The Best Breast Cancer Screening Tests

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Early Breast Cancer Detection and Accuracy

Today, women are encouraged to get a mammogram, so they can find their breast cancer as early as possible. The most promising aspect of thermography is its ability to spot anomalies years before mammography. Using the same ten-year study data, (Spitalier 1) researcher Dr. Getson adds:

Since thermal imaging detects changes at the cellular level, studies suggest that this test can detect activity eight to ten years before any other test. This makes it unique in that it affords us the opportunity to view changes before the actual formation of the tumor. Studies have shown that by the time a tumor has grown to sufficient size to be detectable by physical examination or mammography, it has in fact been growing for about seven years achieving more than twenty-five doublings of the malignant cell colony. At 90 days there are two cells, at one year there are 16 cells, and at five years there are 1,048,576 cells—an amount that is still undetectable by a mammogram. (At 8 years, there are almost 4 billion cells.)

Thermography’s accuracy and reliability is remarkable, too. In the 1970’s and 1980’s, a great deal of research was conducted on thermography. In 1981, Michel Gautherie, Ph.D., and his colleagues reported on a ten-year study, which found that an abnormal thermogram was ten times more significant as a future risk indicator for breast cancer than having a history of breast cancer in your family. (Gautherie 2)

With thermography as your regular screening tool, it’s likely that you would have the opportunity to make adjustments to your diet, beliefs, and lifestyle to transform your cells before they became cancerous. Talk about true prevention.

Clearer Results, Fewer Additional Tests

It seems like the world was set on its ear in November 2009 when the United States Preventative Services Task Force said it recommended that women begin regular mammograms at 50 instead of 40, and that mammograms are needed only every two years instead of annually between the ages of 50 and 74.  Some women felt this was a way for the insurance companies to save money, but I cheered these new guidelines. The Task Force concluded that the risk of additional and unnecessary testing far outweighed the benefits of annual mammograms—and I couldn’t agree more.

Even before the U.S. Preventative Task Force’s recommendation, Danish researchers Ole Olsen and Peter Gotzsche concluded, after analyzing data from seven studies, that mammograms often led to needless treatments and were linked to a 20 percent increase in mastectomies, many of which were unnecessary. (Goetshe 3) Dr. Getson expounded, “According to the 1998 Merck Manual, for every case of breast cancer diagnosed each year, five to ten women will undergo a painful breast biopsy. This means that if a woman has an annual mammogram for ten years, she has a 50 percent chance of having a breast biopsy.”

If you’ve ever had an unnecessary biopsy or been scared by a false positive result on a mammogram, please consider getting a thermogram.  You can always use it in conjunction with the mammogram to figure out your treatment options.

6 Reasons Why I Recommend Breast Thermography

In addition to early detection and accurate test results, here are some other reasons I like thermography:

  1. Good for young, dense breasts and implants. Younger breasts tend to be denser. Thermography doesn’t identify fibrocystic tissue, breast implants, or scars as needing further investigation.
  2.  Detect cell changes in arm pit area. The arm pit area is an area that mammography isn’t always good at screening.
  3.  Great additional test. Thermography can be used as an additional test to help women and their care teams make more informed treatment decisions.
  4.  It Doesn’t Hurt. The pressure of a mammogram machine is equivalent to putting a 50-pound weight on your breast, which can be quite painful for most women.
  5.  No radiation. Another reason the United States Preventative Services Task Force reversed its aggressive mammogram guidelines was because of the exposure to radiation. It’s well known that excessive doses of radiation can increase your risk of cancer. (Semelka 4). It’s ironic that the test women are using for prevention may be causing the very problem they’re trying to avoid in the first place! And this doesn’t even touch on the harm done to the body from unnecessary biopsies, lumpectomies, mastectomies, chemotherapy, radiation treatment, and so forth.
  6.  Thermography is very safe. Thermography is even safe for pregnant and nursing women! It’s merely an image of the heat of your body.

