I have recently seen the media go crazy with a study that was done at Bryn Mawr Hospital comparing mammography and thermography for breast cancer detection. The thermal images in the study failed to impress those conducting the study. And so we see multiple headlines about mammography being superior to thermography.

Thermography and mammography are not the same. A train is not a boat.

I wish the status quo would stop trying to put a train on the water and a boat on the tracks. Each vehicle has its own purpose and strengths.

Thermography is a radiation free test of physiology looking at very early changes in the tissue. Mammography is an x-ray looking at structure or what has already developed. Only a biopsy can diagnose breast cancer.

We need to change our thinking about breast screening and accept the addition of early, non toxic screening in order to give women the opportunity for lifestyle changes, very early intervention and safe screenings for all women including young women with dense breasts.

As thermographers, we are on the health side. We need to take our honorable place in women’s health care. We are not mammograms. We are a boat, not a train.

Now about boats. The thermography used in the “study” was a computer generated diagnosis with information garnered from industrial cameras.

That’s a row boat and can’t be expected to take you across the ocean.

(As a side note, computer generated mammography reports did not do as well as reports by trained radiologists)

Sophisticated and modern Digital Thermal Imaging used at Advanced Medical Thermography utilizes a highly sensitive medical infrared camera with a narrow range. Our images are interpreted by trained Thermologists, who are Medical Doctors and can take the individual history into account. Thermography is best at looking at evolving patterns and change over time. That is why we always establish a thermal fingerprint or baseline.

This is the boat I want to be on to carry me through a healthy life.

Women, beware of tug boats that promise to take you on the cruise, or Train companies who may try and “railroad” you off the trip you are on!

To your health and peace of mind!!!

The ‘No touch breast scan’ product was tested alongside mammography for the detection and diagnosis of breast cancer in the misguided hope of getting a favorable outcome to assist in the generation of investment for their ‘No touch’ company.

Mammograms Beat Thermography for Breast Cancer Detection: Study
U.S. News & World Report
By Kathleen Doheny FRIDAY, May 4 (HealthDay News) — Thermography — a breast cancer detection method touted by some as a substitute for mammography — is an unreliable cancer screen, according to new research. In a study of about 180 women, …
See all stories on this topic »

Infrared Thermography Fails to Predict Breast Malignancy
The Oncology Report
Infrared thermography did not accurately predict malignancy and produced an unacceptably high false-positive rate in women with radiologic abnormalities requiring breast biopsy in a 2-year prospective study. The No-Touch Breast Scan (NTBS) is a …
See all stories on this topic »

The No Touch product, methodology and claims made in this study are NOT representative of the well established and professional practitioners of clinical thermography or the way that thermography is reported and used by medical doctors.

As responsible clinical thermographers know well, the role of thermography is not to detect cancer but simply as an adjunctive screening test to provide additional information and to detect suspicious changes over time which can help the patients doctor with decision making and improve the use of other diagnostic tests such as mammograms, ultrasound or MRI.

The findings that thermography provide ARE NOT COMPARABLE OR COMPETITIVE TO MAMMOGRAPHY.

The ‘No Touch’ system claims a different technique, protocol and expectation than the standard breast screening thermography that is widely used around the world.
The basic concept being promoted by ‘No Touch’ is the use of two FLIR industrial cameras scanning simultaneously to produce additional data, this data is then processed by software that claims to provide a diagnosis.

Over 1000 previous peer reviewed studies over the past 20 years and the history and evolution of thermography in breast screening has taught us that :

1, Patients personal variants will cause unacceptable false positives unless a stable baseline is established.

2, Reports cannot be generated by software alone.  Interpretation of thermogram results by an experienced and qualified medical doctor who will take into consideration all history and symptoms is fundamental to a useful report.

3, Strict standard protocols for taking images are essential for repeatability and the comparative analysis for changes over time. This is where software analysis can assist a doctor with an opinion.

4, Thermography is most sensitive and specific in the early stages of developing pathology (pre-cancerous) before there are findings that can be easily detected by structural tests such as mammogram and ultrasound. Again, THERMOGRAPHY CANNOT SEE TUMORS, CYSTS, CALCIFICATIONS, OR ANY OTHER STRUCTURAL PATHOLOGY.

5,  Thermography is LIMITED to detecting physiological abnormality and physiological (functional) changes over time. Thermography can detect vascular abnormality, inflammation, lymphatic abnormality, hormonal abnormality and other non structural indications of change that justifies additional testing, clinical correlation or close monitoring.

Above all early screening of dysfunction or abnormality gives the patient and her doctor the opportunity for intervention (preventative).

Any controversy relating to breast thermography is generally due to unrealistic or false claims being made about it.

For more information a useful source is : http://acct-blog.com/

Background to the role of Thermography:  http://acct-blog.com/2009/07/07/understanding-the-role-of-diti-in-breast-screening-2/

With the pre mammogram age group (under 50) the benefits of screening to detect any findings or changes that justify additional testing or closer monitoring are simple. With any positive DITI findings in this younger age group, any mammogram and ultrasound sensitivity and specificity will be increased with the objective DITI findings targeting a dysfunction and location and providing decision making information in women that would not have otherwise been tested.

It takes years for most cancers to develop to the stage that they can be detected with mammogram or ultrasound (dense enough for location and biopsy) so DITI is ideally placed as a screening tool to identify changes over time in the ‘early’ development stages, before there is more advanced pathology that can be detected with other tests.

The major benefit in this group is in detecting early changes that precede malignant pathology that will become diagnosable at some stage.

Early detection is aimed at prevention and if early changes are detected then we have an opportunity to intervene and change the outcome.

The earlier an abnormality is detected the better the treatment options will be, resulting in a better outcome.

Prevention may include treatment of inflammation, fibrocystic disease, lymph congestion, estrogen dominance and more specific conditions like angiogenesis.

DITI does not provide any of the same findings or information that mammogram or ultrasound provides, it is a different type of test. DITI shows information relating to vascular activity, inflammation, lymphatic activity, hormonal dysfunction and other ‘functional’ abnormalities. 

There are no contraindications for DITI, it is totally non-invasive, no radiation of any type, no contact with the body so it can ‘do no harm’.

Mammogram and ultrasound shows ’structure’, tissue densities can be evaluated, lumps can be measured, calcifications located and opinions given regarding pathology before biopsy ….. none of which DITI can provide.

There is no comparison or competition between mammogram and DITI. They are two different tests providing different results !    

The results are reported by medical doctors who are certified thermologists and experienced in reading thermograms, the reading doctor takes into consideration all history and symptoms and the results of other tests.

In patients of mammographic age (generally over 50), post menopause or when the density of breast tissue has reduced sufficiently to make mammography more affective, DITI not only provides the benefit of early detection of functional change but can also increase the detection rates of other tests by contributing additional information about functional (physiological) abnormality and also the location of suspicious (positive) thermal findings that may be outside the range of other tests due to location, size of breast, implant, or other limiting factors .

DITI as a screening test in all age groups is designed to establish a baseline (the patients normal thermal fingerprint) for ongoing comparative analysis (normally annual) to detect any physiological change that justifies additional testing (which could be physician exam, mammogram, ultrasound, MRI, blood work, hormone testing or a number of other interventions).

The changes that DITI can detect include, inflammatory pathology (inflammatory carcinoma / inflammatory breast disease) Infection, Lymph dysfunction (lymph congestion, lymph node pathology) Vascular changes (development of new and abnormal blood vessels known as ‘angiogenesis’) and also any suspicious activity outside the range or scope of other tests (outside the boarder of the breast, in the sternum or axilla) so again, there is no comparison or competition between different tests.

DITI cannot detect specific pathology like a biopsy, it cannot detect tumors or micro-calcifications. DITI cannot ‘see’ structure.

