Mammograms

March 8, 2004

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THERMOGRAPHY AS MAMMOGRAPHY ALTERNATIVE

Dr. A. , N.D.

Page 24 Fall/Winter 2001-2002 Carolina Health & Healing magazine

(now called Integrative Health & Self Healing magazine)

www.integrativehealthandhelaing.com

There probably isn't a person in America who has not been touched by a loved

one who has battled breast cancer. Medical science has not yet learned how

to prevent breast cancer but improvements in early detection promise a

greater chance of survival. One of the most exciting and recent developments

in the early detection of breast cancer is in the field of advanced medical

Digital Infrared Thermographic Imaging or DITI. Several new dramatic

improvements in DITI technology, coupled with patient awareness and new

medical warnings concerning overuse of ionizing radiation from x-rays, are

pushing DITI into the breast- screening arena. DITI now offers the

advantages of being totally painless, totally safe, low in cost, and

effective at any age. You may be asking: " If DITI is so great, why haven't

I heard much about it? Why hasn't DITI been utilized more for breast

screening if it offers all these advantages? "

PRESENTING DITI

Medical DITI has been used extensively in human medicine in the U.S.A.,

Europe and Asia for the past 20 years. While the technology lost favor some

time ago because of cumbersome equipment, difficult protocols and unrefined

technology, events are rapidly changing. New ultra-sensitive,

ultra-resolution DITI devices have many doctors and researchers believing

that DITI exams could prove to be a simpler, less expensive and more

effective complement to mammography than other newer imaging methods.

Recent concerns about mammography and the benefits of a new DITI

manufactured by a company from Australia, have resulted in DITI imaging

centers in other parts of the world now being able to offer this technology

to women interested in taking control of their health.

PROBLEMS WITH MAMMOGRAPHY

Until recently, mammography was considered to be our only option in breast

screening. That is rapidly changing as experts in the field of ionizing

radiation are questioning the long- term cumulative effects of these types

of procedures. The truth about mammography is that it may not be as safe or

effective as once believed.

Many informed experts are now questioning the detrimental effects from

cumulative radiation. The fact is that this area has not been properly

researched, especially considering the multiple-exposures being absorbed by

many individuals and the cumulative effects of radiation from mammography,

dental and other radiation sources.

Based on 40 years of research on the effects of low-dose radiation on

humans, Gofman, M.D., Ph.D., a renowned authority on the health effects

of ionizing radiation, estimates that 75 percent of breast cancer could be

prevented by avoiding or minimizing exposure from mammography and X-rays.

Dr. Gofman believes strongly that there is no " safe threshold " for exposure

to low level-level ionizing radiation.

Another potential concern about the mammogram is that it may, on

occasion, even help spread an existing mass of cancer cells. During the

procedure, considerable pressure is placed on the woman's breast by the

mammography technologist as the breast is firmly squeezed between two flat

plastic surfaces. Dr. Lorraine Day, a pathologist and breast cancer

survivor, and other researchers have raised concerns about the negative

effects of breast compression.

The National Cancer Institute (NCI) and the National Academy of Sciences

admit that mammography promotes cancer. Their justification for continuing

to endorse mammography is that the incidence of cancer is small in relation

to the number of early detection cases.

However, Dr. B. Simone, founder of the Simone Protective Cancer

Center and a former clinical associate in immunology and pharmacology at the

NCI, says that earlier detection has not resulted in longer life when the

data is really analyzed.

Here are some other comments on mammography:

" By the time a tumor is large enough to be seen by a mammogram, it is

usually 8 years old, has approximately 500 million cells, and is

approximately an inch long. " Lancet, Oct. 10, 1992.

" If all American women between forty and fifty were screened yearly by

mammogram, 40 out of every 100 cancers would be missed. " New England Journal

of Medicine, 328:176 1993.

" Half of all breast cancers in women under 45 are invisible on a

mammogram. " American Health, 1994

MORE ABOUT DITI

DITI has been recognized as a viable diagnostic tool since 1987 by the AMA

Council on Scientific Affairs, by the ACA Council on Diagnostic Imaging, by

the Congress of Neurosurgeons in 1988 and by the American Academy of

Physical Medicine and Rehabili-tation in 1990.

