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.

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

The benefit of breast thermography is that it offers the opportunity of earlier detection of breast disease than has been possible through breast self examination, doctor examination or mammography alone.

Thermography can detect the subtle physiologic changes that accompany breast pathology, whether it is cancer, fibrocystic disease, an infection or a vascular disease. Your doctor can then plan accordingly and lay out a careful program to further
diagnose and /or MONITOR you during and after any treatment.

Normal

Good thermal symmetry with no suspicious vascular patterns or significant thermal findings.

Fibrocystic Changes

The very significant vascular activity in the left breast justified clinical correlation and close monitoring which returned an opinion of fibrocystic changes taking place.

These changes can be monitored thermographically at regular intervals until a stable baseline is established and is reliable enough for annual comparison.

Early Stage Malignant Tumor

This is the specific area of a small DCIS. We can see the vascular feed and the discreet area of hypothermia that is displacing the surrounding hyperthermia.

Thermography is a painless, non invasive, state of the art clinical test without any exposure to radiation and is used as part of an early detection program which gives women of all ages the opportunity to increase their chances of detecting
breast disease at an early stage. It is particularly useful for women under 50 where mammography is less effective.

Thermography’s role in breast cancer and other breast disorders is to help in early detection and monitoring of abnormal physiology and the establishment of risk factors for the development or existence of cancer. When used with other procedures the best possible evaluation of breast health is made.

This test is designed to improve chances for detecting fast-growing, active tumors in the intervals between mammographic screenings or when mammography is not indicated by screening guidelines for women under 50 years of age.

All patients thermograms (breast images) are kept on record and form a baseline for all future routine evaluations.

This patient’s thermograms have remained stable for two years. These patterns are like a thermal fingerprint which will only change if pathology develops.

Baseline	3 Month Follow-up
First Annual	Second Annual

With the new ultra-sensitive, high resolution digital infrared cameras available today a technology that has been developing over the past 20 years is now becoming more accessible.

Thermography as a physiologic test, demonstrates heat patterns that are strongly indicative of breast abnormality, the test can detect subtle changes in breast temperature that indicate a variety of breast diseases and abnormalities and once abnormal heat patterns are detected in the breast, follow-up procedures including mammography are necessary to rule out or properly diagnose cancer and a host of other breast diseases such as fibrocystic syndrome, Pagets disease, etc.

Canadian researchers recently found that infrared imaging of breast cancers could detect minute temperature variations related to blood flow and demonstrate abnormal patterns
associated with the progression of tumors. These images or thermograms of the breast were positive for 83% of breast cancers compared to 61% for clinical breast examination alone and 84% for mammography.

By performing thermography years before conventional mammography, a selected patient population at risk can be monitored more carefully, and then by accurately utilize mammography or ultrasound as soon as is possible to detect the actual lesion – (once it has grown large enough and dense enough to be seen on mammographic film), can increase the patients treatment options and ultimately improve the outcome.

It is in this role that thermography provides its most practical benefit to the general public and to the medical profession. It is certainly an adjunct to the appropriate usage of mammography and not a competitor. In fact, thermography has the ability to identify patients at the highest risk and actually increase the effective usage of mammographic imaging procedures.

Until such time as a cure has been found for this terrible disease, progress must be made in the fields of early detection and risk evaluation coupled with sound clinical decision making.

Thermography, with its non-radiation, non-contact and low-cost basis has been clearly demonstrated to be a valuable and safe early risk marker of breast pathology, and an excellent case management tool for the ongoing monitoring and  treatment of breast disease when used under carefully controlled clinical protocols.

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

One day there may be a single method for the early detection of breast cancer. Until then, using a combination of methods will increase your chances of detecting cancer in an early stage.

These methods include :

• Annual breast thermography screening for women of all ages.
• Mammography, when considered appropriate for women who are aged 50 or older.
• A regular breast examination by a health professional.
• Monthly breast self-examination.
• Personal awareness for changes in the breasts.
• Readiness to discuss quickly any such changes with a doctor.

These guidelines should be considered along with your background and medical history.

90% of Breast Health problems are benign – not Cancer.
Abnormalities may include: