Under pressure from doctors, some women’s groups and imaging equipment makers, lawmakers are likely to require coverage for more mammograms in health reform legislation than is currently recommended by the U.S. Preventive Services Task Force, the Wall Street Journal reports.

According to the Journal, many doctors’ and patients’ groups in recent years have formed alliances — such as sponsorships, joint events and endorsements — with companies that make mammography equipment. The groups and their corporate partners “swung into action” in November 2009 after USPSTF issued new guidelines suggesting that routine mammograms were not necessary for women in their 40s who have normal cancer risk, the Journal reports. USPSTF said the risks associated with annual mammograms — such as false positives, unnecessary treatment and low-level radiation exposure — could outweigh the benefits for many women in their 40s. The panel recommended that women ages 50 through 74 receive mammograms biennially.

The new recommendations “sowed unease and confusion,” including among major medical societies that disagree with USPSTF, the Journal reports. Advocacy groups stepped up lobbying, and their supporters “swamped lawmakers with angry calls and e-mails” urging them to guarantee access to mammograms under health reform legislation, the Journal reports.

The House in December 2009 voted 426-0 for a nonbinding resolution — named for Rep. Debbie Wasserman Schultz (D-Fla.), a breast cancer survivor — saying that insurers should not use the USPSTF recommendations to deny coverage for routine mammograms. The Senate adopted a similar amendment by Sen. Barbara Mikulski (D-Md.) to its health reform bill (HR 3590). Congressional aides say that a version of the amendment is likely to be in the final bill.

Meanwhile, a few women’s health groups that receive little or no corporate financing are standing behind the USPSTF guidelines. Fran Visco, founder of the National Breast Cancer Coalition, said, “The guidelines were always going to create a firestorm because they threaten some groups’ existence.” Adriane Fugh-Berman, a professor at the Georgetown University School of Medicine, said, “You have to ask if there’s a conflict of interest, because breast cancer advocacy has become big business.”

Sen. Chuck Grassley (R-Iowa) last month sent letters to 33 major not-for-profit groups requesting that they disclose their industry funding. The American Cancer Society said that it had received less than $1 million from screening device makers over the past five years, a sum that its spokesperson said is small compared with its more than $1 billion in annual revenue. The money does not influence ACS’ recommendations, the spokesperson added. Nancy Brinker — co-founder of Susan G. Komen for the Cure, which has received money through partnerships with GE — said the organization has always pushed for early detection (Mundy, Wall Street Journal, 1/12).

Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women’s Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women’s Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

© 2009 The Advisory Board Company. All rights reserved.

Here’s a quote from the article:

“Several years ago, the U.S. Preventive Services Task Force (PSTF) issued an updated set of recommendations about mammogram screenings, suggesting which and how often women should get them. Since the last time the group issued its recommendations in 2002, new study data emerged that has led to a few changes. Its new guidelines, suggesting that women over 40 only need a mammogram every two years, has led to a firestorm of criticism from professional and advocacy groups as well as politicians.”

To read this complete article click here.

The two techniques look at different things. Thermography looks at abnormal blood vessel formation, which is an early event in the life of a cancer. Mammography looks at masses (1 centimeter or larger) and calcification patterns, which are later developments.

Each has reliability in the recent literature of around 88 percent to 96 percent. Each misses tumors picked up by the other (perhaps as many as 10 percent). Mammography cannot visualize tiny tumors with new vessels, which show up on thermography. Conversely, tumors large enough to show up on mammography don’t always have thermographically abnormal vessels.

So, each technique is weak where the other is strong. The techniques are complementary. It is not a case of either one or the other.

One of the reasons for moving the starting age to 50 for mammograms was the vast number of negative breast biopsies for calcifications. I suspect, in my personal experience, I did 20 benign biopsies for calcification for every cancer we picked up. That is way too many, but abnormal calcifications are pretty common — and frequently benign.

Personally, I think the most prudent course for a woman to take is to get a baseline mammogram somewhere between the age of 40 and 50 (unless she has a high-risk family history, in which case earlier is better) to be reasonably sure larger lumps are not seen, and get a baseline thermography to look for early blood-vessel formation.

