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.

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.

Click here to view the article.

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.

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: