Questions on Mammogram Screenings & Adkins Diet

Dear Dr. Spence,
What benefits should I expect from yearly mammogram screenings?
Signed,
CC

Dear CC,
Mammography remains a clinical conundrum. Should we or should we not screen for breast cancer? Given that breast cancer is the second leading cause of cancer death in the United States and that an estimated 40,000 will die from the disease this year, most might immediately advocate widespread screening. A woman’s chance of dying from breast cancer is 1 in 500 from the age of 40 to 49 with the risk nearly doubling for each additional decade of life. The real answer is substantially more complex. Studies demonstrate a 0.1% reduction in breast cancer death with mammography – not particularly impressive. In essence, if 2000 women receive yearly mammograms for 10 years, only one would have her life prolonged. That’s 19,999 mammograms that make no difference in patient outcomes. Furthermore, 10 healthy women would be unnecessarily treated and nearly 200 would suffer emotional distress and undergo additional testing due to false positive mammograms. These are certainly sobering statistics. Approximately 1792 women age 40-49 would need to be screened for 14 years to prevent one death (225,088 total mammograms). Obviously, the decision to screen for breast cancer is an individual one that needs to be discussed thoroughly with your physician.

Dear Dr. Spence,
What do you think of the Adkins diet?
Signed,
Dr. Adkins

Dear Doc,
I hate to be a naysayer, but I truly believe that most fad diets are ineffective in the long term and destined to fail. Studies consistently suggest that weight returns to baseline after two years regardless of what diet is chosen. What’s more, Adkins is tough to adhere to; just ask anyone who has tried it! Despite being a high fat, low carbohydrate diet, it does not appear to effect cholesterol readings, so at least it does not appear to be inherently unhealthy. Weight loss is obviously not easy. As a whole, a patient needs to have a caloric deficit of 3500 calories in order to lose one pound. With strict adherence to low calorie diets, a vigorous exercise regimen and a heap of patience, weight loss is possible though generally slow. I recommend the Mediterranean diet. Though not really a weight loss regimen, the cardiac benefits appear to be substantial.

Do you have any medical questions or concerns that you would like addressed? You can contact Dr. Spence by email at panhandledailydose@hotmail.com or by mailing your question to Daily Dose, P.O. Box 6107, Marianna, FL 32446.