FOUND IN: Medical radiological procedures, such as X-rays, CT scans, fluoroscopy.

THE VERDICT: Evidence from studies of medical exposures to radiation as well as large-scale tragedies such as the atomic bomb in Japan have demonstrated that radiation can cause cancer.

Ionizing radiation is the emission of energetic particles (alpha, beta, neutron) or rays (gamma and x-rays) from a radioactive isotope–also called a ra-dionuclide. These emissions may knock off an elec-tron in its target, thus resulting in ionization. When something absorbs the energy of the ray or the particle, irradiation occurs. When a living being absorbs it, that individual has received a “dose” of radiation.

Curies, Rads, and Rems

The pioneers of the Nuclear Age invented units for measuring radioactivity. The measure of radio – ac-tive decay–the curie (named for Madame Marie Curie)–is the count, per second, of radioactive emissions, also called “disintegrations.” One curie is that amount of a radioactive material that gives off 37 billion radioactive particles or rays per second. This unit is a fixed standard, and concentrations in curies (or fractions of a curie) per gram or per liter, and per second or per minute, can be verified with proper instrumentation. Translating the curie amount into a potential dose to a living organism is far from precise.

Unlike the curie, which has a clear definition, the units for estimating impacts of radiation on living tissues–rads, rems and millirems–are based on models and assumptions. Estimates of the biological impacts of exposure to specific types of radiation have been based on animal experiments and on a limited number of human experiments. Most estimates of dose are based on data collected from the survivors of the Hiroshima and Nagasaki bombs, even when the given situation is different.

The Rad is used to measure the energy absorbed by tissue that is exposed to radioactivity. In Europe the unit for 100 Rads is called a Gray. The Rem combines the amount of radiation exposure (Rad) with its alleged impact on health. The estimated damage or “biological effectiveness” of the radiation is based on models. In Europe the unit for 100 Rems is called a Sievert. The prefix, “milli,” denotes one thousandth of a unit. For example: one rem equals 1,000 millirems.

The Rem (the unit of radiation dose) is not based upon a standard unit that can be verified. One must know the duration of exposure, amount and type of radioactivity involved, the size of the body that ab-sorbed it, and what that radiation event did to the particular body in question. Even under very controlled conditions like medical uses, it is virtually impossible to derive each of these data points with and degree of certainty.

State of the Evidence on Ionizing Radiation

Ionizing radiation is any form of radiation with enough energy to break off electrons from atoms (that is, to ionize the atoms). This radiation can break the chemical bonds in molecules, including DNA molecules, thereby disturbing their normal functioning. X-rays and gamma rays are the only common forms of radiation with sufficient energy to penetrate and damage body tissue below the surface of the skin.

Among the many sources of ionizing radiation are traditional X-rays, computed tomography (CT) scans, fluoroscopy, and other medical radiological procedures. Sources of gamma rays include nuclear medicine procedures such as bone, thyroid and lung scans.

In 2005, the National Toxicology Program classified X-radiation and gamma radiation as known human carcinogens. Most scientists agree that there is no such thing as a safe dose of radiation (Brenner, 2003; NRPB, 1995). A 2006 National Research Council report confirms this finding, stating that “the risk of cancer proceeds in a linear fashion at lower doses [of ionizing radiation] without a threshold and … the smallest dose has the potential to cause a small increase in risk to humans” (NRC, 2005). Radiation damage to genes is cumulative over a lifetime (Boice, 2001). Repeated low-dose exposures over time may have the same harmful effects as a single high-dose exposure.

Exposure to ionizing radiation is the longest-established and most firmly established environmental cause of human breast cancer in both women and men. Ionizing radiation can increase the risk for breast cancer through a number of different mechanisms, including direct mutagenesis (causing changes in the structure of DNA), genomic instability (increasing the rate of changes in chromosomes, therefore increasing the likelihood of future mutations) (Broeks, 2010: Goldberg, 2003; Morgan, 2003; Wright, 2004), and changes in breast cell microenvironments that can lead to damaged regulation of cell-to-cell communication within the breast (Barcellos-Hoff, 2005; Tsai, 2005). Ionizing radiation not only affects cells that are directly exposed, but can also alter the DNA, growth, and cell-to-cell interactions of neighboring cells, a phenomenon referred to as the “bystander effect” (Little, 2003; Murray, 2007b).

Interactions between Ionizing Radiation and Other Factors

There are a number of factors that may interact with radiation to increase the potency of its carcinogenic effect. Some of these factors include a person’s age at exposure, their genetic profile, and possibly a woman’s estrogen levels. As examples:

a. It has been well established in a number of studies of women exposed to military, accidental or medical sources of radiation that exposure in children and adolescents confers greater increased risk than exposure in older women (Boice, 2001).

b. Recent genetic data indicate that women with some gene mutations (such as ATM, TP53 and BRCA1/2) are more likely to develop breast cancer and may be especially susceptible to the cancer-inducing effects of exposures to ionizing radiation (Andrieu, 2006; Berrington de Gonzales, 2009a; Pepe, 2012; Turnbull, 2006).

c. Studies using animal tumor cells and in vitro human breast tumor cells have demonstrated that the effects of radiation on mammary carcinogenesis may be additive with effects of estrogens (Calaf, 2000; Imaoka, 2009; Segaloff, 1971). This is of particular concern given the widespread exposure to estrogen-mimicking chemicals (xenoestrogens) in our environment and the multiple sources of ionizing radiation. In a mouse model, radiation exposure increased blood serum estradiol levels and estrogen associated activation of cell-proliferation pathways (Suman, 2012).

Evidence Linking Ionizing Radiation and Cancer

The link between radiation exposure and cancer has been demonstrated in atomic bomb survivors (Goto, 2012; Land, 1995; Pierce, 1996; Tokunaga, 1994). Rates of breast cancer were highest among women in Hiroshima and Nagasaki who were younger than age 15 when the United States dropped atomic bombs there (Land, 1998). Recent analysis of tumor subtypes and tissue DNA from survivors of the atomic bombs indicate that radiation-associated breast tumors are quite aggressive and are associated with increased levels of genomic instability (too many genes, mutations or incomplete replication of genes, etc.), a trait that has been associated with the development of cancer (Oikawa, 2011). In addition, scientists reported a statistically significant association between ionizing radiation exposure and the incidence of male breast cancer in Japanese atomic bomb survivors (Ron, 2005).

Use of X-rays to examine the spine, heart, lungs, ribs, shoulders and esophagus also exposes parts of the breast to radiation. X-rays and fluoroscopy of infants irradiate the whole body (Gofman, 1996). Decades of research has confirmed the link between radiation and breast cancer in women who were irradiated for many different medical conditions, including tuberculosis (MacKenzie, 1965), benign breast disease (Golubicic, 2008; Mattson, 1995), acute postpartum mastitis (Shore, 1986), enlarged thymus (Adams, 2010; Hildreth, 1989), skin hemangiomas (Lundell, 1999), scoliosis (Morin-Doody, 2000), Hodgkin’s disease (Bhatia, 2003; Guibout, 2005; Horwich, 2004; Wahner-Roedler, 2004), non-Hodgkin’s lymphoma (Tward, 2006) and acne (El-Gamal, 2006). A dose-response relationship (meaning a higher dose of radiation is related to a higher incidence of breast cancer) was found in women who had been treated with X-rays and who had a family history of breast cancer (Ronckers, 2008). Evidence from almost all conditions suggests that exposure to ionizing radiation during childhood and adolescence is particularly dangerous with respect to significantly increased risk for breast cancer later in life (John, 2007).

Female radiology technologists who had sustained daily exposures to ionizing radiation demonstrated an increased risk of breast cancer if they began working during their teens or, independent of age, worked in the field before the 1940s, when exposure levels were substantially higher than they have been in more recent decades (Doody, 2006; Simon, 2006). The susceptibility of radiologists to later diagnosis of breast cancer may be affected by common variants in particular genes that are involved in the metabolism of circulating estrogens (Sigurdson, 2009). A review and analysis of all existing related studies found that women who work as airline flight attendants had increased levels of breast cancer. Factors that could explain this increase may include lifestyle and reproductive histories as well as increased exposures to cosmic (atmospheric) ionizing radiation (Ballard, 2000).

Medical Radiation: Risks and Benefits

Computed tomography (CT) Scans
There is considerable evidence that medical X-rays, which include mammography, fluoroscopy and computed tomography (CT) scans are an important and controllable cause of breast cancer (Gofman, 1999; Ma, 2008). Although there has been a substantial decrease in exposures to ionizing radiation from individual X-rays over the past several decades, there has been a sixfold increase in exposure to medical sources of radiation from the mid-1980s through 2007, with an annual increase of 16 percent, primarily arising from the increased use of CT scans and nuclear medicine (Larson, 2011; Linet, 2012). In 2007, approximately 72 million CT scans were conducted in the United States (Berrington de Gonzales, 2009b). When a CT scan is directed to the chest, the individual receives the equivalent radiation of 30 to 442 or more chest X-rays (Redberg, 2009). Recent modeling estimates that use of chest CTs and CT angiography in 2007 alone will lead to an additional 5,300 cases of lung and breast cancer within the next two to three decades (Berrington de Gonzales, 2009b). Other modeling suggests that 1 in 150 women who are 20 years old when they undergo CT angiograms of the chest, and 1 in 270 women (of all ages) having the procedure, will subsequently develop cancers of the chest, including breast cancer (Smith-Bindman, 2009).

Recent modeling of the long-term effects of cardiac CT angiography, a source of comparably high radiation to the chest, demonstrates a statistically significant increase in risk for breast cancer, especially in pre-menopausal women (Huda, 2011).


Damage from lower-energy sources of X-rays, including those used in mammography, cannot be predicted by estimating risk from models based on higher doses (Heyes, 2009; Millikan, 2005). Recent evidence indicates that the lower-energy X-rays provided by mammography result in substantially greater damage to DNA than would be predicted by these models. Evidence also suggests that risk of breast cancer caused by exposure to mammography radiation may be greatly underestimated (Heyes, 2009).

As with other risk factors for breast cancer, evidence indicates that both age at exposure and the individual’s genetic profile influence the degree of increased risk for disease in women exposed to multiple mammograms. For example, women who had multiple mammograms more than five years prior to diagnosis had an increased risk for breast cancer (Ma, 2008).

This age effect is of particular concern, since it is often recommended that high-risk women, including those with either of the BRCA mutations, foolishly begin annual mammography screening at ages 25 to 30. Further complicating this age-related finding are the data now demonstrating that young women with the very mutations that lead them to begin mammography screenings at earlier ages are actually more vulnerable to the cancer-inducing effects of early and repeated exposures to mammograms. This increased vulnerability has been found in women with BRCA mutations (Berrington de Gonzales, 2009a; Jansen-Van der Weide, 2009) as well as in women with other relatively uncommon variations in genes known to be involved in the process of DNA repair (Millikan, 2005). A recent study found that diagnostic radiation exposure before age 30 increased risk of breast cancer in a dose-dependent manner among women with BRCA mutations (Pijpe, 2012).

The detrimental risks from mammography might also be heightened in older women, whose breast epithelial cells have gone through several decades of cell division. Cells derived from older women’s breast tissue were more sensitive to the DNA-damaging effects of low-energy radiation, increasing the likelihood of later conversion to cancerous cells (Soler, 2009).

In 2009 the U.S. Preventive Services Task Force recommended against the use of routine mammography screening for women under 50 (Nelson, 2009; USPSTF, 2009) and recommended that women 50 to 75 get screened every two years. The Task Force concluded that for women 40 to 49 the benefits of mammograms do not outweigh the harms, which include false-positive results that lead to unneeded breast biopsies and follow up-imaging, and to unnecessary anxiety and distress. Also, the Task Force found that mammograms play an extremely modest role in reducing the likelihood of dying from breast cancer. Among women 40 to 49, who tend to have low rates of breast cancer to begin with, the procedure is responsible for saving very few lives. As women are now facing the need to make their own decisions about whether to undergo routine screening mammography, it is critical that both physicians and women are better educated about mammography’s harms, along with its unproven, perceived potential benefits (Gotzsche, 2009; Jansen-van der Weide, 2010).

Radiation Therapy

Some studies suggest that doctors and patients should carefully evaluate the risks and benefits of radiation therapy for survivors of early-stage breast cancer, particularly older women. Women older than 55 derive less benefit from radiation therapy in terms of reduced rate of local recurrence (Veronesi, 1999) and may face increased risks of radiation-induced cardiovascular complications (EBGTCG, 2000), as well as secondary cancers such as leukemias and cancers of the lung, esophagus, stomach and breast (Mellemkjaer, 2006; Roychoudhuri, 2004). Using the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) data, researchers showed a 16-fold increased relative risk of angiosarcoma of the breast and chest wall following irradiation of a primary breast cancer (Huang, 2001).

More recent data indicate that women younger than 45 who received the higher radiation exposure associated with post-lumpectomy radiotherapy (as compared to post-mastectomy radiation) had a 1.5-fold to 2.5-fold increase in later contralateral breast cancer diagnoses. This effect was especially prominent in younger women with a family history of breast cancer (Hooning, 2007; Ng, 2009; Stovall, 2008).


Adams, M., Dozier, A., Shore, R., Lipshultz, S., Schwartz, R., Constine, L., … Fisher, S. (2010). Breast cancer risk 55  years after irradiation for an enlarged thymus and its implications for early childhood medical irradiation today. Cancer Epidemiol Biomarkers Prev, 19, 48–58.

Andrieu, N., Easton, D., Chang-Claud, J., Rookus, M., Brohet, R., Cardis, E., … Goldgar, D. (2006). Effect of chest X-rays on the risk of breast cancer among BRCA1/2 mutation carriers in the International BRCA1/2 Carrier Cohort Study: A report from EMBRACE, GEGNNEPSO, GEO-HEBON, and IBCCS Collaborators’ Group. J Clin Oncol, 24, 3361–3366.

Ballard, T., Lagorio, S., De Angelis, G., & Verdecchia, A. (2000). Cancer incidence and mortality among flight personnel: A meta-analysis. Aviat Space Environ Med, 71, 216–224.

Barcellos-Hoff, M., Park, C., & Wright, E. (2005). Radiation and the microenvironment: Tumorogenesis and therapy. Nat Rev Cancer, 5, 867–875.

Berrington-de-Gonzalez, A., Berg, C., Visvanathan, K., & Robson, M. (2009). Estimated risk of radiation-induced breast cancer from mammographic screening for young BRCA mutation carriers. J Natl Cancer Inst, 101, 205–209.

Berrington-de-Gonzalez, A., Mahesh, M., & Kim, K.-P. (2009). Projected cancer risks from computed tomographic scans performed in the United States in 2007. Arch Intern Med, 169, 2071–2077.

Bhatia, S., Yasui, Y., Robison, L., Birch, J., Bogue, M., Diller, L., … Meadows, A. (n.d.). High risk of subsequent neoplasms continues with extended follow-up of childhood Hodgkin’s disease: report from the Late Effects Study Group. J Clin Oncol, 21, 4386–94.

Boice, J. (2001). Radiation and breast carcinogenesis. Med & Pediatr Oncol, 36, 508–513.

Brenner, D., Doll, R., Goodhead, D., Hall, E., Land, C., Little, J., … Zaider, M. (2003). Cancer risks attributable to low doses of ionizing radiation. Proc Natl Acad Sci, 100, 13761–13766.

Broeks, A., Braaf, L. M., Wessels, L. F. A., Van de Vijver, M., De Bruin, M. L., Stovall, M., … Van ’t Veer, L. J. (2010). Radiation-Associated Breast Tumors Display a Distinct Gene Expression Profile. Int J Radiat Oncol, 76(2), 540–547.

Calaf, G., & Hei, T. (2000). Establishment of a radiation- and estrogen-induced breast cancer model. Carcinogenesis, 21, 769–776.

Doody, M., Freedman, D., Alexander, B., Hauptmann, M., Miller, J., Rao, R., … Linet, M. (2006). Breast cancer incidence in U.S. radiologic technologists. Cancer, 106, 2707–2715.

EBCTCG, E. B. C. T. C. G. (n.d.). Favorable and unfavorable effects on long-term survival of radiotherapy for early breast cancer: An overview of the randomized trials. Lancet, 355, 1757–1770.

El-Gamal, H., & Bennett, R. (2006). Increased breast cancer risk after radiotherapy for acne among women with skin cancer. J Am Acad Dermatol, 55, 981–989.

Gofman, J. (1996). Preventing Breast Cancer: The Story of a Major, Proven, Preventable Cause of this Disease, 2nd ed. San Francisco: CNR Book Division, Committee.

Gofman, J. (1999). Radiation from Medical Procedures in the Pathogenesis of Cancer and Ischemic Heart Disease: Dose-responseSstudies with Physicians per 100,000 Population. San Francisco: CNR Book Division, Committee for Nuclear Responsibility.

Goldberg, Z. (2003). Radiation-induced effects in unirradiated cells: A review and implications in cancer. Int J Oncol, 21, 337–349.

Golubicic, I., Borojevic, N., & Pavlovic, T. (2008). Risk factors for breast cancer: is ionizing radiation among them. J BUON, 13, 487–494.

Goto, H., Watanabe, T., Miyao, M., Fukuda, H., Sato, Y., & Oshida, Y. (2012). Cancer mortality among atomic bomb survivors exposed as children. Environ Health Prev Med, 17(3), 228–234.

Gotzsche, P., Hartling, O., Nielsen, M., Brodersen, J., & Jorgensen, K. (2009). Breast screening: the facts or maybe not. Br Med J, 338, 86.

Guibout, C., Adjadj, E., Rubino, C., Shamsaldin, A., Grimaud, E., Hawkins, M., … De Vathaire, F. (2005). Malignant breast tumors after radiotherapy for a first cancer during childhood. J Clin Oncol, 23, 197–204.

Heyes, G., Mill, A., & Charles, M. (2009). Mammography: oncogenecity at low doses. J Radiol Protect, 29, 123–132.

Hildreth, N., Shore, R., & Dvoretsky, P. (1989). The risk of breast cancer after irradiation of the thymus in infancy. New England J Med, 1281–1284.

Hooning, M., Aleman, B., Hauptmann, M., Baaijens, M., Klijn, J., Noyon, R., … Van Leeuwen, F. (2007). Roles of radiotherapy and chemotherapy in the development of contralateral breast cancer. J Clin Oncol, 34, 5561–5568.

Horwich, A., & Swerdlow, A. (2004). Secondary primary breast cancer after Hodgkin’s disease. Br J Cancer, 90, 294–298.

Huang, J., & Mackillop, W. (2001). Increased risk of soft tissue sarcoma after radiotherapy in women with breast carcinoma. Cancer, 92, 532–536.

Huda, W., Schoepf, U. J., Abro, J. A., Mah, E., & Costello, P. (2011). Radiation-related cancer risks in a clinical patient population undergoing cardiac CT. Am J Roentgenol, 196(2), W159–165.

Imaoka T, Nishimura M, Iizuka D, et al. (2009). Radiation-induced mammary carcinogenesis, in rodent models: what’s different from chemical carcinogenesis? J Radiat Res, 50:281-293.

Jansen-Van Der Weide M (2009). Mammography screening and radiation-induced breast cancer among women with a familial or genetic predisposition: a metaanalysis. Published abstract of presentation at the 95th annual meeting of the Radiological Society of North America, Chicago.

Jansen-van der Weide, (2010) Exposure to low-dose radiation and the risk of breast cancer among women with a familial or genetic predisposition: a meta-analysis. Eur Radiol. 2010 Nov;20(11):2547-56.

John, 2007 Medical radiation exposure and breast cancer risk: Findings from the Breast Cancer Family Registry. International Journal of Cancer. 15 July 2007; Volume 121, Issue 2: Pages 386–394

Land CE (1995). Studies of cancer and radiation dose among A-bomb survivors: The example of breast cancer. J Am Med Assoc, 274:402-407

Land CE (1998). Epidemiology of radiation-related breast cancer. Workshop Summary: National Action Plan on Breast Cancer, Breast Cancer Etiology Working Group, Workshop on Medical Ionizing Radiation and Human Breast Cancer. November 17-18, 1997.

Larson (2011). Rising use of CT in child visits to the emergency department in the United States, 1995-2008. Radiology. 2011 Jun;259(3):793-801.

Linet (2012). Cancer risks associated with external radiation from diagnostic imaging procedures.

CA Cancer J Clin. 2012 Mar-Apr;62(2):75-100

Little JB (2003). Genomic instability and radiation. J Radiol Protection, 23:173-181.

Lundell M, Mattsson A, Karlsson P, et al. (1999). Breast cancer risk after radiotherapy in infancy: A pooled analysis of two Swedish cohorts of 17,202 infants. Radiat Res, 151:626-632.

Ma, H., Hill, C., Bernstein, L., & Ursin, G. (2008). Low-dose medical radiation exposure and breast cancer risk in women under age 50 years overall and by estrogen and progesterone receptor status: Results from a case-control and a case-case comparison. Breast Cancer Res Treat, 109, 77–90.

MacKenzie, I. (1965). Breast cancer following multiple fluoroscopies. Br J Cancer, 19, 1–8.

Mattsson, A., Ruden, B., Palmgren, J., & Rutgvist, L. (1995). Dose-and time-response for breast cancer risk after radiation therapy for benign breast disease. Br J Cancer, 72, 1054–1061.

Mellemkjaer, L., Friis, S., Olsen, J., Scelo, G., Hemminki, K., Tracey, E., … Brennan, P. (2006). Risk of second cancer among women with breast cancer. Int J Cancer, 118, 2285–2292.

Millikan, RC., Player, J., Decotret, A., Tse, C., & Keku, T. (2005). Polymorphisms in DNA repair genes, medical exposure to ionizing radiation, and breast cancer risk. Cancer Epidemiol Biomarkers Prev, 14, 2326–2334.

Morgan, W. (2003). Non-targeted and delayed effects of exposure to ionizing radiation: II. Radiation-induced genomic instability and bystander effects in vivo, clastogenic factors and transgenerational effects. Radiat Res, 159, 581–596.

Morin Doody, M., Lonstein, J. E., Stovall, M., Hacker, D. G., Luckyanov, N., & Land, C. E. (2000). Breast cancer mortality after diagnostic radiography: Findings from the U.S. scoliosis cohort study. Spine, 25(16), 2052–2063.

Murray, T., Maffini, M., Ucci, A., Sonnenschein, C., & Soto, A. (2007). Induction of mammary gland ductal hyperplasias and carcinoma in situ following fetal bisphenol A exposure. Reprod Toxicol, 23, 383–390.

Nelson, H., Tyne, K., Naik, A., Bougatsos, C., Chan, B., Humphrey, L., & U.S. Preventive Services Task Force. (2009). Screening for breast cancer: an update for the U.S. preventive services task force. Ann Intern Med, 151, 727–737.

Ng, A. K., & Travis, L. B. (2009). Radiation therapy and breast cancer risk. J Nat Comp Cancer Network, 7(10), 1121–1128.

Committee to Assess Health Risks from Exposure to Low Levels of Ionizing Radiation. Health risks from exposure to low levels of ionizing radiation: BEIR VII Phase 2. Washington, DC: The National Academies Press; 2006

NRPB, N. R. P. B. (1995). Risk of radiation-induced cancer at low doses and low-dose rates for radiation protection purposes. Documents of the NRPB, 6, 25.

Oikawa, M., Yoshiura, K.-I., Kondo, H., Miura, S., Nagayasu, T., & Nakashima, M. (2011). Significance of genomic instability in breast cancer in atomic bomb survivors: Analysis of microarray-comparative genomic hybridization. Radiat Oncol, 6(1), 168.

Pepe, S., Pensabene, M., & Condello, C. (2012). Modifiers of risk in BRCA1/2 mutation carriers. Curr Women’s Health Rev, 8(1), 23–29.

Pierce, D., Shimizu, Y., Preston, D., Vaeth, M., & Mabuchi, K. (1996). Studies of the mortality of atomic bomb survivors. Report 12. Part I. Cancer: 1950-1990. Radiat Res, 146, 1–27.

Pijpe, A., Andrieu, N., Easton, D. F., Kesminiene, A., Cardis, E., Noguès, C., … Van Leeuwen, F. E. (2012). Exposure to diagnostic radiation and risk of breast cancer among carriers of BRCA1/2 mutations: Retrospective cohort study (GENE-RAD-RISK). BMJ (Online), 345(7878)

Redberg, RF (2009). Cancer risks and radiation exposure from computed tomographic scans: how can we be sure that the benefits outweigh the risks? Arch Intern Med. 2009 Dec 14;169(22):2049-50.

Ron, E., Ikeda, T., Preston, D., & Tokuoka, S. (2005). Male breast cancer incidence among atomic bomb survivors. J Natl Cancer Inst, 97, 603–605.

Ronckers, C. M., Doody, M. M., Lonstein, J. E., Stovall, M., & Land, C. E. (2008). Multiple diagnostic X-rays for spine deformities and risk of breast cancer. Cancer Epidemiol, Biomar Prev, 17(3), 605–613.

Roychoudhuri, R., Evans, H., Robinson, D., & Moller, H. (2004). Radiation-induced malignancies following radiotherapy for breast cancer. Br J Cancer, 91, 868–872.

Segaloff, A., & Maxfield, W. (1971). The synergism between radiation and estrogen in the production of mammary cancer in the rat. Cancer Res, 31, 166–168.

Shore, R., Hildreth, N., Woodard, E., Dvoretsky, P., Hempelmann, L., & Pasternack, B. (1986). Breast neoplasms in women given X-ray therapy for acute postpartum mastitis. J Natl Cancer Inst, 77, 689–696.

Sigurdson, AJ., Bhatti, P., Chang, S., Rajaraman, P., Doody, M., Bowen, L., … Struewing, J. (2009). Polymorphisms in estrogen biosynthesis and metabolism-related genes, ionizing radiation exposure, and risk of breast cancer among U.S. radiologic technologists. Breast Cancer Res Treat, 118, 177–184.

Simon, S., Weinstock, R., Doody, M., Neton, J., Wenzl, T., Stewart, P., … Linet, M. (2006). Estimating historical radiation doses to a cohort of U.S. radiologic technologists. Radiat Res, 166, 174–192.

Smith-Bindman (2009) Radiation dose associated with common computed tomography examinations and the associated lifetime attributable risk of cancer. Arch Intern Med. 2009 Dec 14;169(22):2078-86.

Soler, D., Pampalona, J., Tusell, L., & Genesca, A. (2009). Radiation sensitivity increases with proliferation-associated telomere dysfunction in nontransformed human epithelial cells. Aging Cell, 8, 414–425.

Stovall, M., Smith, S. A., Langholz, B. M., Boice, J. D., Jr, Shore, R. E., Andersson, M., … Bernstein, J. L. (2008). Dose to the contralateral breast from radiotherapy and risk of second primary breast cancer in the WECARE study. Int J Rad Oncol, 72(4), 1021–1030.

Suman, S., Johnson, M. D., Fornace Jr., A. J., & Datta, K. (2012). Exposure to ionizing radiation causes long-term increase in serum estradiol and activation of PI3K-Akt signaling pathway in mouse mammary gland. International J Radiat Oncol, 84(2), 500–507.

Tokunaga, M., Land, C., Tokuoka, S., Nishimori, I., Soda, M., & Akiba, S. (1994). Incidence of female breast cancer among atomic bomb survivors, 1950-1985. Radiat Res, 138, 1950–1985.

Tsai, K., Chuang, E., Little, J., & Yuan, Z. (2005). Cellular mechanisms for low-dose ionizing radiation-induced perturbation of the breast tissue microenvironment. Cancer Res, 65, 6734–6744.

Turnbull, C., Mirugaesu, N., & Eeles, R. (2006). Radiotherapy and genetic predisposition to breast cancer. Clin Oncol, 18, 257–267.

Tward, J., Wendland, M., Shrieve, D., Szabo, A., & Gaffney, D. (2006). The risk of secondary malignancies over 30 years after the treatment of non-Hodgkin lymphoma. Cancer, 107, 108–115.

USPSTF. (2009). Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med, 151, 716–727.

Veronesi, U., Luini, A., Del Vecchio, M., Greco, M., Galimberti, V., Merson, M., … Salvadori, B. (1993). Radiotherapy after breast-preserving surgery in women with localized cancer of the breast. New England J Med, 328, 1587–1591.

Wahner-Roedler, D., & Petersen, I. (2004). Risk of breast cancer and breast cancer characteristics in women after treatment for Hodgkin lymphoma. Drugs Today, 40, 865–79.

Wright, E. (2004). Radiation-induced genomic instability: Manifestations and mechanisms. Int J Low Radiat, 1, 231–241.

radiotherapy-originRadiotherapy – Origin (3:36)

surgery-radiation-and-chemo-cannot-work-against-the-stem-cellsSurgery radiation and chemo cannot work against the stem cells (1:00)

radiation-is-not-safeRadiation IS NOT safe (0:30)

radiation-is-carcinogenic-and-we-have-known-for-125-yearsRadiation is Carcinogenic and we have known for 125 years (0:41)

radiation-is-not-specificRadiation is not specific (0:51)

chemo-radiation-and-surgery-are-largely-ineffectiveChemo Radiation and Surgery are largely ineffective (1:23)

chemo-and-radiation-are-killing-cancer-patientsChemo and radiation are killing cancer patients (1:00)

chemo-and-radiation-are-non-specificChemo and radiation are non-specific (1:15)

chemo-surgery-and-radiation-are-not-very-effectiveChemo surgery and radiation are not very effective (0:34)

death-by-doctor-with-chemo-surgery-and-radiationDeath by Doctor with chemo surgery and radiation (4:09)

fda-has-never-approved-chemo-or-radiation-for-childrenFDA has never approved chemo or radiation for children (0:42)

how-hazardous-are-chemo-and-radiationHow hazardous are chemo and radiation (2:04)

