Breast Cancer Prevention & The Hidden Truths About Mammograms You’re Not Told

I had the pleasure of speaking with Cynthia Thurlow, NP, about breast cancer prevention, screening, and the truths most women aren’t told. As a breast surgeon turned integrative oncologist, my goal is to help women make informed, bioindividual decisions—so you can prevent disease where possible, recognize true emergencies, and choose treatments intentionally when needed.

Why prevention and perspective matter

Breast cancer is often presented as a random event, but there are many modifiable contributors. I believe roughly 80% of breast cancer diagnoses are preventable. We also overdiagnose by 20–30% because of the limits of our current screening model. That combination means many women undergo harmful treatments they might not have needed, and others survive a diagnosis but are left with long-term side effects that dramatically reduce quality of life.

My work is about shifting from reactive care to proactive health-building: understanding risk, addressing inflammation and toxin exposures, managing stress and trauma, and being thoughtful about diagnostic and treatment choices.

When breast changes are an emergency

Certain presentations require immediate systemic treatment. These include:

• Inflammatory breast cancer

  — a clinical diagnosis. If you see a mass plus red, swollen, pitted (“peau d’orange”) skin changes, treat it as inflammatory breast cancer until proven otherwise. This needs urgent systemic therapy.

• Bone metastasis with fracture

  — pain and structural damage require prompt care to control symptoms and stabilize the situation.

• Brain metastases

  — the skull is a fixed space; swelling can be life-threatening and requires immediate treatment.

Outside of these true emergencies, most diagnoses give you time to learn, think, get second opinions, and design a plan that fits your values and biology.

Understanding what pathology tells us

Pathology is how we grade how far a tissue has departed from normal breast architecture. A few core concepts:

• Normal breast cells

  have estrogen and progesterone receptors and arrange in ducts and lobules.

• Atypia

  (abnormal cells) may sit in ducts without spreading.

• DCIS (ductal carcinoma in situ)

  is contained within ducts and, by definition, lacks the vessels or lymphatics inside ducts to spread. DCIS cannot metastasize and is not a life-threatening disease on its own.

• Invasive cancers

  are named by the pattern they form (invasive ductal, invasive lobular). The further from normal the cells appear, the higher the grade and the more aggressive the disease tends to be.

• Receptor status

  (ER/PR/HER2) matters: cancers that retain hormone receptors resemble normal tissue more and are generally less aggressive. Triple-negative cancers (lacking ER, PR, and HER2) are a different, often more aggressive biological disease.

• Metaplastic

  and very undifferentiated cancers are highly atypical and more aggressive.

Mammograms: origins, limits, and harms

Mammographic screening was well-intended—based on the idea that cancer grows in a linear, predictable way. But breast cancer biology is not strictly linear or size-dependent. Large population studies (including very large Swedish cohorts) show screening increases diagnoses by 20–30% without reducing overall breast cancer mortality in the screened population.

Important points about mammography:

• The amount of ionizing radiation in a mammogram is not uniform—it increases with breast density and size. People with dense, large breasts can receive substantially more radiation than those with small, fatty breasts.

• Repeated exposure over decades accumulates. Lifetime screening likely contributes to some of the increased incidence we see.

• Mammography finds many lesions (including DCIS and tiny invasive lesions) that may never become clinically relevant. Treating them like invasive, life-threatening cancer can create harm without survival benefit.

• Mammography remains a diagnostic tool when there is a symptom or palpable mass. The problem is using ionizing radiation as a routine screening test in healthy populations—especially among those already predisposed to trouble with DNA repair.

Radiation and long-term consequences

Radiation can reduce local recurrence after breast-conserving surgery, but it has not been shown to increase overall survival for most women. Radiation also causes short- and long-term harm beyond cosmetic changes:

• Fibrosis of the chest wall and muscles; brittle, weakened ribs (risk of fracture).

• Cardiac damage—increased coronary artery disease and cardiomyopathy, particularly when the left breast is irradiated.

• These treatment-related complications often are recorded as cardiovascular deaths rather than attributed to cancer therapy, obscuring the full impact of treatments.

There are situations where radiation is life-saving or necessary (brain mets, pain control, local control in certain aggressive disease). But it’s crucial patients understand trade-offs and long-term risks before consenting.

Screening alternatives and diagnostics

For clinically healthy women (the screening population) I advocate minimizing exposure to tools that cause harm. Practical options:

What I recommend

1. Monthly self–breast exam:

   Know your breasts better than anyone. Look and feel for changes—size, shape, dimpling, nipple changes. Premenopausal: check one week after menses; postmenopausal: pick a consistent day each month.

2. ARA tear test:

   A simple at‑home test that detects inflammatory proteins (S100A8/S100A9) with high sensitivity for early inflammatory risk. A positive result means you should pursue imaging and evaluate causes of inflammation—an opportunity to intervene before disease develops.

3. Imaging:

   For screening, I prefer non‑ionizing, non‑toxic options when possible. Ultrasound is better than exposing healthy women to radiation, though its resolution is lower. QT imaging (Perfection Imaging) is a promising, radiation‑free 3D modality using sound waves through water—no compression, no radiation, no gadolinium. It was designed to help high‑risk and dense‑breasted women who are poorly served by mammography.

Thermography and MRI

Thermography detects inflammation and can be useful as a general inflammation screen, but it is not a reliable screening test for breast cancer—many slow-growing cancers do not generate enough heat/inflammation to show up. Don’t spend money on thermography expecting it to replace proper imaging.

MRI avoids ionizing radiation but relies on gadolinium contrast. Gadolinium is a heavy metal that can accumulate in tissues; for women with impaired detoxification or genetic predisposition, adding more load can be problematic. MRI has its place (diagnostic work‑up, certain high‑risk situations), but it’s not a perfect solution for everyone.

High-risk individuals: how to think about screening

Women at higher risk (family history, genetic mutations, or impaired detox capacity) deserve thoughtful screening that doesn’t compound their vulnerability. Routinely subjecting high‑risk individuals to repeated mammographic radiation is, in my view, ethically questionable because it may increase risk in a population already prone to DNA repair issues.

QT imaging, targeted ultrasound, and careful, individualized strategies offer safer alternatives until more accessible radiation-free technologies are widely available.

Treatment philosophy: blend the best of conventional and integrative care

I’m neither dismissive of conventional cancer treatments nor a blind advocate. Surgery, chemotherapy, and radiation are powerful tools—sometimes lifesaving. But they are not without cost. My approach is pragmatic and bioindividual:

• When disease is life‑threatening or symptomatic (inflammatory cancer, painful bone fractures, brain mets), we act promptly with conventional systemic treatments.

• For non‑emergent disease, we have time to understand tumor biology, patient goals, and alternatives. That’s when integrative strategies, lifestyle changes, and targeted conventional therapy (when necessary) become powerful.

• Avoid “all‑or‑nothing” systems that force a single standardized pathway. Many patients respond dramatically to initial therapy and wish to reassess rather than automatically finishing a rigid protocol—this deserves honest conversation, not condemnation.

The Forgotten Woman: consequences after treatment

Treatment can save lives—but most women are not given adequate post‑treatment support. Many experience:

• Cognitive impairment (“chemo brain”), depression, anxiety, insomnia

• Forced or worsened menopause—brain fog, weight redistribution, low libido, joint pain

• Fatigue, altered relationships, urinary incontinence, bone and cardiovascular complications

Too often survivors are told to “be grateful” and left without resources to restore their health. Helping women rebuild physical, mental, and sexual health after cancer is central to my practice and upcoming work.

Trauma, chronic stress, and breast cancer risk

Chronic stress and unresolved trauma aren’t just psychological—they alter physiology. Our bodies interpret prolonged stress as danger, flooding us with cortisol, dysregulating immunity, and impairing DNA repair. Data show a notable correlation:

• Approximately 30% of early breast cancer cases report known trauma.

• Up to 80% of metastatic breast cancer patients report prior trauma; all have the trauma of diagnosis added on.

The body keeps score. If stress and trauma are left unaddressed, they contribute to a milieu that favors disease. Healing must include mental and emotional care, not just tumor‑directed interventions.

Common contributors and risk factors I evaluate

Cancer is a response to an abnormal environment. Key contributors I look for include:

• Chronic inflammation from diet (processed foods), obesity, diabetes

• Chronic inflammatory diseases (autoimmune disease, celiac—often unnoticed) and infections (viral, bacterial, fungal, parasitic)

• Radiation exposure—including repeated mammography in lifetime screeners

• Chemical exposures: plastics, pesticides, phthalates, xenoestrogens, heavy metals (e.g., dental amalgams)

• Frequent antibiotic use and disrupted microbiome

• Dental infections and root canals that harbor chronic inflammation

• Alcohol use, night shift work, chronic poor sleep

• Electromagnetic exposure (emerging concern), and chronic stress from relationships, caregiving, work, or unresolved trauma

Practical, preventive screening routine I recommend

1. Monthly self–breast exam (know your baseline).

2. Use the ARA tear test to detect early inflammatory risk if available—this is preventive and actionable.

3. If imaging is needed, prefer non‑ionizing options when screening (QT/Perfection Imaging where available or targeted ultrasound). Reserve mammography for diagnostic evaluation when there is a palpable abnormality or concerning symptom.

Where to get more help and resources

I continue to work at the intersection of conventional oncology and integrative care. My book, The Smart Woman’s Guide to Breast Cancer, was written so women can understand the tests and treatments before they are in the middle of a crisis. My podcast, Keeping a Breast with Dr. Jen, offers regular discussions and practical guidance. I also run programs through RealHealthMD to support women one‑on‑one and in groups.

I’m building clinician training to bring oncologic perspective into functional and integrative practices so providers can confidently and safely care for patients with breast concerns.

Final thoughts: informed, individualized care is the point

Breast health is not separate from overall health. The same habits that protect your brain, heart, bones, and gut protect your breasts. Be skeptical of one‑size‑fits‑all screening and treatment paradigms. Ask questions, pause when possible, and demand clear discussions about benefits, risks, and long‑term consequences.

"Breast cancer is not a surgery deficiency, chemotherapy deficiency, radiation deficiency, or hormonal blockade deficiency. These are mops in a flood—sometimes necessary, but always with consequences. Understand before you act." — Dr. Jen Simmons

If you want to be proactive about prevention, learn your risk profile, address inflammation and toxin load, and build the emotional resilience that keeps your immune system strong. That’s how we shift from reacting to disease to building lasting health.

For more information, watch this youtube video: