2. A diagnosis of cancer, whether true or false, will not just seem emotionally traumatizing, but can have profound psychophysiological effects, having negative impacts on immune function for example ( https://www.sciencedirect.com/science/article/pii/01638343829002 , http://www.tandfonline.com/doi/abs/10.1080/09515078808254204?journalCode=ccpq20 ). And for someone who gets this initial diagnosis, even after later getting the good news that the initial result seemed a false positive, and that the latest tests indicate that they do not have cancer, this effect may last last not for months but for years or even a lifetime. After all, if the first positive test proved inaccurate and less than infallible, it seems reasonable to suspect that the negative test might also. And like Pandora’s box, once opened and releasing its contents, shutting it will not solve the problem.

      “American radiologists are so afraid of being sued for malpractice that the bar they use is much lower.” Perhaps that seems one reason. . But as Dr. Greger pointed out in an earlier video on mammograms in this series, as a general principle, the more people you treat, and the more tests you can get them to take, the more money you make. And this applies not just to the medical industry, but to doctors as well. As George Bernard Shaw put it:

      “As to the humor and conscience of doctors, they have as much as any other class of men, no more and no less. And what other men dare pretend to be impartial where they have a strong pecuniary interest on one side? Nobody supposes that doctors are less virtuous than judges; but a judge whose salary and reputation depended on whether the verdict was for plaintiff or defendant, prosecutor or prisoner, would be as little trusted as a general in the pay of the enemy. To offer me a doctor as my judge, and then weight his decision with a bribe of a large sum of money and a virtual guarantee that if he makes a mistake it can never be proved against him, is to go wildly beyond the ascertained strain which human nature will bear. It is simply unscientific to allege or believe that doctors do not under existing circumstances perform unnecessary operations and manufacture and prolong lucrative illnesses. . . . ”

      http://www.gutenberg.org/files/5069/5069-h/5069-h.htm

      And it does seem worth bringing up, that even for those who do not undergo the trauma of a false positive, that X-rays do not seem benign, even in small amounts, a subject I see Dr. Greger will address in a later video.

    3. HI ~~~
      Thanks for the series on mammograms. This is an important subject for my sisters and me given that our mother died in 1980 from breast cancer that probably could have been dealt with, if the cancer had been caught before it metastasized.

      That said I’ve been a loyal supporter of mammograms and self examinations. Over the years I have had numerous ‘false-negatives’ because my breasts are ‘dense.’ Early on I had to deal with the fears between the time I got word something appeared wrong and when they said it was a false negative. Phew. NO fun. But then, my pcp suggested that I have not ‘just a mammogram’ done, where later that ‘week’ someone takes a look at the Xrays. She said there was a ‘diagnostic’ (read: more expensive) script that she could write that would up the ante. I think the only difference is that one waits for the results, i.e., the Xrays are read while you are in the office and further testing can occur, if necessary. I’ve also taken to pointing out that I’ve had numerous false negatives, and so am asking them to keep that in mind…. please look at my records before concluding further Xrays are needed.

      My other story is as follows: I signed up to participate in a study when they were testing 3D mammos. I thought, advance the science, Yes, please. Well the initial screening found something. And I was told a biopsy was needed. Low and behold it turned out to be a false negative in which they placed a small dot of something to id the ‘area’ in the future. OK, but then I received a $400 bill for the procedure. What’s wrong with this picture?! I was so peeved that I would not return to this Woman’s Hospital for mammograms, but opted instead to have the mammo done at the “cancer treatment’ hospital in the city. They seem to not be so hyper=-onservative in id’ing false negatives, perhaps because they are dealing with saving women from actual tumors.

      3rd story, my sister tells me that she has been recommended to have mammograms twice a year. (What the hey?!) S he lives in the furthest outreaches of Maine. That sounds like a classic case of supporting the mammography industry if I have ever heard it, but she has been ‘frightened’ into complying with the recommendation I have her watching these videos, so fingers crossed!

        1. Hi Jane,
          I also have ‘dense’ breast (only one since the other was removed by mastectomy for DCIS in 1999). I undergo a yearly mammogram on the remaining breast and automatically get breast ultrasound at the same visit. The point of the ultrasound is because dense breast(s) don’t image well and the ultrasound helps clarify what’s going on in the cystic areas that don’t show well in the mammogram. I also chose to travel into a large nearby city to a good breast surgeon for my check-ups. For me it’s worth the security of having someone who’s well versed in this sort of thing.

          I know you mis-typed “false negative” but that is an actual problem with dense breasts. I had a clear mammogram in September 1998 and a stage 3 tumor self-discovered in April of 1999. So indeed, while you meant you had some “false positives”, it is possible to have a “false negative” due to poor imaging in dense breasts.

          All the best,
          Dianne

  2. I’m assuming the next episode will talk about women who are treated for those false positives – treated with cancer-causing drugs and radiation, even unnecessary surgery.

    1. I have experienced this scenario. In 2014, my mammogram showed suspicious calcifications that were biopsied. The pathology came back as DCIS, otherwise known as stage 0 cancer.

      Multiple docs recommended bilateral mastectomies to be safe. I chose the more conservative route of lumpectomy with possible radiation afterward. This initial surgery found no DCIS, but it also missed the mark. Since calcifications are not directly visible to a surgeon, wires were placed using a mammogram to guide the surgeon where to cut. Something went wrong, and healthy tissue was removed in error. The hospital offered me a free do-over with the head of radiology to be involved in the next procedure. That didn’t sit well with me, so I changed to a new medical team and hospital.

      Over the next years, I had 2 additional surgeries, none of which found DCIS. I had my original pre-surgery biopsy slides reviewed by a specialized breast pathologist and later confirmed by another expert. Both found them to show a benign condition that they thought could look a lot like DCIS to someone with less training like the general hospital pathologist who made my DCIS diagnosis (yes, from the same hospital).

      It turns out that I never had cancer and never needed surgery. I spent a whole year seeking treatment, researching medical options and lifestyle changes, and ultimately finding an amazing breast care team and this website. I was unable to work for that year, obsessed with 2nd guessing the standard of care that would half disfigured me even more than I am now had I gone along with it. Even though my husband had insurance coverage through his work (so grateful), we still had over $10K in out of pocket expenses to add to my lost income for that period. We are still digging out if that hole and can only now afford to look at reconstruction options 2 years later. Looking back, I now realize I was depressed, and I still deal with persistent fears of cancer.

      The lesson for readers of this article is that medical professionals with the best of intentions also have an economically driven incentive to overtreat coupled with a risk aversion resulting in over-diagnosis. I wonder how many women (and men) like me are still dealing with profound life changing fallout of a false positive?

      Regarding legal options to influence the system, even with the admitted mistakes made by various people, the details were too complex and didn’t offer enough reward for any attorney to take my case on a contingency basis. I was not able to find a firm in my community to work on a medical case on an hourly basis, not that I could have afforded to pursue that route on my own. By now, 2 years have passed, and I no longer have legal recourse.

      In terms of ongoing monitoring, I now alternate annual MRI and sonogram. My lead doc is concerned that every mammogram would find something to biopsy in my sense breasts. I travel to Chicago from FL to use one of the latest generation MRI machines that will find the most minute irregularity.

      The silver lining of this experience is that I have learned more about nutrition and made a lifestyle “turn-around.” I have found made many friends and found a renewed feeling of purpose. Of course I wish I hadn’t gone through that dreadful process, but I am taking the best fromit and moving on.

      1. Mimi,

        Thank you for sharing your harrowing story. Nobody should have to go through what you did. Perhaps in the telling you will influence other women that they must be strong advocates for themselves, and that they cannot take what the doctors tell her as absolute certainty. And maybe more of them will stop having mammograms.

        Though I’ve had a strong interest in nutrition for well over 50 years, a lot of what I had learned from books and a nutrition course I took were not correct, not up to date, and, with their emphasis of animal protein, certainly not the healthful diet I sought.

        It was only through the experience of having an aggressive breast cancer that I discovered The China Study and began finding better answers, more honest researchers like Dr G, and more up to date and accurate information about staying healthy and keeping cancer from returning.

        I no longer have mammograms at all. I rely on my whole foods plant based diet to keep me from having a return of the cancer. If that doesn’t work I’ll go on a medically supervised water fast and clear it up that way. No more radiation, drugs or surgery for me!

    2. I have experienced this scenario. In 2014, my mammogram showed suspicious calcifications that were biopsied. The pathology came back as DCIS, otherwise known as stage 0 cancer.

      Multiple docs recommended a bilateral mastectomy to be safe. I chose the more conservative route of lumpectomy with possible radiation afterward. This initial surgery found no DCIS, but it also missed the mark. Since calcifications are not directly visible to a surgeon, wires were placed using a mammogram to guide the surgeon where to cut. Something went wrong, and healthy tissue was removed in error. The hospital offered me a free do-over with the head of radiology to be involved in the next procedure. That didn’t sit well with me, so I changed to a new medical team and hospital.

      Over the next year, I had 2 additional surgeries, none of which found DCIS. I had my original pre-surgery biopsy slides reviewed by a specialist breast pathologist and later confirmed by another expert. Both found them to show a benign condition that they thought could look a lot like DCIS to someone with less training like the general hospital pathologist who made my DCIS diagnosis (yes, from the same hospital).

      It turns out that I never had cancer and never needed surgery. I spent a whole year seeking treatment, researching medical options and lifestyle strategies, and ultimately finding an amazing breast care team and this website. I was unable to work for that year, obsessed with 2nd guessing the standard of care that would have disfigured me even more than I am now had I gone along with it. Even though my husband had insurance coverage through his work (so grateful), we still had over $10K in out of pocket expenses to add to my lost income for that period. We are still digging out if that hole and can only now afford to look at reconstruction options 2 years later. Looking back, I now realize I was depressed, and I still deal with persistent fears of cancer.

      The lesson for readers of this article is that medical professionals with the best of intentions also have an economically driven incentive to overtreat coupled with a risk aversion resulting in over-diagnosis. I wonder how many women (and men) like me are still dealing with profound life changing fallout of a false positive?

      Regarding legal options to influence the system, even with the admitted mistakes made by various people, the details were too complex and didn’t offer enough reward for any attorney to take my case on a contingency basis. I was not able to find a firm in my community to work on a medical case on an hourly basis, not that I could have afforded to pursue that route on my own. By now, 2 years have passed, and I no longer have legal recourse.

      In terms of ongoing monitoring, I now alternate annual MRI and sonogram. My lead doc is concerned that every mammogram would find something to biopsy in my dense breasts. I travel to Chicago from FL to use one of the latest generation MRI machines that will find the most minute irregularity.

      The silver lining of this experience is that I have learned more about nutrition and made a lifestyle “turn-around.” I have made many friends and found a renewed feeling of purpose. Of course I wish I hadn’t gone through that dreadful process, but I am taking the best fromit and moving on.

  3. False positive, undergo a needle biopsy and then they want to place a biopsy clip (metal piece the size of a sesame seed) so they can find the spot again IF there is malignancy. They place that metal seed whether or not they know if there is malignancy.

    I refused the clip as I truly knew it was a false positive where the radiologist was just checking ANYTHING that vaguely looked suspicious. The bar is extremely low in the USA and healthcare is using us as pin cushions and experiments. The nurse attempted to discuss with me about the potential of mastectomy BEFORE the needle biopsy. Are they selling this procedure? Or seeking out guinea pigs?

    Change your diet and lifestyle and be judicious about when you have mammograms. Don’t just jump on the bandwagon.

    1. The doctor diagnosed my Dad as possibly having thyroid cancer because his thyroid gland gets bigger and he wants to do a biopsy to confirm. My dad and us said no. This was 10 years ago and nothing had happened since then. But my Dad was 85 at the time and not 20 or 40 year old and so it is an easy decision.

      I read that biopsy may cause cancer to happen when you disturb the possible cancerous tumor and not including infection.

    2. I also had a false positive, needle biopsy and then a chip implanted to mark the spot they didn’t even know was any type of cancer yet. Wish I had refused it-didn’t know you could. The whole episode involved 13 radiographic films because the spot was so small and didn’t show up in most of them and didn’t show up on ultrasound either so let’s assume it’s cancer anyway? Seriously? 10,000 women being diagnosed with false positives? That is unacceptable to me. They recommended I have a six month follow up mammogram which I did not do. For what? A false positive- no cancer found. Even their own radiology journals state that aggressive follow up for benign findings is not necessary. In a study conducted, no additional cancers were found in a six month or one year follow up for benign findings. In a two year follow up mammogram, only two possibilities that bore further testing.

      1. Holly, you are in charge of your healthcare. You can refuse ANY procedure you disagree with. Research the issue and then make your choice. The radiologist did not like the fact that I told him “no clip”. They are not used to patients being knowledgeable and willing to go against their mainstream.
        He had to respect my wishes. I work in healthcare and don’t just stare agog at the “divine doctor.” They test to make sure they don’t get sued. It is amazing how many people just abdicate their health to the doctors. It’s your health. You are paying them.

        1. Deborah,

          What I fear is that as the U.S. moves closer and closer to a “Socialist” style medical system, will we lose our ability to just say No? Could it happen that someday, if we refuse to take a particular test, will we be fined? On our income tax return, we will have to get a note from the medical system saying that we’ve had all the required tests that year. Otherwise, we pay a fine. The statistical bean-counters will say, if you refuse this or that test, you may cost the “State” more later on, therefore you have to take it! Or if we do take the test and it is positive, and we refuse to take the “State” required treatment, will we be fined and not allowed any other treatment?

          We’re not there yet, but …

          Glad I found this website and am taking my health into my own hands and trying to eat a healthy diet! The future of Health “care” could become really scary.

          1. I would not worry about a single payer healthcare system taking away your choices. I’ve lived in both Canada and the US and I have had more problems in the US because of insurance issues and arrogant, unethical practitioners.

            Keep in mind that in our current US system many people can’t make a decision regarding medical testing because they can’t afford to see a doctor in the first place.

          2. Darwin,
            I lived in Japan for 20 years. They call it Democratic Socialism. I was able to refuse to stay in the hospital after giving birth to my daughters even though the Japanese women choose to stay in 1st so insurance kicks in after about 7 days and 2nd because they have to go home and start tending house again. They could have chosen to go home. They just don’t. We could learn a lot from the Japanese style of universal health care. They cut costs in the right places and cover costs in the right places. A system for comparison.

            Let us work toward NOT allowing our great nation to go down the FACIST path. I for one will fight it and I know that many others will too. We are far from that. Even though people seem to be in a frenzy. If we prevent the need for diagnostic testing by BEING HEALTHY then we will win. I will leave if my choices are taken away from me. I am in control of my health and destiny.

            Guess what actually works even better?? Prevention…prevention…prevention….and serious lifestyle change. Americans right now want their cake and eat it too. They are causing their own chronic diseases. If Americans chose to eat as vegans we could knock healthcare right down on it’s overly ample tush.

            Whole food, plant based, no to low oil and we eliminate many chronic lifestyle diseases, change the impact on the planet due to livestock production and reduce the need for Big Pharma. I am vegan and have been vegan/vegetarian since 1979. I got conned into the mammogram. The fear mongers’ got to me. I won’t fall for that again.

            What can we do? Follow the right path… Dr. Gregor, Dr. Barnard, Dr Esselstyn, Dr. T. Colin Campbell, Dr. Ornish, Dr.Thomas Campbell and many others are on the right path. We CAN change health in America. Never give up.

              1. Yes, that is what I mean. Oil can damage the endothelial lining of the arteries and if you have a proclivity toward heart disease because you eat the Standard American Diet (SAD) and don’t exercise etc….you are setting up for heart disease.

                It is possible to do without any added oil. Natural oils in nuts, seeds, avocados are possible but if there is risk for heart disease not recommended.

                Dr. Caldwell Esselstyn ” Reverse and Prevent Heart Disease” author explains it best…in this link to a YouTube video
                entitled “No Oil – Not even Olive Oil”: – (HeartAttackProof.com)

                https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0ahUKEwiS8vmUyJbZAhUJrVkKHSV2Ai0QtwIIJzAA&url=https%3A%2F%2Fwww.youtube.com%2Fwatch%3Fv%3Db_o4YBQPKtQ&usg=AOvVaw0ZN_LrjXM6vBYOoPwz9oBM

                Dr. Gregor also has numerous videos about Oil, EVOO etc.

                The human body creates its own cholesterol and does not need to consume artificial pressed oils.
                But everyone picks their poison. Do some research and see if it doesn’t make sense.

              2. Not sure if anyone caught the BBC Health headline yesterday about ‘Food may influence cancer spread’ http://www.bbc.com/news/health-42976851 They speak about an amino acid asparagine found not only in asparagus but poultry , seafood and many other items . Dr Greger did a terrific video years ago about which foods tested best against cancer. It’old, it’s a classic, and it’s well worth watching https://nutritionfacts.org/video/1-anticancer-vegetable/

            1. Deborah,
              Yes, I agree in cutting costs where it really counts. And I, of course, too, don’t want a Dictatorship of any kind, whether it be Facist, Socialist, or Communist. The U.S. Constitution and Bill of Rights work really well, if we follow them the way they were originally intended.

              And, yes, Prevention is the key! And disease reversal with a Whole Plant Food diet where possible. I’m always amazed by the story of Nathan Pritikin, who took it upon himself to cure his own heart disease with diet change, against the recommendations of his doctors.

              I have been WPF, no SOS, for a while now and am enjoying all it’s benefits every day. And thank you for listing all the great doctors. I not only follow Dr. Greger, Dr. Barnard, Dr Esselstyn, Dr. T. Colin Campbell, Dr. Ornish, Dr.Thomas Campbell, but also I would add in Dr McDougall and Dr Fuhrman :-)

              1. Just as a informational thing. Socialism does not trend to dictatorship. Karl Marx established his view of socialism as a stepping stone to communism. But his writings were written about almost 200 years ago,Socialism as a concept has been independent of his idea since the 1930’s or so. Socialism has advanced. It stands independent of communism nor is it a progression to that. It is a stand alone mechanism.
                .
                India for one as per its constitution is a socialist state. The Nordic model describes democratic socialism as referenced above…
                Specifically it is capitalistic in nature built on a capitalistic model but with social structures which assist peoples. Capitalism in such a system is heavily taxed and regulated. But it remains capitalism. India has not the ability to enable very many social programs at all as they are poor but nevertheless in ideology they are socialistic.
                Socialism as per Venezuela may have ownership of industry by the state. But it is like capitalism, it can be this and that and still be capitalistic. Monarchy per example can be capitalistic. So it is with current socialism, it may be any number of things and dependent on economy of state ownership or not depending on government..


                https://en.wikipedia.org/wiki/Nordic_model

              2. I’d caution against over-reliance on a constitution and its early amendments which were quite consistent with ongoing slavery, which continued for a lifetime after the nation’s start.
                US ideology emphasizes ‘freedom’ (while from the first denying a wisp of freedom to millions) as the Soviet Union stressed ‘equality’ even though some, said Orwell, were more equal than others.
                It seems all harken to a golden age of anarchy, defined as only voluntary associations of people, some adding the goal of peace between associations.
                While such a system exists between humans most of the time, and is quite well developed on this site, it is feared as a solution to problems of the state. In that respect, all become like US MDs, relying on tests [or laws] beyond ordinary reason

          3. I tend to favor a mixed public private system. Even in “single payer” Canada, 30% of the funding comes from private sources. I personally am in favor of affordable, as well as the right amount of health care for all, but that doesn’t mean the government has to pay for everyone’s healthcare. But, unlike Republicans, I certainly wouldn’t cut funding for Medicare, I just wouldn’t put everyone on Medicare. I do support Medicaid expansion of the ACA that many Republicans oppose, but I don’t need to be on Medicaid. Many millions of people get good health coverage from their jobs, and so they don’t need to be on Medicare. Even in Canada, many get the health coverage the government doesn’t cover, such as Prescription drugs, from their jobs. And of course, prevention, prevention and prevention with a WFPB diet along with daily exercise and a good social support network.

            1. Peoples tend to think medicare is a free governmental funded program. It is not. One pays currently 134 USD per month on a low or medium income. A high income person pays a higher amount. And not all things are covered so one typically has to secure additional insurance which runs from 50 to 100 or more additional depending on plans offered and benefits received. Prescription drug plans cost significantly more.

              I will not mention any poilitical party so as not to make this a political thread. But the yearly cost for a universal health care is considered to be about 80 billion per inclusive of savings by scale. WE have by all reports just spent close to one trillion in developeing one fighter jet. And it is now proposed we revamp our nuclear arsenal which will cost approximately 1.5 trillion. I follow hiking things on youtube. One supplier just did a review of a tent the army just purchased for the troops….one tent 2000 USD. 2 person tent I believe that is with a ability to attach other tents to it. Like coleman does for about 300 per. Point being I think there may be funding available for that thing if we so desired. Defense is currently 700 billion annually.

              1. Here is a review of the most expensive one person tent in the world (sorry I thought it was two)

                http://www.wideopenspaces.com/nemo-builds-expensive-military-tent-world/

                High tech weighs something like a pound or some such a great new innovative things…nah it weighs 8 pounds, which means tent wise it is a piece of junk. Hiking army or civilian light weight is the necessary with functional ability…just to show there may be a little or a lot of fat to cut to enable universal health care or medicare for all..

    3. From what I read…the next issue is the possible risk from a biopsy. Any time a potential cancer is physically disturbed you run the risk of releasing cancer stem cells into the rest of the body…possibly resulting in the spread of the cancer?

      Same with prostate cancer?

      Same issues…standard of care….fear of legal ramifications?

      1. And the inflammation of surgery to remove cancer, specifically breast cancer, can foster recurrence spiking at 2 and 5 years following the procedure. I can’t find the article, but this pattern was first noticed in Italy and then found consistent with global data. There was an improvement if anesthesiologist used a certain drug during the surgery. Would be great to see Dr G’s take on this.

        1. all, after participating in this series for several weeks now, the one thing that continues to perplex me is where are all the Komen affiliates fighting for their long established messaging …. “early detection saves lives”
          which is code for clinical exams and mammography? I am fairly confident that i have read none of you defending your messaging for at least the sake of your fund-raising efforts. Could it be that the great we no longer believes the tonic you’ve sold for decades now and that you no longer have a place in the scientific community that is not otherwise propped up by millions of dollars of self-interest? In the absence of your version of reality, could it be that your organization is of no value?

          The Komen organization has long been part of the industry feeding us the alleged benefits of mammography and helping the general public to fall in line like sheep to the slaughter.

          This is one little lamb searching for a better way…

  4. Perhaps this won’t be a popular thing to say, but getting a false positive could be a great thing in some ways. Who doesn’t need a wake up call, a reminder that life doesn’t go on forever? It’s moments like these that bring clarity and can change the way we move forwards in our lives. A reminder to focus on the things that matter most.

    1. Celandine Foxglove, if for you a false positive is a welcome wake up call, then I say “congratulations!” You must have led a relatively uneventful life. As for me, I’ve had too many close calls, and know too many friends and family members to die prematurely to need a “wake up call.” I would prefer to forgo all false positives. And certainly those experienced at the rate they occur by mammography screening in this country. And as I’ve said before: a biopsy is no picnic or walk in the park. It was more painful for me than the subsequent lumpectomy. I hope I never have to undergo another one, and certainly not for a false positive “wake up call.”

  5. I had a “suspicious” mammogram and was referred for a second, more “intense” mammogram. Yeah, that was the word they used. It only took a couple of days to schedule it, but I was getting pretty nervous by the time I went in. The radiologist was there for the second mammogram, and he was funny. He said he looked at the original and thought is was an “artifact” and not the beginning of a cancer. He didn’t expect to find anything in the second, and he didn’t. His comment was that the initial mammogram isn’t read by the best radiologists in a big urban hospital, it may even be read by a trainee.

    All of this led me to believe that mammograms are not the be-all and end-all that my doctor would like me to believe. I am unlikely to get another mammogram unless I feel something odd in a self-exam.

  6. False positive is worse than false negative if it will lead to irreversible damage such as the breast is removed or unnecessary chemo is performed.

    False positive should include also cancer treatment that although there is a cancerous tumor, it may not do any damage if it is left alone.

    Having said this, the above video does not give any statistics of the percentage of cases that this happened beside the anxiety that false positive may cause which is minor, I think. In some cases, concern for cancer may be helpful if it pushes people to have a more healthy lifestyle.

    False negative is the same as doing no screening. Don’t tell, don’t know.

  7. Dr Gregor, what about Breast Thermography or Ultrasounds as safer options for screening? Are they effective screening tools? I would love it if you would address this. Thank you (and your team) SO MUCH for all you do for us! You are saving lives every day.

    1. There are several other testing methods in addition to mammogram for breast cancer screening. Studies, though, vary in how the tests are done and in whom and which kind of breast tissue (dense or not). There aren’t great uniform studies to show the best test. For example, a good review of thermography studies found that some studies reported great ability to detect cancers, and other studies found this test missed a lot of cancers. There can also be false positives with any modality. With this complex issue, it’s best to hear the pros and cons of various screening tests from a trusted doc, plus know your own risk of breast cancer (for example, if your sister ad mother have had it, you’re at higher risk) to decide whether and which kind of screening is the best choice for you. One day, hopefully this will be an easier question to answer! -Dr Anderson, Health Support Volunteer

  8. Dr Greger, you asked for feedback and I do truly appreciate that you are taking on these topics and that you are interspersing them in with nutrition.

    Nutrition is about health and I appreciate that you are handling these are confusing health issues.

    You have already set the foundation of dealing with these major health issues, with the “How Not to Die” series.

  9. Some of the latest research suggests that invasive treatments may inadvertently spread cancer stem cells. I hope Dr. Greger will include a discussion of breast cancer stem cells in his series.

    One of the complications of a core needle breast biopsy is the formation of a seroma, filled with wound fluid. These tend to be painful for months following the procedure.

  10. Well… I was one of those patients who had call backs and while one was a “no cancer” result, another was a “positive for cancer” result… Stage 2, in fact, as a result of a poorly read mammogram due to dense tissues where tumors can not be well assessed. The clinical team should have taken steps to discuss options of an biopsy or other evaluations, such as ultrasound; rather than simply doing and saying nothing …. Yes, it was all distressing and emotionally painful. I don’t think we need a video to be told of the emotional yo-yo this BS creates… even those of us who are not clinicians already know that. And yes, it feels much like a ticking time bomb when a “positive” result happens. Next time please tell us something we don’t know … . or teach us something new … such as do cancer tumors of a given stage need a clinical response or not … The each woman is different and needs to make her own decisions for her own health is an insulting and infantile cop-out, and sounds like so much medical crap spoken by physicians unwilling to provide sound guidance or untrained to provide sound guidance.

    I love the plant-based life and the information from Dr. G….. but lets go the distance when producing content please.

  11. I wonder if another aspect of the lower rate of false positives in Europe could have to do with the proficiency of the radiologists reading the mammograms. In the US radiologists are required to read only 500 mammograms per year to be considered sufficiently proficient. There are sub-specialty trained breast radiologists, but the vast majority of mammograms are read by radiologists who only have to meet the threshold of 500 reads to qualify. In my own experience as a pathologist for 30 years, the greater the number of mammograms a radiologist reads per year, the better the sensitivity and specificity. Many fewer false positives, much less harm. In another 5-10 years, we will have a blood test to screen for breast cancer and most mammograms will be for diagnostic purposes, not for screening.

    1. LD,
      Do you have an estimate as to when “liquid biopsies” will become available for breast cancer screening? It seems to me that this is a critical area which should be prioritized for research. Thank you for your perceptions regarding the accuracy of reading mammograms.

    1. Here’s a pop science article on the topic:
      https://www.sciencedaily.com/releases/2018/02/180207140401.htm

      “Investigators now are considering conducting an early-phase clinical trial in which healthy participants would consume a low-asparagine diet. If the diet results in decreased levels of asparagine, the next scientific step would involve a clinical trial with cancer patients. That trial likely would employ dietary restrictions as well as chemotherapy and immunotherapy, Knott said.”

  12. I went through a false positive mammogram in 2001. My doctor’s office called me two weeks after the mammogram to tell me to schedule a biopsy with a surgeon. They did not provide any information on the likelihood it was cancer. I later learned that there was a 90% chance it was not cancer. Knowing that would have saved me a lot of worry.

    The surgeon recommended surgery, not a needle biopsy. He gave me no written materials on the pros and cons of the choices. After some more research on the internet, I decided to have the needle biopsy. I learned that the hospital makes 3-4 times more money with the surgery option. With all these false positive biopsies, this is big business for the hospitals.

    I’ve had follow-up diagnostic mammograms a number of times when they just weren’t sure if there was an issue. One of the mammograms caused a duct problem which required surgery. Last year when they wanted to do follow-up diagnostics I spoke to the radiologist on the phone. I asked a number of questions about the likelihood of cancer and the risk of waiting a year. I decided to wait a year and all was fine the next year. It’s ridiculous having to be so well informed as a patient so that you can push back against doctor’s recommendations.

  13. Had a false positive, another mammogram and then a biopsy. Had a bleed in my breast from the biopsy. Infection was introduced when the bleed was drained. Quite an ordeal with the breast care place telling me to go to my doctor and my doctor telling me to go back to the breast care center. Massive antibiotics—no cancer, so I guess I’m just thankful.

  14. The ‘sue’ culture in America (and also in uk now) is just dreadful. Surely it’s better to be called back for further investigation If there’s even a minuscule chance that you might have breast cancer – and then once you have been double checked you have the peace of mind that you are all clear. Why on earth would anyone even think about sueing people trying their level best to make sure you are ok?????????

    1. Agree 100% with the intention of the post….who would sue?
      But on filing suit oneself….. it enables our ability to hold others to account.The triangle shirt factory fire no lawsuits were possible and scores of young women burned to death being trapped by locked doors to prevent theft….the owners went on to establish another factory with no problem at all.
      The making of a cough syrup which had ethyl glycol in it and killed many…he did not suffer any penalty nor lawsuit, none was possible at the time by legal interpretation. The chemist who developed it did commit suicide in shame but the producer….lawsuit was not possible.

      Lawsuit serves a very necessary function. The above led to fire codes and the FDA but government was a little late to the party. If lawsuit was possible perhaps those tragedies would not have occurred. In both cases little occurred to the owners responsible. Now a days…they would both be in court for years and years rightfully so.

  15. Hello, I live in the UK and the media here is reporting a link between the amino acid asparagine and the spread of breast cancer. Scientists in Cambridge in the UK discovered that reducing asparagine, which is found in seafood, soy products, nuts etc can reduce the spread of breast cancer cells in animal trials, foods we believe are healthy for us. Not absolutely sure where we go from here. This story is getting big coverage here in the UK. Further information from the BBC website. Could Doctor Greger give his opinion on this? Thank you.

    1. Perhaps one of the moderators will see this and respond.
      But just me and off the top of my head…nuts soy foods excepting fish due to contaminates, are the things which seem in a human fashion to most protect us against cancer. Soy intake and a decrease in breast cancer rates has been shown in some studies.
      Animals are not humans. And while animal studies have there place I think humans studies are more relevant.

      I don’t trust main stream media for nutritional advise. They post contradictory things about every week. The studies themselves are quite large in number thousands produced each year. To a extend one may pick and choose. And if one is uninformed or unqualified which reporters often are a study may not be able to be qualified as true or not in finding by methodology validity determination.

  16. ~On the subject of breast cancer: there is a study that has been circulating stating the amino acid “asparagine” causes the spread of breast cancer cells. This amino acid is not only found in most food articles, but is also produced by the body. They are suggesting that women decrease their intake of asparagine containing foods, or administering an asparagine blocking drug. How much of this is accurate vs. not? Is this a new variant on the “vitamin A” concluded theory: that the vitamin was some killer substance, not taking in account that along with other plant properties, the vitamin performs a more useful and important task? What are your thoughts?

  17. The person above states the study is based upon animals not humans. If they are right in that a absolute read on human from animal study is never present.
    Animal studies serve as a base from which human studies may be endeavored and do not suffice as stand alone instruments.

    1. StefanLoda – you need to read The China Study by T. Colin Campbell, Ph.D. and Tom CAmpbell, M.D. That book will answer your questions.

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