DITI does have the potential to create anxiety for a patient (as does mammogram) with equivocal results or results that cannot be confirmed or positively diagnosed but both tests can minimize unnecessary anxiety with better informed consent, education and realistic expectation for the test.

The best possible plan is to use every appropriate test adjunctively to get the highest detection rates without generating additional or unnecessary invasive testing.

It would be unfortunate for a patient to forgo a necessary mammogram that was justified, and any decision should be made with consultation between the patient and her doctors based on individual history, symptoms and test results. 

Peter Leando PhD. DSc. DAc..

Fellow, Royal Society of Medicine.

Fellow, American College of Clinical Thermology.

2030 West First St., Suite E

Fort Myers. FL. 33901

Office: 1-239-337-3631

Fax: 1-239-337-3632

Suzanne Somers Discusses Mammogram Alternatives

Suzanne Somers admits she has a controversial viewpoint on mammograms. Watch as she explains the risks she sees behind mammograms and offers her alternatives to breast cancer screenings.

by:  Cicero T. Silva & Nausheen Naveed & Syed Bokhari & Kenneth E. Baker & Lawrence H. Staib & Saad M. Ibrahim & Karl Muchantef & Thomas R. Goodman

Received: 11 January 2012 / Accepted: 1 February 2012
Copyright of Am Soc Emergency Radiology 2012

Abstract Young children or those with intellectual disability with trauma to an extremity often undergo radiographs of the whole limb. The objective of the study was to assess the efficacy of digital infrared thermal images (DITI) in pediatric extremity trauma. We hypothesized fractures to be associated with local hyperthermia, detectable with DITI, which could direct focused radiographs. In this exploratory study, patients seen over a 2-month period in a pediatric emergency department for limb trauma were included if an extremity radiograph was taken on the same day. Patients had DITI of symptomatic and contralateral limbs. The warmest area of each image was compared to the site of pain and/or fracture on the radiograph. Fifty-one patients were enrolled. DITI matched 73% of pain sites. Fractures were seen in 11 patients. DITI matched 7 of 11 (64%) fracture sites. DITI performance in pinpointing the site of injury, although suboptimal, is encouraging for further evaluation.

Click here to view complete PDF of the trial.

We’ve written to you many times in the past about mammograms. Despite the fact that this breast cancer screening procedure is painful and risky the mainstream still chooses to cling to it like it’s a long lost child.

In recent years, mounting evidence has challenged the validity and safety of mammograms in breast cancer prevention… Now, a recent study by Southampton University researchers has found that too many screening programmes, including mammograms, lead to misdiagnosed results and the overtreatment of harmless breast lumps.

Weighing up the pros and cons

When it comes to cancer, an early diagnosis is absolutely imperative and screening programmes are supposedly designed to save lives through early diagnosis of cancer. The question now is, has the mainstream got it wrong?

Back in 2001, a controversial report, published in the medical journal The Lancet, concluded that breast cancer screening, offered to all women in the UK over the age of 50, does not reduce deaths. Even back then some experts felt that screening may do more harm than good.

Now, 10 years later, the latest study, published in the British Medical Journal, echoes exactly the same sentiment. The Southampton researchers say that the negative outcomes of screening programmes cancel out up to half of the benefits that others get from living longer lives.

In short, this means that while a positive result after screening may give an extra year of life to one breast cancer victim, it could result in six months’ worth of suffering due to unnecessary treatment for another patient.

Previous research has shown that for every 2,000 screenings, 200 women will have a “false positive” result and 10 of those women will have unnecessary surgery, but only one life will be saved.

The lead researcher of the Southampton study, Prof James Raftery, said: “To save one life, that woman will have surgery, but 10 more will have surgery that do not need it. The reason is they have lumps that are diagnosed as cancer but… most of those lumps would not have gone on to become cancer or to have killed a person.”

Needless surgery cuts the benefits

In 1986, the Forrest Report led to the introduction of breast cancer screening in the UK. According to the Forrest Report, the effectiveness of these screening programmes would be measured in “quality of life years” (QALYs) — the extra years of life patients gain as a result of screening.

Back then, it was estimated that screening programmes would gain patients 3,301 QALYs over a 20-year-period. However, this estimate did not take into account the potential harm of false positive results. As a result, the damaging impact of false positive diagnoses and needless surgery cut the expected QALYs of 3,301, by more than half to 1,536 QALYs, according to the results of the latest study.

The researchers added that for the first eight years, women were more likely to be harmed than to enjoy any benefit. Only 20 years after screening do the net benefits for patients really begin to accumulate.

Prof Raftery said: “”There are lots of women who have had surgery who believe their lives were saved when in fact only around one in 10 has had their life saved.”

Lay out the options

Of course, this does not mean that women should stop being screened for breast cancer altogether. However, patients should be warned about the possible negative effects of screening and have a better understanding of the risks of unnecessary treatment before they are screened. Yet this is clearly not happening…

A damning report from the Cochrane Collaboration, published in 2010, said that women are being seriously misled by health officials who dramatically downplay the risks of mammography X-rays while overstating the benefits. The report also questioned the prevailing view that mammograms save lives and says that this is based on shoddy and biased science.

Women should also be given the option to choose the method of screening they prefer. As I mentioned earlier, mammograms are extremely painful and invasive procedures. The real kicker is that a breast cancer tumour is only detected by a mammogram after it’s grown for several years, and achieved more than 25 doublings of the malignant cell colony. So, by the time you get a warning from your mammogram the tumour may already be at a growth-stage where it is too difficult and too late to treat. Worse still, the compression required for mammograms can actually break down cancer tissue and rupture small blood vessels that support the cancer, causing it to spread.

Luckily, there are safer and less painful screening options, like thermography or thermal imaging. Mammograms look at anatomical changes in the breast, as they detect masses or lumps in the breast tissue. Thermograms, on the other hand, look at vascular changes in the breast, as they detect blood flow patterns, inflammation and asymmetries, which allows them to detect irregular patterns in the breast before a noticeable lump is formed.

In the case of inflammatory cancer, there are no detectable lumps, which makes self-examination and mammograms pointless. However, thermography will certainly help in these cases with an early detection.

Thermal imaging does not cause pain, is non-invasive and quick – your multi-image examinations usually take less than 15 minutes. Plus, it makes no contact with your body – no compression (unlike mammograms) and it emits absolutely NO radiation.

It all adds up: No radiation, no squashing and bruising, early detection, quicker diagnoses and prevention and a healthier cancer-free you!

Sources:

‘Breast cancer screening could cause more harm than good’ published online 09.12.11, telegraph.co.uk

Dr. Peter Leando, the founder of Meditherm, Inc. has worked in the thermography industry for over 20 years. He shares with us the evolution of thermography and how it provides opportunities for early intervention. Women are looking for choices for protecting their breast health, so they will appreciate his candid information about what to look for in a thermography service. Thermologyonline.org provides a complete list of thermography services available in the US. Don’t miss this thermography 101 session!

Podcast: Download

Click here to visit WebTalkRadio.net and listen to the Podcast there.

Women with dense or non-fatty breast tissue may need additional breast cancer screening, a U.S. researcher says.

Dr. Roshni Rao, assistant professor of surgery at the University of Texas Southwestern Medical Center in Dallas, said one woman’s personal battle with breast cancer was the inspiration for Henda’s Law — a Texas law named for Henda Salmeron that requires women to be informed about their breast tissue’s density and the limitations of mammography in certain cases.

Rao, Salmeron’s breast surgeon, said radiologists use a grading system to describe the density of breast tissue based on the amount of fat (non-dense) and connective (dense) tissue. Research is under way into why some women have denser breast tissue, but as women age, their breast tissue generally becomes more fatty, Rao said.

“Breast tissue that has minimal or no fat may appear white, or dense, on a mammogram. This sometimes makes it difficult to identify cancers, which also typically appear as small white spots,” Rao said in a statement. “Many factors contribute to a woman’s risk of breast cancer. Having dense breast tissue may be one of them, but your doctor considers other factors — age at which a women had her first child, family history of cancer or age at the onset of menstruation, among others — when evaluating your risk and tailoring your screening program.”

Digital mammograms may be best at finding cancer for women with dense breast tissue. Other tests, including breast magnetic resonance imaging and ultrasound and breast thermography, may be helpful, but only in addition to mammograms, Rao said.

Copyright United Press International 2011

The California State Legislature passed a bill last Friday requiring doctors to inform women if they have dense breasts after a mammogram, making California the second state this summer and the third state so far to have passed a so-called breast density law.

The bill, SB 791, passed the state Senate 35-1, and is now going before Gov. Jerry Brown to get signed.

When he signs it, starting next year, Calif. radiologists will have to send women with dense breasts, as determined by an American College of Radiology-developed system, this text:

Because your mammogram demonstrates that you have dense breast tissue, which could hide small abnormalities, you might benefit from supplementary screening tests, depending on your individual risk factors. A report of your mammography results, which contains information about your breast density, has been sent to your physician’s office and you should contact your physician if you have any questions or concerns about this notice.

Texas Gov. and Republican presidential hopeful Rick Perry signed into law a similar bill, Texas Act HB 2102, or Henda’s Law, in June. And breast density legislation was also passed in Connecticut in 2009.

New Hampshire, Massachusetts, New York and Florida all have similar legislation pending.

The American College of Radiology Imaging Network says that around 40 percent of women getting screening mammograms have dense breasts, with younger women typically having denser breasts.

Dense breasts are less fatty, with more connective tissue. The connective tissue appears white on a mammogram, just like the cancer, making it harder to diagnose, according to Are You Dense, an advocacy group.

A January 2011 study by the Mayo Clinic found three-quarters of cancers in women with dense breasts are missed by mammograms.

“When it comes to your health, ignorance is not bliss. What you don’t know can hurt you,” State Sen. Joe Simitian, a Democrat from Palo Alto who authored the bill, said in a statement.

The idea for the bill came from by Amy Colton, a registered nurse who had breast cancer not discovered by a mammogram, and who learned she had dense breasts only after her cancer was diagnosed, according to Are You Dense. She suggested the bill in Simitian’s “There Oughta Be a Law” contest.

However, the bill met some opposition from the California Medical Association. Writing about an earlier incarnation of the bill, SB 173, the CMA warned that it could bring legal and practical problems for Calif. doctors.

“Because the scope of who must receive the notice is so broad, women will be ‘scared’ into thinking they need these expensive additional screenings when it isn’t at all warranted, leading to increased costs and pressures on a physician’s practice,” the group wrote in a notice on its website. “Moreover, because the grading of the condition that may/may not lead to their receipt of the prescribed notice is subjective in nature, the absence of the notice could lead to lawsuits against doctors if a patient is later diagnosed with breast cancer.”

But the bill was backed by several other groups, including the California Nurses Association, the Breast Cancer Fund, the California Association of Health Underwriters and California NOW.

SACRAMENTO, Calif. (AP) — It took seven years of annual mammograms and a cancer diagnosis for Amy Colton to learn something her doctors had realized from the beginning: Her breast tissue is so dense that it could have masked tumors on earlier exams.

“I requested a copy of the report sent from my radiologist to my primary care physician, and every single one said, ‘Patient has extremely dense breast tissue,’” the registered labor and delivery nurse said. “I was really outraged that I didn’t know this.”

About 40 percent of women over 40 have breast tissue dense enough to mask or mimic cancers on mammograms, but many of them don’t know it. Mammogram providers in California will be required to notify those patients, and suggest that they discuss additional screenings with their doctors based on their individual risk factors, if Gov. Jerry Brown signs a bill that the Legislature passed this month. Similar laws have passed in Texas and Connecticut in the past two years but no data is available yet from either state on the effect of the legislation.

“The notice in the bill is a two-sentence notice that gets added to a letter,” said the bill’s author, Democratic state Sen. Joe Simitian of Palo Alto. “I believe these two sentences can save thousands of lives.”

Brown has not given his opinion about the bill, but many doctors oppose it. Researchers studying breast density, a relatively young field, said such requirements may end up causing undo anxiety in millions of women and lead to unnecessary and expensive ultrasound or MRI screenings.

The California Medical Association, which represents 35,000 doctors, recommended a public education campaign instead of individual notifications, and said there isn’t enough evidence to support the idea the extra money spent on additional screenings will save more lives.

Those tests could cost the state more than $1 billion, and many women wouldn’t be able to afford them, said Dr. Karen Lindfors, a professor of radiology and chief of breast imaging at the University of California, Davis Medical Center in Sacramento. She testified against the bill before a legislative committee.

“I just don’t think that at this point we have the ability to meet the kind of demand either financially or in terms of manpower that this is going to create, and we also don’t have proof that it’s going to save lives,” she said.

The women who would receive the notifications have more tissue than fat in their breasts. As women age, their breasts become more fatty. Fat appears black on a mammogram, making it easier to spot cancer, which shows up as white.

Doctors agree that high breast density is an increased risk factor for cancer, but researchers say the issue needs more study to determine whether the risk is great enough to justify a higher level of screenings for women who have it.

Pre-menopausal women are more likely to have dense tissue, regardless of whether they are at high risk for breast cancer, said Celine Vachon, an associate professor of epidemiology at the Mayo Clinic in Rochester, Minn. She said women who get the notifications required by the California bill could be frightened into seeking additional screenings, such as MRIs or ultrasounds, which can pick up false positives and cost thousands of dollars.

“If women want their breast density information, that’s their right,” Vachon said. “However, breast density is not yet a risk factor that’s used clinically, so what women will do with this information is not clear. We need improved density measurements as well as models that do a better job of predicting women’s risk. Everyone wants density to be this silver bullet, but to date, it’s not.”

Colton, who got the California legislation rolling by contacting Simitian’s office, said women ought to be told whether their breast density could make cancer difficult to detect.

She said she practiced self-exams monthly, had no family history of breast cancer and thought she was among the lucky cohort of women at a low risk for breast cancer. But five surgeries, six weeks of daily radiation and 15 rounds of chemotherapy later, she is angered that she went years without being told about her dense breast tissue.

“I don’t want anyone to think this is a rare story. There are countless women like me, and many with worse diagnoses,” she said.

Dr. Judy Dean, a diagnostic radiologist in Santa Barbara who specializes in breast imaging, supports the effort. She said 20 of her patients have found cancers through ultrasounds after she informed them that their dense tissue might be hiding tumors in a mammogram.

“Negative doesn’t mean negative; you could still be positive,” she said.

All radiologists agree that a mammogram — an X-ray image of the breast — is the best way for a woman to discover whether she has dense tissue, but few agree on how to proceed with that information.

Researchers have been experimenting with new breast imaging techniques that might provide the same answers as an MRI or ultrasound for women with a high risk for cancer, but with less expense. 3-D X-ray images known as “stereo mammograms” and molecular breast imaging are two techniques that are better than traditional mammograms at spotting cancers and cost much less than MRIs.

Some say a notice about the hidden risks of dense tissue should be sent to all women receiving the results of their mammogram, not just those with dense tissue. That way, everyone can be armed with the available information, said California state Assemblywoman Linda Halderman, a former breast cancer surgeon.

She said the bill would end up giving women with low breast tissue density false assurances they are not at risk for cancer.

“We’re offering something to women that doesn’t help improve their care or shed any light on the best way to assess their risk for breast cancer,” said Halderman, a Republican from Fresno. “Unfortunately, breast density is just one of those things we don’t know about yet.”