If both are negative, then follow with annual thermography looking for new vessel formation, with mammography every few years to look for solid lumps. Less frequent mammography means less radiation and mechanical pressure.

That regimen allows a woman to take advantage of the strengths of each technique without undue risks from radiation or unnecessary biopsy and, it seems to me, to maximize cost-benefit considerations.

— Robin A. Bernhoft, M.D., practices medical toxicology in Ojai.

Click here to read complete article at Cancer Decisions website.

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Women Have A Safe Alternative to Mammograms to Maintain Annual Screenings

For immediate release from the American College of Clinical Thermology.

 Women of all ages received good news with the recent revision of the government recommendations for screening mammography.  The US Department of Health and Human Services released their findings and recommendations that screening mammography should now be started at age 50 and performed bi-annually. Up until now, screening was recommended on an annual basis at age 40; this new recommendation has created renewed controversy as doctors have concerns about reducing the number of mammograms that would be clinically justified and indicated..  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 Breast Thermography or Digital Infrared Thermal Imaging (DITI) is ideally placed as an alternative 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. If changes for the better are to be made, then the recent recommendations of the Preventative Services Task Force will establish the foundation of a more affective screening program which should integrate other types of safe testing.  Of the various testing options Breast Thermography or Digital Infrared Thermal Imaging (DITI) offers the most promise for screening the younger age group women.  

To understand the arguments and issues involved with the new recommendations, we need to understand the difference between ‘screening mammography’ and ‘diagnostic mammography’:

‘Screening’ mammography has been performed annually on healthy women from the ages of 40 to 70 and is aimed at identifying suspicious findings, which justify further investigation. ‘Diagnostic’ mammography is performed on patients who have one or more risk factors, clinical symptoms, or most commonly a palpable lump. There is little argument about mammography’s role as the ‘gold standard’ for

evaluating suspicious symptoms but the question was, can we still justify subjecting women without symptoms to ‘screening’ mammography ?  The answer was NO.

The federal department of health and human services  task force says that “the modest benefit of screening mammograms must be weighed against the harms… which are nearly cut in half when mammograms are performed every other year  but the benefits remain the same”. It needs to be pointed out that the recommendations of the task force are not intended for women at increased risk for breast cancer who should continue to be referred for diagnostic mammography by their doctors when appropriate, and on a case by case basis. It is interesting to note that The United States is currently the only country that routinely screens women below age 50 and extends its screening practice by taking two or more mammograms per breast annually in women over age 50. This contrasts with the more restrained European practice of a single view every two to three years. The evidence concludes that while there is a justifiable role for mammography to play in a breast cancer screening program that role is very different from the one currently in place.

For over 20 years Breast Thermography is being used increasingly  by women throughout the US, and it has been rapidly gaining acceptance by doctors as an additional tool in the early diagnosis of breast disease. FDA registered since 1984, Thermography is an adjunctive diagnosic test being offered by hundreds of clinics in all states. A list of certified thermography clinics can be found at the The American College of Clinical Thermology website at :   http://www.thermologyonline.org/Breast/breast_thermography_clinics.htm. Thermography is 100% safe, has no radiation, does not touch the breast, and only takes a couple of minutes. A positive or suspicious thermal study will indicate medical necessity for a mammogram, ultrasound or other tests. The thermal findings will increase the sensitivity and specificity of most other tests by targeting an area of the breast showing dysfunction and providing decision making information in women that would not have otherwise been tested.

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. There are no contraindications for DITI, it is totally non-invasive, no radiation of any type, and no contact with the body so it can ‘do no harm’. DITI is positioned as the ideal screening test for women of all ages but particularly for the 30 to 50 age group. 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 between the patient and her doctors based on individual history, symptoms and test results.

The principle of informed consent in medicine is ignored if women are not informed of the evidence relating to any risks of a test and if women more readily consent to annual mammograms because they have been given ‘misinformation’ this is as bad as obtaining consent by deliberately blocking valid information. Women are entitled to know the full range of responsible opinion about the benefits, the risks, and the many uncertainties of mammography.

The government task force are to be applauded for presenting the evidence for women and their doctors to be able to make better informed decisions about breast screening.

As reported, the scientific and medical evidence indicates that:

No ‘screening’ mammography is justified for women under the age of 50.

A baseline screening mammogram may be justified at age 50 and bi-annually thereafter.

Accountability and responsibility should be considered in regard to all radiation exposure and the accumulative biological effects.

Reducing ionizing radiation exposure from all other sources whenever possible should be practiced.

Up-to-Date and accurate information must be given to patients for informed consent.

Other non invasive tests should be promoted as part of a breast screening program.

Thermography, Ultrasound and MRI should be further explored, adapted and integrated.

The Record

Alternative to mammograms

In view of the recent U.S. Preventive Services Task Force recommendations concerning new guidelines for having mammograms, some vital information for women needs to be presented. The new guidelines are for the general population, not those at high risk of breast cancer because of family history or gene mutations.

It has always been known that mammograms carry a significant risk of causing and spreading breast cancer, although this has largely been ignored by mainstream medicine. They can cause breast cancer through repeated irradiation of the breasts and spread cancer by the fracturing of the fibrous capsule surrounding the tumor through compression of the breasts.

A 1999 meta-analysis, “Is Screening for Breast Cancer with Mammography Justifiable?,” was published in The Lancet, the United Kingdom’s premier medical journal, in 2000. It said, “Screening for breast cancer with mammography is unjustified.” This study showed that “for every 1,000 females having mammograms over a 12-year period, the life of one was saved, while the total number of deaths increased by six.” The United States continued to screen with mammography until the new recommendations appeared in the Nov. 17 issue of the Annals of Internal Medicine.

Many women are asking themselves, “What should I do now?” The answer is simple: thermography, or digital infrared thermal imaging. This is a true “screening” test that is absolutely 100 percent safe, since it does not require contact with the breasts or use ionizing radiation. It has been approved by the FDA for breast cancer screening since 1982.

Thermography employs an infrared camera that measures the physiology of the breast, not the structures within the breast, as does mammography. The physiology is function rather than structure, more specifically inflammation. Inflammation at any tissue depth will be recorded by the sympathetic fibers in the neurological supply of nerves to that area. This neural information will then be processed through the central nervous system, which will then cause a sympathetic (automatic) response in the area of the skin corresponding to the affected site. Thermographically, the area of hyperthermia seen at the surface of the skin is due to a decrease of sympathetic motor tone (reduced sympathetic function) allowing increased blood flow through the postganglionic gates serving that area. And, all this happens before the presence of a tumor.

In addition, thermography can pick up breast disease eight to 10 years earlier than mammography can pick up a tumor. This happens long before tumor formation, whereas a tumor of a rather large size must be present for mammography to be effective. The bottom line is thermography is preventive, and mammography is no more than “early detection” of an already present tumor.

If any further studies are required for diagnosis, breast ultrasound and breast MRI are the tests of choice, since they are completely safe and do not employ radiation.

Women 21 or older should screen for cancer by doing breast self-examination, clinical breast examination annually and at each doctor’s visit, and thermography.

Alan L. Woods. 

Wyckoff, Nov. 17

The writer, a physician, is director of natural health education for the Institute of Natural Health and Wellness in Wyckoff.

Readers Comments:

Welcome attack on ‘holy grail’

Speaking from the vantage point of a senior citizen, I am thrilled that the U.S. Preventive Task Services Force has issued new guidelines for mammogram screenings.

In the past, whenever I tried to have a conversation with my doctors about the risks of mammography, my questions were answered with anger and belligerence as if I were violating a sacred holy grail.

Now, women can feel free to ask such questions as: Will repeated radiation exposures to the breast pose a cancer risk for premenapausal women under 50?

What about so-called indolent cancers that will never spread and tiny cancers that might go away by themselves? Is it possible that I could be subjected to unnecessary surgery, radiation and chemotherapy and really be healthy?

Wendy McCoole
Executive Director, Founder and Survivor
BreastCancerStories.org
www.breastcancerstories.org