is-stage-4-cancer-curable-using-chemotherapy-radiation-or-surgeryIs Stage 4 Cancer curable using Chemotherapy Radiation or Surgery (8:04)

radiation-and-chemotherapy-resistanceRadiation and Chemotherapy resistance (1:45)

the-chemo-radiation-surgery-industry-wont-go-awayThe chemo radiation surgery industry wont go away (0:36)

treatment-resistance-of-radiation-and-chemoTreatment resistance of radiation and chemo (0:50)

why-chemo-radiation-and-surgery-cant-workWhy chemo radiation and surgery cant work (6:58)

blind-faith-in-science-is-often-misplacedBlind faith in science is often misplaced

chemo-kills-just-as-many-people-as-cancerChemo Kills Just as Many People as Cancer

dr-desaulniers-2-percent-chemo-effective-rateDr Desaulniers 2 percent chemo effective rate

abc-news-the-prevalence-of-hospital-errorsABC news the prevalence of hospital errors

dr-lodi-conventional-medicine-doesnt-workDr Lodi Conventional medicine doesnt work

am-i-doing-what-is-best-for-the-patientAm I doing what is best for the patient

be-confident-on-your-chosen-treatmentBe confident on your chosen treatment

blind-obedience-can-kill-you-question-your-doctorBlind obedience can kill you question your doctor

chemo-surgery-and-radiation-are-not-very-effectiveChemo surgery and radiation are not very effective

Side Effects


To access the site, you must agree to the following;

Terms of Use


Please read these Terms of Use carefully before accessing or using our website. By accessing or using any part of the site, you agree to be bound by these Terms of Use. If you do not agree to all the terms and conditions of this agreement, then you may not access the website or use any services.

This website is operated by private parties in the Republic of Panama. Throughout the site, the terms “we”, “us” and “our” refer to, which offers this website, including all information, tools and services available from this site to you, the user, conditioned upon your acceptance of all terms, conditions, policies and notices stated here.

You understand and agree that you are accessing a website registered, owned, and hosted in the Republic of Panama. Therefore, all issues of a legal nature fall under the jurisdiction of the Republic of Panama legal system.

You understand and agree that as an authorized user you may only access information to which you have the legal authority to view and use. will monitor and record activity on this system to protect the system and its information and may use that monitoring information for official administrative or legal purposes. You understand and agree that you are not permitted to record, screenshot, or disseminate any information contained on the website to any party for any purpose whatsoever, and as such, you agree not to engage in such banned activities.

You understand and agree that unauthorized use of the system such as gaining unauthorized access to data, changing data, causing harm to the system or its data, or misuse of components is prohibited and may result in criminal, civil, or administrative penalties.

You also understand that can suspend or stop your use of this system if suspects any unauthorized use of the system attributable to you has occurred.

Your access to and use of the site is conditioned on your acceptance of and compliance with these Terms. These terms apply to all visitors, users and others who access or use the site. By accessing or using the site, you agree to be bound by these Terms. If you disagree with any part of the following Terms of Use, then you may not access the site.

By visiting our site and/ or purchasing anything from us, you engage in our “Service” and agree to be bound by the following terms and conditions (“Terms of Use”, “Terms”), including those additional terms and conditions and policies referenced herein and/or available by hyperlink. These Terms of Use apply to all users of the site, including without limitation users who are browsers, vendors, customers, merchants, and/ or contributors of content.

Any new features or tools which are added to the current website shall also be subject to the Terms of Use. You can review the most current version of the Terms of Use at any time on this page. We reserve the right to update, change or replace any part of these Terms of Use by posting updates and/or changes to our website. It is your responsibility to check this page periodically for changes. Your continued use of or access to the website following the posting of any changes constitutes acceptance of those changes.



By agreeing to these Terms of Use, you represent that you are at least the age of majority in your state, province, country or city of residence, or that you are the age of majority in your state, province, country or city of residence and you have given us your consent to allow any of your minor dependents to use this site.

You may not use any of our website for any illegal or unauthorized purpose nor may you, in the use of the Service, violate any laws in your jurisdiction (including but not limited to copyright laws).

You must not transmit any worms or viruses or any code of a destructive nature.

A breach or violation of any of the Terms will result in an immediate termination of your Services.



We reserve the right to refuse service to anyone for any reason at any time.

You agree not to reproduce, duplicate, copy, sell, resell or exploit any portion of the Service, use of the Service, or access to the Service or any contact on the website through which the service is provided, without express written permission by us.

The headings used in this agreement are included for convenience only and will not limit or otherwise affect these Terms.

You understand and agree that this website is for information purposes only, and that by providing the information contained herein, we are not diagnosing, treating, curing, mitigating, or preventing any type of disease or medical condition. You understand and agree that before beginning any type of natural, integrative or conventional treatment regimen, it is advisable to seek the advice of a licensed healthcare professional.

You understand and agree that the information on the site is presented for the sole purpose of disseminating health information for general educational purposes only. You understand and agree that if you think you may have a medical emergency, you should call your doctor or 911. You understand and agree that the information on this site is not intended or implied to be medical advice, and you understand and agree that the information does not constitute the provision or practice of medical, nursing, or professional health care advice or services. You understand and agree that you will not use the information on this site as a substitute for professional medical advice, diagnosis, or treatment. You understand and agree that you should always seek the advice of your physician or other qualified health care provider prior to starting any treatment or with any questions you may have regarding a medical condition.

You understand and agree that nothing contained on this site is intended to be or will be used by you for medical diagnosis or treatment. You understand and agree that you should never disregard professional medical advice or delay in seeking treatment based on the information contained on this site. You understand and agree that the service and any content or information contained on the site is provided on an ‘as is’ basis. You understand and agree that while efforts have been made to assure the accuracy of the information on this site, there is no guarantee that such information is accurate or up-to-date. You understand and agree that, except for information, products, or services clearly identified as being supplied by the site, the site does not operate, control, or endorse any information, products, or services on the internet, in any way.

In addition, access to this site constitutes acceptance and understanding of the following,

By accessing this system, you hereby acknowledge, consent, and agree to all listed provisions and consent to monitoring.

You understand and agree that any copyright laws pertaining to the ownership and reproduction of all data fall exclusively under Panamanian legal jurisdiction for

If you are a copyright holder, or a director, officer, owner, employee, agent, supplier, licensor, contributor, service provider, website hosting company, trade partner, heir or assign of a copyright holder and feel that you or anyone you are engaged in any form of relationship whatsoever may have rights to data as part of this site or related sites, your agreement with the terms of use constitutes the following agreement, which is mandatory in order to access the data contained on this site.

I do hereby declare, understand, agree and warrant that I am a copyright owner, or an authorized representative of a copyright owner of film, print, slide, movie, video, artwork, digital image, negatives or any other material in any format whatsoever (hereafter referred to as “COPYRIGHTED DATA”) which I believe to be, known to be, or suspect to be contained on the website.

I hereby freely grant a non-exclusive license to and its agents to reproduce these COPYRIGHT DATA in perpetuity, and I represent and warrant that I have the legal right and authority to grant such a license. I may at my discretion ask to be credited for my contribution or the contributor I represent to the site as a contributor whether this occurred with or without my knowledge, but even if I or the contributor I represent remains uncredited, this agreement shall survive since participation in the free flowing of information for the public at large is a paramount responsibility we all should share. Therefore, in the best interest of free-flowing information for the public at large, I am freely undertaking this agreement, and clearly warrant that I have the authority to do so. I agree to indemnify and hold harmless and any of its directors, officers, owners, employees, agents, suppliers, licensors, contributors, service providers, website hosting companies, trade partners, heirs and assigns from any and all liability, damages, and expenses (including reasonable actual attorney’s fees) that may incur as a result of use and publication of said material, including any claims brought by any person claiming an interest in the COPYRIGHTED DATA or their subject matter. I agree and warrant that anyone containing any format of data from contained in any medium outside of the website itself, is bound by this agreement, since acceptance of this agreement is the only way to legally access such data. In addition, I understand and agree that accessing or storing any format of data contained in any medium outside of the website where it is hosted, constitutes a violation of the copyright laws of Panama against the offending party. I understand and agree that if I copy, contain, possess, or transmit any such data from the site in any format outside of the website itself, that my possession of such materials is a violation of Panamanian laws, and I agree to destroy such data forthwith.



We are not responsible if information made available on this site is not accurate, complete or current. The material on this site is provided for general information only and should not be relied upon or used as the sole basis for making decisions without consulting primary, more accurate, more complete or more timely sources of information. Any reliance on the material on this site is at your own risk.

This site may contain certain historical information. Historical information, necessarily, is not current and is provided for your reference only. We reserve the right to modify the contents of this site at any time, but we have no obligation to update any information on our site. You agree that it is your responsibility to monitor changes to our site.



We reserve the right at any time to modify or discontinue the Service (or any part or content thereof) without notice at any time.

We shall not be liable to you or to any third-party for any modification, change, suspension or discontinuance of the Service.



Any use by you of optional tools offered through the site is entirely at your own risk and discretion and you should ensure that you are familiar with and approve of the terms on which tools are provided by the relevant third-party provider(s).

We may also, in the future, offer new services and/or features through the website (including, the release of new tools and resources). Such new features and/or services shall also be subject to these Terms of Use.



Certain content, products and services available via our Service may include materials from third-parties.

Third-party links on this site may direct you to third-party websites that are not affiliated with us. We are not responsible for examining or evaluating the content or accuracy and we do not warrant and will not have any liability or responsibility for any third-party materials or websites, or for any other materials, products, or services of third-parties.

We are not liable for any harm or damages related to the purchase or use of goods, services, resources, content, or any other transactions made in connection with any third-party websites. Please review carefully the third-party’s policies and practices and make sure you understand them before you engage in any transaction. Complaints, claims, concerns, or questions regarding third-party products should be directed to the third-party.



If, at our request, you send certain specific submissions (for example contest entries) or without a request from us you send creative ideas, suggestions, proposals, plans, or other materials, whether online, by email, by postal mail, or otherwise (collectively, ‘comments’), you agree that we may, at any time, without restriction, edit, copy, publish, distribute, translate and otherwise use in any medium any comments that you forward to us. We are and shall be under no obligation (1) to maintain any comments in confidence; (2) to pay compensation for any comments; or (3) to respond to any comments.

We may, but have no obligation to, monitor, edit or remove content that we determine in our sole discretion are unlawful, offensive, threatening, libelous, defamatory, pornographic, obscene or otherwise objectionable or violates any party’s intellectual property or these Terms of Use.

You agree that your comments will not violate any right of any third-party, including copyright, trademark, privacy, personality or other personal or proprietary right. You further agree that your comments will not contain libelous or otherwise unlawful, abusive or obscene material, or contain any computer virus or other malware that could in any way affect the operation of the Service or any related website. You may not use a false e-mail address, pretend to be someone other than yourself, or otherwise mislead us or third-parties as to the origin of any comments. You are solely responsible for any comments you make and their accuracy. We take no responsibility and assume no liability for any comments posted by you or any third-party.



Occasionally there may be information on our site or in the Service that contains typographical errors, inaccuracies or omissions that may relate to product descriptions, pricing, promotions, offers, product shipping charges, transit times and availability. We reserve the right to correct any errors, inaccuracies or omissions, and to change or update information or cancel orders if any information in the Service or on any related website is inaccurate at any time without prior notice (including after you have submitted your order).

We undertake no obligation to update, amend or clarify information in the Service or on any related website, including without limitation, pricing information, except as required by law. No specified update or refresh date applied in the Service or on any related website, should be taken to indicate that all information in the Service or on any related website has been modified or updated.



In addition to other prohibitions as set forth in the Terms of Use, you are prohibited from using the site or its content: (a) for any unlawful purpose; (b) to solicit others to perform or participate in any unlawful acts; (c) to violate any international, federal, provincial or state regulations, rules, laws, or local ordinances; (d) to infringe upon or violate our intellectual property rights or the intellectual property rights of others; (e) to harass, abuse, insult, harm, defame, slander, disparage, intimidate, or discriminate based on gender, sexual orientation, religion, ethnicity, race, age, national origin, or disability; (f) to submit false or misleading information; (g) to upload or transmit viruses or any other type of malicious code that will or may be used in any way that will affect the functionality or operation of the Service or of any related website, other websites, or the Internet; (h) to collect or track the personal information of others; (i) to spam, phish, pharm, pretext, spider, crawl, or scrape; (j) for any obscene or immoral purpose; or (k) to interfere with or circumvent the security features of the Service or any related website, other websites, or the Internet. We reserve the right to terminate your use of the Service or any related website for violating any of the prohibited uses.



We do not guarantee, represent or warrant that your use of our service will be uninterrupted, timely, secure or error-free.

We do not warrant that the results that may be obtained from the use of the service will be accurate or reliable.

You agree that from time to time we may remove the service for indefinite periods of time or cancel the service at any time, without notice to you.

You expressly agree that your use of, or inability to use, the service is at your sole risk. The service and all products and services delivered to you through the service are (except as expressly stated by us) provided ‘as is’ and ‘as available’ for your use, without any representation, warranties or conditions of any kind, either express or implied, including all implied warranties or conditions of merchantability, merchantable quality, fitness for a particular purpose, durability, title, and non-infringement.

In no case shall anyone affiliated with including our directors, officers, employees, affiliates, agents, contractors, interns, suppliers, service providers or licensors be liable for any injury, loss, claim, or any direct, indirect, incidental, punitive, special, or consequential damages of any kind, including, without limitation lost profits, lost revenue, lost savings, loss of data, replacement costs, or any similar damages, whether based in contract, tort (including negligence), strict liability or otherwise, arising from your use of any of the service or any products procured using the service, or for any other claim related in any way to your use of the service or any product, including, but not limited to, any errors or omissions in any content, or any loss or damage of any kind incurred as a result of the use of the service or any content (or product) posted, transmitted, or otherwise made available via the service, even if advised of their possibility. Because some states or jurisdictions do not allow the exclusion or the limitation of liability for consequential or incidental damages, in such states or jurisdictions, our liability shall be limited to the maximum extent permitted by law.

You understand and agree that no singular individual, group of individuals or entity in any form whatsoever is responsible or liable in any manner for any content generated on, for, or as a result of the existence of this site, since this is a community generated site. You understand and agree that as this is a community generated site, and as a result of this, there is no good way to control what users and contributors post on or through the sites and cannot be responsible for any offensive, inappropriate, obscene, unlawful, infringing or otherwise objectionable or even illegal user generated content you may encounter on the sites or, in connection with your use of the sites.

You understand and agree with the following statement made on behalf of, “We, on behalf of our directors, officers, employees, agents, suppliers, licensors, contributors and service providers, exclude and disclaim liability for any losses and expenses of whatever nature and howsoever arising including, without limitation, any direct, indirect, general, special, punitive, incidental or consequential damages; loss of use: loss of data; loss caused by a virus: loss of income or profit: loss of or damage to property: loss of life: claims of third parties: or other losses of any kind or character, or the inability to use, the site or the content even if we have been advised of the possibility of such damages or losses, arising out of or in connection with the use of this site or any web site with which it is linked.”



You agree to indemnify, defend and hold harmless and our parent, subsidiaries, affiliates, partners, officers, directors, agents, contractors, licensors, service providers, subcontractors, suppliers, interns and employees, harmless from any claim or demand, including reasonable attorneys’ fees, made by any third-party due to or arising out of your breach of these Terms of Use or the documents they incorporate by reference, or your violation of any law or the rights of a third-party.



In the event that any provision of these Terms of Use is determined to be unlawful, void or unenforceable, such provision shall nonetheless be enforceable to the fullest extent permitted by applicable law, and the unenforceable portion shall be deemed to be severed from these Terms of Use, such determination shall not affect the validity and enforceability of any other remaining provisions.



The obligations and liabilities of the parties incurred prior to the termination date shall survive the termination of this agreement for all purposes.

These Terms of Use are effective unless and until terminated by us. You may terminate use of the site, but this Terms of Use shall survive in perpetuity.

If in our sole judgment you fail, or we suspect that you have failed, to comply with any term or provision of these Terms of Use, we also may terminate this agreement at any time without notice and you will remain liable for all amounts due up to and including the date of termination; and/or accordingly may deny you access to our Services (or any part thereof).



The information supplied through this website, or by any representative or agent of Dr. Farrah, whether by telephone, in person verbal, email, letter, image, text, facsimile or any other conceivable form of communication, is for informational purposes only and does not constitute medical, legal or other professional advice. Health-related information provided through this website is not a substitute for medical advice and should not be used to diagnose or treat health problems or to prescribe any medical devices or other remedies. The receipt of any questions or feedback that you submit in any form to any Dr. Farrah medium does not create a professional relationship and does not create any privacy interests.
You agree to indemnify, defend and hold harmless and our parent, subsidiaries, affiliates, partners, officers, directors, agents, contractors, licensors, service providers, subcontractors, suppliers, interns and employees, harmless from any claim or demand, including reasonable attorneys’ fees, made by any third-party due to or arising out of your breach of these Terms of Service or the documents they incorporate by reference, or your violation of any law or the rights of a third-party.



These Terms of Use and any separate agreements whereby we provide you Services shall be governed by and construed in accordance with the laws of the Republic of Panama.



You can review the most current version of the Terms of Use at any time at this page.

We reserve the right, at our sole discretion, to update, change or replace any part of these Terms of Use by posting updates and changes to our website. It is your responsibility to check our website periodically for changes. Your continued use of or access to our website or the Service following the posting of any changes to these Terms of Use constitutes acceptance of those changes.



Questions about the Terms of Use should be sent to us at

Upon agreeing to these terms and conditions, you gain access to the website and assume total responsibility for any and all actions undertaken by you as a result of your access to the website. You agree and understand that the terms of this agreement shall be binding upon you, your respective heirs, successors, assigns and legal representatives. You understand and agree that all provisions of this Terms of Use agreement that by their nature should survive termination shall survive termination, including, without limitation, ownership provisions, warranty disclaimers, indemnity, licensing in perpetuity and limitations of liability.