Alternatives to Mammography

Because of insurance carrier changes and frequent moving,  I wound up going to a lot of different providers in order to stay in network.  I always felt VERY pressured to have mammos once I turned 40, no matter where I went  (though no doctor ever told me I was high risk for BC). 

These so called experts kept assuring me that the rad dose was SO low.. so insignificant.  Yet not ONE, in my experience, ever asked me about the previous lifetime radiation exposures I'd had. 

I'd have to ask them, "is radiation cumulative in the body"? And they'd say yes.  Then I would spell out the excessively high rad exposures I've had...  

They treat every woman walking in the door as if the risks of mammo are low - without ever taking individual histories into account?  

Frankly, I think they deserve a class action suit for that alone... it's no different than handing out a prescription without asking what other drugs the patient takes, or about allergies.... 

Oww. Good one Spring, I am going to look into getting that book too. I just looked it up on Amazon. It got great reviews.

And Pill, you wrote:

"Yet not ONE, in my experience, ever asked me about the previous lifetime radiation exposures I'd had. 

I'd have to ask them, "is radiation cumulative in the body"? And they'd say yes."

You know, that's been one of my issues, as well. WE'VE ALL BEEN PUT THROUGH ALL KINDS OF X-RAYS since childhood. And noone has been holding tally, because "that's not in the literature." I totally agree with you: this is CRIMINAL. Now, who's talking about quackery, around here? If this is not mainstream quackery, I don't know what is.

I fired my oncologist after discovering that she had been putting me through the most aggressive possible chemo despite a low Onco-DX recurrence rate, and despite the fact that my tumor is HER-, and I did not present any lymph nodes. She put me through that chemo WITHOUT INFORMING ME OF MY TEST RESULTS. Granted: I should have been proactive. But I was new to cancer, frightened, and lost. It took me a while to start researching, that's why this doctor was able to do this.

Then, I had to fire the next oncologist I hired, because his solution for my breast cancer was to put me through 1 MAMMO EVERY 5 months! He also handed me a prescription for Tamoxifen, WITHOUT SAYING ONE WORD ABOUT THE POSSIBLE SIDE-EFFECTS.

And before all that, I had left the first oncologist I had seen, because he wanted to put me on a chemotherapy trial at all cost (I later on discovered that he is known as "trial crazy" in my area here, and does that with every breast cancer patient). And he was going to put me through radiation also, despite the fact that I had had a mastectomy, which I later discovered, SHOULD NOT BE DONE. So good thing I fled that first office.

I was called a "fool", a "recklless" woman when I turned down the 1 mammo every 5 months......

And then,........................(talking about mammo screening), look at what is happening now.......... So if I had gone along with it to please doctors, I cannot even begin to imagine what a nervous wreck I would be right now, knowing that they are slowly coming around to admitting how dangerous this kind of all-out screening really is.

You know, that's been one of my issues, as well. WE'VE ALL BEEN PUT THROUGH ALL KINDS OF X-RAYS since childhood. And noone has been holding tally, because "that's not in the literature." I totally agree with you: this is CRIMINAL. Now, who's talking about quackery, around here? If this is not mainstream quackery, I don't know what is.

I know... I think of all the dental x-rays I've had and how they put a lead shield over my abdomen since I was a girl of future child-bearing age. At the time, I thought, "geez, if stray radiation could damage my reproductive origins, what the bleep could this be doing to my HEAD?!" But, the dentist always just made you do it, didn't ASK if you wanted it or explain the pros or cons... you just DID it as a matter of course. UGH.

It reminds me of a story I read of a cool x-ray machine some shoe company rolled out in the 40's. Kids could go and get their feet x-rayed for a perfect fit! Kids loved it! umm, until those same kids started getting FOOT CANCER en masse. I can't help but wonder about all the dental x-rays and mammograms.... they even forced me to have a chest x-ray before my surgery last week even though I told them I didn't want or need it. (They said it was to make sure my lungs were strong enough for general anesthesia -- WHAT??! I've had two procedures under general anesthesia and was fine... why on earth would they force me to do it now?? But, I succumbed... I was doped up by then and didn't have the strength to resist....)

"They want to believe."

That's the whole point. They want to believe. They desperately want to believe.

It is like telling a kid there's no Santa Clause. Some days, I just don't have the strength! 

Good article Vivre. 

And I  just received this by email from my work support group facilitator:

http://www.nexcura.com/Newsletter/eNews.asp?CT=5&Month=NOV&Year=2009&INST=1&EG=457AC38AE4194C7CB183CD75B402C170&NewsId=2500

Time to rethink the way cancer screening is promoted
Source: (cancerfacts.com)
Tuesday, October 27, 2009

SAN FRANCISCO - Oct. 27, 2009 - Is detecting breast and prostate cancers at their earliest stages paying off in reductions in later stage cancers and of dying of the two diseases? A new study says no, touching off a new round of controversy over the strategy of screening for very early stage cancers.

Led by Dr. Laura Esserman at the University of California at San Francisco and Dr. Ian Thompson of the University of Texas, an analysis of the past 20 years of screening for breast and prostate cancer showed that, while detection of early stage disease nearly doubled for both cancers, there was not a corresponding reduction in regional disease as would be expected if early detection were resulting more cases being cured at the early stage.

"One possible explanation is that screening may be increasing the burden of low-risk cancers without significantly reducing the burden of more aggressively growing cancers and therefore not resulting in the anticipated reduction in cancer mortality," the authors wrote.

The study results were published in the current issue of the Journal of the American Medical Association, and have re-ignited the controversy about the value of screening. The American Cancer Society has been quick to reassure people that while they conduct ongoing review of the research and make changes to their guidelines, they are not changing their guidelines in light of this latest study just yet.

In a statement issued in response to the New York Times Oct. 21 story about this latest study, Dr. William Brawley, chief medical officer for the ACS, wrote that the findings suggest that current screening methods are not perfect.

"While the advantages of screening for some cancers have been overstated, there are advantages, especially in the case of breast, colon and cervical cancers. Mammography is effective - mammograms work and women should continue get them," Brawley wrote. "Seven clinical trials tell us that screening with mammography and clinical breast exam do reduce risk of breast cancer death. This test is beneficial in that it saves lives, but it is not perfect. It can miss cancers that need treatment, and in some cases finds disease that does not need treatment."

The Society's guidelines regarding screening for prostate cancer already are more moderate, reflecting the relatively lower precision of the prostate specific antigen (PSA) test and the very nature of prostate cancer.

"Since 1997 the American Cancer Society has recommended that men talk to their doctor and make an informed decision about whether or not prostate cancer early detection testing is right for them. This recommendation also still stands," Brawley adds.

Experts in both diseases have long acknowledged that aggressive cancer screening does pose the risk of over diagnosis and overtreatment. Current estimates suggest that for every 100 women who are told they have breast cancer, as many as 30 have tumors that are so slow-growing they are unlikely to be life-threatening. Similarly in the case of prostate cancer, for every 100 men diagnosed, as many as 70 have cancers that likely would never pose a threat to them.

The bottom line seems to be that screening should continue to be done, but patients need to understand that current screening methods are not certain. Meanwhile researchers need to develop better screening methods to allow patients and doctors to more accurately assess the real risk posed by a given diagnosis. As Esserman's research team concluded, better methods should help avoid treating cancers that don't need to be treated and reduce deaths from those that do.

"To reduce morbidity and mortality from prostate cancer and breast cancer, new approaches for screening, early detection, and prevention for both diseases should be considered," they wrote.

SOURCE: JAMA 2009;302(15):1685-1692. Rethinking Screening for Breast Cancer and Prostate CancerLaura Esserman; Yiwey Shieh; Ian Thompson. http://jama.ama-assn.org/cgi/content/full/302/15/1685

Spring, oh yes blue=good!!! On the therm you don't want to see red because that means hot spots which could be something ya just don't want. How have you been feeling since your last operation???

Patty

Spring - you are glowing in your new avatar! I hope this photo reflects how well you are feeling after surgery!?

I need help with Thermagraphy. Patty, I read you had your first one. The closest I can find is one 3 hours away. My BS has agreed to treat me however I want to be treated but I have taken all his tools away. He knows nothing about themagraphy but he is willing to learn. We will not likely have Therm here for 2-3 more years.My BS would like for me to have a baseline mammagram since I have had surgery (3) and the area looks different now. I don't want to but I am thinking maybe I should? Then if I can get the therms if they see something I might have annother mammogram and I will need something to compare it to? Thoughts?

How often should I have the therms? I suppose Insurance does not pay for them, correct?

Thanks,

Angee

http://www.iact-org.org/links.html

This international list of qualified breast thermography centers has been compiled in response to the volume of inquiries we have received concerning referrals for breast thermography. We will be updating this list frequently as more centers become available.

Please note that only Board Certified or Provisionally Certified Clinical Thermologists and Technicians are listed on this page.

This page is not an official endorsement of any of the labs listed or of any additional services or treatments that they may offer and is provided solely for your reference in contacting a thermographic breast center nearest you. While every effort has been made to insure that only well-trained certified clinical thermologists and technicians are provided, we cannot guarantee the accuracy of any information you might receive. In order to avoid the problems found in unqualified centers, please select a lab from the list below.

Key for abreviations

DABCT - Diplomate of the American Board of Clinical Thermography
DIACT(B) - Diplomate of the International Academy of Clinical Thermology (the "B" denotes additional training in breast interpretation
FIACT - Fellow of the International Academy of Clinical Thermology
CTT - Certification as a clinical thermographic technician

Provisional Certification as a Clinical Thermographic Technician (Provisional CTT) denotes an individual who is currently involved in his or her thermographic residency program and has demonstrated competency in capturing thermographic images under the supervision of an IACT instructor. IACT provides offsite supervision for such centers and the public should feel quite confident in their quality of service. Images taken at a center which does not have a qualified interpreter (Thermologist) on staff will be read by an outside specialist who has met IACT standards and guidelines for interpretation of infrared images.

If you have any questions concerning breast thermography, please contact us at info@iact-org.org.

New Thermography Technologies

http://www.iact-org.org/professionals/new-therm-tech.html

With the recent interest in breast thermography, some commercial equipment manufacturers have begun developing and marketing new technologies aimed specifically at this market.

Unfortunately, this has led to a variety of manufacturer's claims as to the "superiority" of their particular technology, often without a legitimate basis.

It is our sincere wish that continued advancements in this technology will be made in an effort to save more lives. However, there are some who are misleading the public with unproven, and possibly detrimental, technologies. Qualified clinical thermographers, certified through a recognized agency, are familiar with the scientific literature and the technologies involved and have the experience to determine the validity of such claims. Unqualified thermographers and technicians, however, may simply accept these claims at face value and pass it on to the general public as fact. Since this can be extremely confusing for a patient simply attempting to find a thermography center, we offer this section as an aid to separate the fact and fiction in some of the claims we have heard regarding "new" thermographic technologies. This also applies to physicians and technicians attempting to enter this field.

New Forms of Infrared Imaging Equipment

There are many very high quality and acceptable thermography systems on the market. There are also some that appear promising, but are not proven. A few systems also incorporate questionable procedures that may prove detrimental to the patient by providing incorrect data. Then there are those that have been long abandoned by the thermographic community. The following information will be confined to the use of thermographic equipment for breast cancer screening.

Currently, there are some manufacturing companies making claims that their product is superior to the infrared imaging systems of the past. Are these new infrared imaging systems capable of "seeing" more? Sometimes yes, but sometimes no. Is seeing more thermal data diagnostically superior? No one knows at this time. There is no research to substantiate any of these claims.

One cannot compare a thermodynamic imaging procedure (thermography) to the simple principles of X-ray (i.e. mammography) where seeing more is definitely better. Well over 99% of the research found in the literature, all the large-scale studies, and all the current standards and protocols were performed using first and second generation infrared imaging systems. And as such, breast thermography has been proven as a valid and accurate procedure having a sensitivity and specificity of 90%. The bottom line is research.

Until enough valid research is performed using new technologies, the equipment and methods will remain investigational. Manufacturers and supporters of these new systems must meet the same research standards used in previous thermographic studies if a valid comparison is to be made. A study comprising a sample of 20,000-30,000 women observed over 5-10 years would yield enough data to draw valid conclusions concerning a new technology. Also, if any new form(s) of interpretation (computerized or manual) are involved, the studies will need to use at least 2 experienced board certified clinical thermographers reading the same exams in order to evaluate the new method(s) used.

When this data is compiled and published in a peer-reviewed index-medicus journal, those of us who provide this critically important service to women will be able to make an informed decision as to whether or not this new technology yields any additional benefit to the patient. This is the only proper way to evaluate any new procedure or equipment used in the health care field.

As a consumer, the best way to protect yourself from these sales tactics is to look to the personnel who are performing and reading your scans as a guideline for proper thermographic imaging. As long as the technician and interpreter are board certified by a reputable agency, their level of instruction is intended to protect the patient by providing them with accepted infrared imaging standards which includes proper equipment selection and imaging protocols.

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Specific Equipment Types

There are two very basic categories of thermal imaging devices: contact and non-contact. Contact devices, as the term implies, are touched directly to the skin. Modern infrared camera systems are of the non-contact type.

Due to certain inherent errors involved with contact devices, their use has basically been discontinued. However, there are two types of direct contact thermographic devices currently produced: Liquid Crystal and Thermocouple. Liquid crystal systems have merit while the recent resurrection of thermocouple systems (1940's technology) is problematic. The following is a simple overview of the reasons why modern infrared imaging systems have replaced these outdated devices.

Liquid Crystal Thermography (LCT)

These devices are currently being phased out in today's clinical setting. This does not mean that they are not accurate in the hands of a Board Certified Clinical Thermographer, but the technology is old and incapable of discrete objective thermovascular analytical procedures afforded by modern computerized systems.

A LCT system includes a set of flexible temperature sensitive liquid crystal plates that are supported in a frame. This frame holds the plates firmly in place allowing the clinician or technician to push the plate against the breasts. The plates are imbedded with a mixture of organic crystals, which when activated by the heat of the body emit visible light in varying colors allowing accurate temperature measurement. A camera is also mounted on the frame for photographic recording of the examination for analysis. Keep in mind that in the hands of a highly trained clinical thermographer, this system produces very good quality diagnostic thermograms. Systems have been sold worldwide and used by universities, hospitals, and private practice clinicians.

There are several concerns surrounding the actual contact with the breasts:

That the actual touching of the breast might produce a sympathetic reflex response in the patient, thus altering blood flow to the breast and changing the actual temperature.

That accurate temperatures cannot be measured. A temperature or color scale is provided on the side or bottom of the detector plates, which closely match the colors of the crystals. However, there is some overlap in these color scales, which makes actual spot temperature (accurate quantitative analysis) readings impossible.

Two objects of differing temperatures, when brought into contact, will attempt to reach thermal equilibrium (Zeroeth Law of Thermodynamics), thus changing the actual temperature of both objects. The detector plates being of room temperature, and thus much colder than the skin, when brought into contact with the breasts will change the factual temperature of the skin and thus the true thermal data being analyzed. In an attempt to compensate for this, the liquid crystal plates are designed to react (develop) very quickly. However, contact has been made leaving question to the amount of data change.
While infrared cameras are superior to LCT, the technology provides a very good and inexpensive screening tool for the average office.

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Thermocouple Devices

The reputable thermographic community has abandoned these devices on an international level. Early research performed in the 1950's used thermocouples, as reliable infrared camera systems had not been invented yet. Most of these devices are composed of a hand-held device with a heat sensitive metal sensor called a thermocouple at the end.

The thermocouple device is touched to the skin and temperature is recorded either by reading an analog meter, a liquid crystal display, or by a computer program. Of concern is the current resurrection of these devices marketed as a superior form of thermography. Some health care providers are using these systems within their specialties, but research on the reliability and clinical utility of these devices remains lacking, and in some cases, spurious. Some manufacturers have been marketing that thermocouple "thermography" is proven by thousands of research studies, but neglects to inform the public that these studies were performed with infrared camera systems and not thermocouples.

We have also seen some of these devices marketed as "new thermography" with FDA approval. It is unfortunate that the general public and untrained health care practitioners have become the target of aggressive marketing.

The concerns with this technology are some of the same as with LCT. However, the problems are so significant with thermocouple devices that the technology has been abandoned.

Accuracy: Two objects of differing temperatures, when brought into contact, will attempt to reach thermal equilibrium (Zeroeth Law of Thermodynamics), thus changing the actual temperature of both objects. The thermocouples being of room temperature, and thus much colder than the skin temperature of the breasts, when brought into contact with the breasts will change the factual temperature of the skin and thus the true thermal data being analyzed. Unlike LCT, thermocouples react much slower; thus necessitating a longer contact time with the skin. This longer contact time increases the temperature change in the skin further decreasing the accuracy of the reading.

Thermal carry over: Once touched to the body, a metal thermocouple retains heat from that area. When applied to another area of the body, the warmed thermocouple changes the temperature of the skin; thus giving a false or artificial reading (thermal carry over). An example of this would be in examining for a difference in temperature between the two nipples. Let us assume that the right nipple is slightly warmer than the left. The right nipple is measured first, and then touched to the left. The carry over heat pattern may make the left nipple appear warmer than it actually is, and thus the difference between nipples might appear normal when indeed a serious pathology is present. The cooler and normal nipple would simply appear warmer and closer to the temperature of the affected nipple because of the carry over.

Poor Resolution: A significant failing of these devices is the general lack of target sensitivity related to body mass. These devices are very small typically measuring only a few millimeters of skin tissue. When applied to the skin, a few measurements are taken off of each breast. Modern infrared thermographic cameras measure and make composite maps of tens of thousands of data points on each breast, without contacting the patient's body. The important diagnostic information that is missed by these devices is completely unacceptable to modern clinical practice.
We hope that this information has been helpful. If you have any further questions, please feel free to contact us at info@iact-org.org.

Gorgeous pic Spring and I liked the other one also. Always made me smile. Looked like you had a little secret. Congratulations! 

Yazmin, There's a bunch of good stuff there. In particular I am interested in the credentials and the types of machines they use. Seems some folks purchased established medical practices, inherited the patients but have very little experience.

BTW. I had 2 areas show up red on my  first Therm that were nothing. One was from a shaving nic under my arm from the previous day and the other was from bruising I received from an overzealous echo tech. More importantly it showed vascular activity in the same area that showed up twice on my MRI. When I went in for the MRI biopsy after a month and half it was gone. Really good news. Carole 

Vivre - thank you for the info. I checked chiropractors in ky area and there are none that do breast therms. Only one does spine therms. I am going to call the two I have heard of in Indy.

Carole, great info - thank you for posting it.

Springtime - congrats on finishing surgery!!!!