Thermography is a better technology for all of the reasons I’ve already described. Plus, it gives results that are unique to you, time after time. But Dr. Getson says there are some things you need to know. For one, not all thermographic equipment is the same. When you are choosing a thermography center, be sure to ask what the “drift factor” is for their machines.  Anything over 0.2 degrees centigrade leads to poor reproducibility. Also, the room in which the study is performed should be free of outside light and the temperature should always be at 68-72 degrees Fahrenheit, with a proper cooling system in place.

Be sure that your thermography center of choice is backed by qualified, board-certified physicians who are specifically trained in the interpretation of these images. And, be sure that the physician is available to explain and discuss all findings. Finally, make sure the images are “stat”-ed or marked up for future comparison.

The Best Test for You

As with anything, I suggest you let your inner guidance help you in all decisions about your health. If you feel it’s best to get a bi-annual or annual mammogram, then by all means continue with them. Just be aware of the drawbacks and risks associated with the test.

And, don’t be intimidated or feel guilty if you prefer to forgo mammography completely. A thermogram can tell you how healthy your breasts are rather than just screening them for cancer.  When done properly, it also has the potential to truly detect breast cell anomalies long before mammography can detect cancer. This allows you to implement lifestyle changes that can improve the health of your breasts proactively.

In honor of Breast Health Awareness month, I encourage you to check out thermography for yourself and your loved ones!

To read the full article, click here.

American Cancer Society, in a Shift, Recommends Fewer Mammograms

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One of the most respected and influential groups in the continuing breast-cancer screening debate said on Tuesday that women should begin mammograms later and have them less frequently than it had long advocated.

The American Cancer Society, which has for years taken the most aggressive approach to screening, issued new guidelines on Tuesday, recommending that women with an average risk of breast cancer start having mammograms at 45 and continue once a year until 54, then every other year for as long as they are healthy and likely to live another 10 years.

The organization also said it no longer recommended clinical breast exams, in which doctors or nurses feel for lumps, for women of any age who have had no symptoms of abnormality in the breasts.

Previously, the society recommended mammograms and clinical breast exams every year, starting at 40.

The changes reflect increasing evidence that mammography is imperfect, that it is less useful in younger women, and that it has serious drawbacks, like false-positive results that lead to additional testing, including biopsies.

But the organization’s shift seems unlikely to settle the issue. Some other influential groups recommend earlier and more frequent screening than the cancer society now does, and some recommend less, leaving women and their doctors to sort through the conflicting messages and to figure out what makes the most sense for their circumstances.

In fact, although the new guidelines may seem to differ markedly from the old ones, the American Cancer Society carefully tempered its language to leave plenty of room for women’s preferences. Though it no longer recommends mammograms for women ages 40 to 44, it said that those women should still “have the opportunity” to have the test if they choose to, and that women 55 and older should be able to keep having mammograms once a year.

This year, 231,840 new cases of invasive breast cancer and 40,290 deaths are expected in the United States.

The new guidelines were published on Tuesday in the Journal of the American Medical Association, along with an editorial and an article on the benefits and risks of screening, which provided evidence for the guidelines. A separate article and editorial on the subject were also published in another journal, JAMA Oncology.

The guidelines apply only to women at average risk for breast cancer — those with no personal history of the disease or known risk factors based on genetic mutations, family history or other medical problems.

The changed policy resulted from an exhaustive review of research data, which the cancer society conducts regularly to update its screening guidelines, said Dr. Richard C. Wender, the organization’s chief cancer control officer. The last review was in 2003, and this one took about two years.

Dr. Wender said he hoped the new guidelines would end some of the debate and confusion about mammography. But some doubted that the guidelines would bring clarity.

“I think it has the potential to create a lot of confusion amongst women and primary care providers,” said Dr. Therese B. Bevers, the medical director of the Cancer Prevention Center at the University of Texas M.D. Anderson Cancer Center in Houston.

Dr. Nancy L. Keating, a professor of health care policy and medicine at Harvard and a co-author of the JAMA editorial about the guidelines, said she thought the new advice had been thoughtfully developed and was headed in the right direction. Dr. Keating, who practices at Brigham and Women’s Hospital in Boston, said doctors and patients had clung to the practice of early and yearly mammograms out of fear that they would otherwise miss detecting a cancer.

The National Comprehensive Cancer Network, an alliance of prominent cancer centers, recommends mammograms every year starting at age 40. The American College of Obstetricians and Gynecologists recommends them every year or two from ages 40 to 49, and every year after that. It also recommends yearly clinical breast exams starting at age 19.

The obstetricians’ group said it was convening a conference in January, with the participation of the American Cancer Society, the comprehensive cancer network and other organizations, to try to develop a consistent set of guidelines.

Among those invited are the United States Preventive Services Task Force, which recommends less testing: generally mammograms every other year for women ages 50 to 74. In 2009, it advised against routine mammograms for women ages 40 to 49, a decision that ignited a firestorm of protests from doctors, patients and advocacy groups.

The task force, an independent panel of experts appointed by the Department of Health and Human Services, subsequently softened its approach. Now, instead of advising against routine screening for women in their 40s, the group says, “The decision to start screening mammography in women before age 50 years should be an individual one.”

But the task force gave the evidence for screening women under 50 a rating of “C,” reflecting its belief that the benefit is small. Services with a C rating do not have to be covered by the Affordable Care Act, according to the Department of Health and Human Services — a serious worry for advocates.

In response to the new cancer society guidelines, the task force issued a statement saying it would “examine the evidence” the cancer society had developed and reviewed before finalizing its recommendations. The statement also noted that the task force recognized “that there are health benefits to beginning mammography screening for women in their 40s.”

In making recommendations about screening, experts try to balance the benefits of a test against its potential harms for women in various age groups. A general explanation of the reasoning behind the new guidelines is that breast cancer is not common enough in women under 45 to make mammograms worthwhile for that age group, but that the risk of the disease increases enough to justify screening once a year after that. Specifically, the risk of developing breast cancer during the next five years is 0.6 percent in women ages 40 to 44, 0.9 percent from 45 to 49 and 1.1 percent from 50 to 54.

The risk keeps increasing slowly with age, but by 55, when most women have passed through menopause, tumors are less likely to be fast-growing or aggressive, and breast tissue changes in ways that make mammograms easier to read — so screening every other year is considered enough.

As for the decision to stop recommending clinical breast exams, the society said that there was no evidence that the exams save lives, but that there was evidence that they could cause false positives — meaning they could mistakenly suggest problems where none existed and lead to more tests. The exams can take five or six minutes that could be put to better use during office visits, said Dr. Kevin C. Oeffinger, the chairman of the cancer society subgroup that developed the guidelines and director of cancer survivorship at Memorial Sloan Kettering Cancer Center in New York.

According to the evidence review accompanying the guidelines, the benefit of regular mammography is that it can reduce the risk of dying from breast cancer by about 20 percent. Because breast cancer is less common in younger women, their baseline risk of dying is lower, and screening them saves fewer lives.

While younger women have less to gain from mammograms, the cancer society found, they incur all the potential harms. One harm is false positives, which can lead to more tests, including biopsies. A 2011 study cited in the article explaining the new guidelines found that 61 percent of women who had yearly mammograms starting at age 40 had at least one false positive by the time they were 50. Being tested every other year instead of every year can cut the false positive rate significantly, the JAMA Oncology article explaining the guidelines said, to about 42 percent from 61.

Some women consider false positives a small price to pay for the chance of identifying a cancer early. Others find being called back for more tests too nerve-racking.

Another potential risk of mammography is overdiagnosis, meaning some of the tiny cancers it finds might never progress or threaten the patient’s life. But because there is now no way to be sure which will turn dangerous, they are treated anyway.

There are no widely accepted figures on how often overdiagnosis occurs. Researchers think that it is mostly likely in women found to have ductal carcinoma in situ, or D.C.I.S., tiny growths in the milk ducts that may or may not evolve into invasive cancer. About 60,000 cases of D.C.I.S. are diagnosed in the United States each year.

“We would all love to avoid diagnosing and treating a breast cancer that doesn’t need treatment,” Dr. Oeffinger said. “But we don’t have the tools.”

But he added: “This area is rapidly changing. In five to seven years, we’ll have more knowledge in this area that will let us be more personalized in our approach.”

Dr. Keating said, “Radiologists are working hard to find new and better screening tests, which we desperately need, but I think it will take time.”

Source: A version of this article appears in print on October 21, 2015, on page A14 of the New York edition with the headline: American Cancer Society, in Switch, Recommends Fewer Mammograms

Cold Stressing Breasts And Why Don’t We Do It Anymore And The Thermal Rating System

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Cold stress testing of the breast was performed on the assumption that thermography would identify angiogenesis and that angiogenesis could be correlated with the development and existence of breast cancer. This can be possible if a number of factors are present but there are too many variables that we now know make this an unreliable procedure. We don’t know at what stage angiogenisis begins but we do know that it does not continue throughout all stages of breast disease. No studies have been done to find out how long it takes for new (angiogenic) blood vessels to establish sympathetic fibers which then let the vessel behave like a normal vessel (contract when cold stressed) but even if we did have a better understanding of this physiology it would still not be a reliable test as many patients would undoubtedly fall outside of the window of detectable angiogenesis.

Considerations, the logic and philosophy of performing a cold stress test:
1. If there are no suspicious thermal patterns to test, (negative thermogram) the test is not justified.

2. If there are suspicious patterns (positive thermogram) then the patterns remain suspicious irrespective of the results of cold stress testing……. A cold stress test does not and should not affect the thermographic opinion and resulting report.

3. A cold stress test might offer results relating to a particular suspicious pattern but if there is no way of correlating this information to a clinically valid or plausible rational to act on this information then the test is not justified in the first place.

4. If a cold stress test is performed and the results are reported, this changes the status of the test and the report, both of which make claim to diagnostics and will carry the associated increase of liability and issues of scope of practice and medical licensure (practicing medicine without a license).

5. The disservice to patients who suffer unnecessary mammography, biopsy, and other tests as a result of positive thermography generated by the attempt to produce diagnostic results from a single study is unacceptable.

6. Reporting vascular change over extended periods of time by comparative analysis of thermal testing may be enhanced by the inclusion of a cold stress test if ordered specifically by a licensed physician who can integrate the results into decision making or a differential diagnosis. Historically, it was the way breast thermography was used with protocols that included cold stress testing (and the diagnostic claims that were made) which generated the criticism that thermographers still suffer from today. The accusations of unreliability and the clinical trial results showing false positives and false negatives were all generated by the protocols that included cold stress testing. Cold stress is a test of sympathetic function which has good utility in many areas of medicine and is the definitive diagnostic test for CRPS / RSD. These tests were used before it was tried in breast screening.

In the mid eighties many people, including myself got excited by the potential offered by breast thermography performed with cold stressing. I was lucky enough to be working in France where the concept originated and I did a lot of cold stress thermography with a liquid nitrogen cooled NEC Sani and a Hues Aircraft Probeye, both of which were excellent cameras at the time. My own observations regarding the low rates of correlation between the results of cold stress tests and case histories and the growing evidence of false positives and false negatives led me to abandon cold stressing of breasts in the early nineties. I learned a more logical and more efficient approach which still relied on the detection of changes in the breast over time but was far more objective and reliable.

We have advanced significantly in our understanding of physiology and how thermography can be effectively used. No technology stands still, we expect science to advance, medical knowledge to improve and evolve and we have to be prepared to learn from experience….. both our own and others. I have no doubt that there will be ongoing advances in thermographic imaging and they may even include new forms of stress testing but the best way to move forward is to learn from experience and then look ahead rather than back.

By Dr. Peter Leando Ph.D., D.Ac., FACCT

See original article here