DITI works differently than tests such as x-ray, ultrasound or MRI.

Those technologies can detect changes in tissue structure only, because they

are anatomical tests. Tumors must be formed, dense and of a certain size to

be detected by mammography or ultrasound.

DITI is unique in its ability to show physiological change and metabolic

processes that are strongly indicative of breast abnormality. DITI can

detect subtle changes in breast temperature that indicate a variety of

breast diseases and abnormalities. Once abnormal heat patterns are detected

in the breast, follow up procedures are recommended to rule out or properly

diagnose cancer and a host of other diseases such as fibrocystic syndrome

and Paget¹s disease.

Breast tumors always involve increased vascularization and blood flow as

part of the body¹s immune response prior to tumor formation. Identifying

this increased vascularization and abnormal hypothermic patterning is what

gives DITI earlier detection advantages over mammography and other tests.

Many of the so-called false positives of DITI breast screening are often

true positive findings of angiogenesis (increased blood supply) preceding

actual tumor development. Detection in these early stages is unreliable by

conventional means, often due to the fact that the tumor has not yet

developed any mass or sufficient density.

For younger women in particular, DITI offers a major advantage. In women

under fifty, where tumor-doubling time is significantly increased,

mammography is not nearly as effective. The faster a malignant tumor grows,

the more infrared radiation it generates. This makes detection by DITI in

young women highly probable and accurate at an earlier stage than other

types of screening.

Non-cancerous masses show different patterns than cancerous masses under

DITI screening. DITI therefore has advantages in screening for cancerous

versus non-cancerous growths. It is possible and highly probable that with

increased use of DITI, many women could be spared unnecessary invasive

testing and radiation exposure.

While other more traditional methods such as MRI and ultrasound are

being developed and touted as new advancements in screening, they are much

more expensive and are still limited to structural changes even though they

may deliver an improvement in sensitivity to smaller tumors.

WHO SHOULD HAVE A DITI EXAM?

DITI is for any woman who would rather not undergo the discomfort of

mammogram radiation if not necessary. DITI is especially appropriate for

younger women between 20 and 50 whose denser breast tissue makes it more

difficult for mammography to pick up suspicious lesions. It is appropriate

for women who are outside of the mammogram screening guidelines due to

surgical procedures, breast implants or other contraindications. The DITI

session can provide a clinical marker to the doctor or thermographer

indicating that a specific area of the breast needs particularly close

examination.

A DITI exam takes 15 minutes, is pain-free and establishes a baseline

from which other exams can be compared in the future. If an abnormality is

found, your doctor can then plan accordingly and lay out a program to

further diagnose and /or monitor you until other standard testing is

positive. This allows for the earliest possible treatment.

DITI's role in breast cancer and other breast disorders is to help in

three ways: early detection, the monitoring of abnormal physiology, and the

establishment of risk factors for other developments of cancer. When used

with other procedures, the best possible evaluation of breast health is

made.

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, and not a competitor, to the appropriate use of mammography. In

fact, thermography has the ability to identify patients at the highest risk

and actually increase the effective use of mammography imaging procedures.

For more information on DITI, or breast screening centers utilizing the

latest DITI technology, please contact the author.

Dr. A. , N.D. is President of the Vision Medical Group

/VMG, Inc. a medical equipment supplier and consultant to the health care

industry for DITI and other biological medicine technologies. He can be

reached at 1-888-352-8570.

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A Consideration: X-Rays and Your Health

In 1965, the British Journal of Cancer published the first study indicating

that medical x-rays are a cause of breast cancer.

In 1969, I entered the nursing profession. In the past thirty-two years,

the " cure for cancer " is still " just around the corner " , and little has

changed, except that more women, and younger women are diagnosed with breast

cancer.

In 1997, I was introduced to Gofman, MD, PhD, while researching an

article I was writing for Women’s Health Month.

According to Gofman’s study, seventy-five percent of all recent,

current, and incubating breast cancer cases are caused by radiation.

Gofman’s research, published in his book, Preventing Breast Cancer, gives us

much to look at and consider.

Gofman contends that the resistance to new ideas is one of the major

obstacles that keep the public, and women especially, poorly informed about

prevention.

While we know that good wholesome, organic food is health promoting, we

also need to consider the impact of drinking pure water, reducing stress,

and getting good exercise. We have to consider the impact of environmental

poisons, poisons in food, and the increasing amount of EMF exposure.

Specifically these factors co-act with x-rays to make things worse. Much of

this research is addressed in the work of Epstein, MD, of the

University of Illinois at Chicago.

This is where education and prevention step in.

Radiation doses and disease risk can be reduced significantly without

reducing the quality of the diagnostic process. This is important because

breast tissue is very sensitive to ionizing radiation. Ultrasound and

thermography are screening methods that reduce exposure to ionizing

radiation.

According to Gofman, " if we care about preventing breast cancer, we

will establish a relentlessly positive program of measuring and recording

x-ray doses, so that physicians and patients will know if the United States

is succeeding, or not, in the one known action guaranteed to reduce breast

cancer rates. "

Dr. Gofman is Professor Emeritus of Molecular and Cell Biology at

the Univ. of California, Berkeley, former director of Biomedical Research at

Livermore National Lab, author of three scientific monographs on x-ray

health effects, and chair of Citizens for Nuclear Responsibility.

The X-rays and Health Project web site is www.X-raysandhealth.org

<http://www.x-raysandhealth.org/>

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Check the sites below regarding the location of a qualified breast

thermography center nearest you, this information can be found at the

following link. If your state or region is not listed on this page, we are

not aware of a qualified center in your area at this time.

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

Thermography is currently an unregulated industry in the U.S.. Consequently,

there are no laws governing the levels of training and experience necessary

to provide this service. The doctors and technicians listed on this page

have all been certified by recognized thermographic professional

associations. This list is provided as a starting point for anyone seeking

this important service. Other centers may also exist that are not on this

list. However, please be sure to check on the credentials of any and all

thermographic technicians and interpreters to avoid visiting an untrained or

poorly trained provider.

Some helpful links on choosing a qualified center -

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

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

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

If these links have not answered your questions, please resubmit your

question to info@... and we will respond to your email

within 72 hours of receipt.

June 8, 2004

,

Funny thing, I too went for my mammogram on June 7th.

The tech I had was also very kind. Right off I tell them I'm fused & not as

flexible as some techs would like.

The feeling that you got your boobs caught in the garage door is universal. I

biggest problem is my neck. They want to twist it to the side & it just won't go

as far as most peoples.

Hope it turns out with no problems.

Joyce( RN-Atlanta)

June 8, 2004

Michele,

I had mine not too long ago and it was one of the easiest I'd had. My answer

to your question was actually that, yes, it is very difficult. However, my

experience at 1110 Beacon in Boston was actually not that bad.

Where did you go?

Carole

June 8, 2004

Whoops! Should have said 1101 Beacon Street for Mammograms.

June 9, 2004

Michele,

Just for the record, a friend of mine who is an xray tech told me that, most

of the time when women are called back for a re-take, it is because the tech

made a mistake. So, at least for the time being, please do not think that you

have that dreaded disease! Wait and see what transpires? I am so sorry you

have to go through this.

Sincerely,

Carole

June 9, 2004

This is for " HeyTina " .

Thank you for the suggestion regarding a sonogram instead of a mammogram!

Perhaps I shall bring this up at my next appointment! What a great idea!

Midhele, are you reading this?

Carole

April 6, 2005

, Thank you so very much for the notes too on thermograms and

mammograms. It is on my to do list to research it further for my friends and

family,

in particular the feasability of having thermograms. When I was diagnosed the

mammogram literally brought me to my knees in pain, the tech could not

understand why I was crying for so long after the procedure. I have read since

then

that from the writers point of view mammograms can spread the cancer. They

went on to state that physicians are taught in medical school to be gentle in

examining breasts to prevent dislodging cells. I have to wonder if it was not

the mammogram that was the culprit for initiating the spread.

Having worked in a health care facility for many years, we had a CEO who

talked about the competition for facilities with imaging machines, CT scans

etc...He said that in ours and neighboring counties alone we had more of this

equipment than all of Canada. As such there is a financial incentive to not

only

have this equipment pay for themselves, but make a profit. It is obvious the

need for early detection although I am frightened by the radiation to which many

scoff. In reassuring me clinicians have stated how much safer they are now.

They were still routinely using them on patient's when they were not as safe

and as such does not give me much comfort. I will share any further

documentation I find. Donna

September 7, 2005

Hi!

Here is an interesting article regarding the importance of mammograms. I had my female annual exam a week ago and my doctor insisted that I have annual mammograms because I am over the age of 40. This article doesn’t necessarily agree.

Kenda

Mammograms — what's best for you?

by Dixie Mills, MD, FACS

Should you get an annual mammogram? Most women are told by their doctors that turning 40 means a yearly screening for the rest of their lives — a notion that reassures some but fills others with dread. If you don’t get a yearly mammogram are you more likely to die from breast cancer? The truth is more ambiguous than you may think.

We’ve been told that mammograms save lives, then we hear of a woman who had a clean mammogram three months prior to finding a lump in her breast and was dead in a year. What does this mean? The fact is, annual mammograms will not prevent you from getting cancer — they will detect some pre-existing lumps, but the technology (and the experience) is far from perfect.

Early detection through mammography is still the most important tool we have in beating breast cancer, especially if you have a family history or are over 65 — but it won’t protect you from cancer. At our practice, mammography is a supporting player in good breast health, not the lead role. We put as much (or more) emphasis on optimal nutrition, exercise, and a healthy lifestyle.

So, what about that annual mammogram?

The answer really depends on you. I’d like to give you the latest information so you can work with your practitioner and make an educated decision for yourself.

What is a mammogram?

Mammograms are black-and-white X-rays of a flattened breast. Annual mammograms allow a radiologist to detect something new or a change in your breast tissue. They don’t prevent or treat breast cancer. Getting your yearly mammogram is not like going to have your teeth cleaned and checked by the dentist, even though it may feel like a similar ritual.

After age 40 or 50, depending on your medical practice, mammograms become an additional feature of your annual well-woman exam that includes a physical exam of the breast and surrounding tissue. If you feel a lump it should be brought to the attention of your primary care provider (PCP) even if your mammogram was clean.

Over the past thirty years, mammograms have been shown to decrease breast cancer deaths in women over 50 years of age. The benefit for the women in their 40’s was never clearly demonstrated, begging the question of when is the best time to start — age 40 or 50? In some studies there was no difference, in others there was a smaller (10-20%) advantage. There's no consensus among organizations in the field either: some recommend starting mammograms at 40, while others advocate 50. Most recommend stopping mammograms at age 70, but this is another controversial topic. (Click here for more on when to start having mammograms.)

The general wisdom has been that the smaller the lump, the less time the cancer has had to grow, making it easier to eradicate. But as more information becomes available, that’s not so clear.

The controversy over mammograms

An article published in the July, 2005 issue of the Journal of the National Cancer Center found that regular mammogram screening did not actually decrease deaths from breast cancer.

Advance reports of an article to be published in Cancer in September, 2005 implied that early detection boosted survival, but the benefit was much more substantial for women over 65. Yet another article published in August in JNCI reported that women whose breast lumps were detected by mammography had a better prognosis. So what is a woman to believe or to do?

Despite the news that the death rate from breast cancer has fallen somewhat, the incidence of breast cancer is still rising, albeit slowly. By now, we all have known or have had a friend who has been diagnosed with the disease and more and more of us know someone who died from breast cancer at a young age.

We still don’t know what causes breast cancer or how to prevent it — it’s definitely not like lung cancer where there is a clear link to nicotine and stopping smoking does save lives. If there were a similar connection between mammograms and breast lumps, there would be no controversy. Of course we want something that will save lives!

Most women are willing to undergo whatever testing they can to beat the odds of this frightening disease. So why am I hearing from more and more patients: “Do I really need that mammogram?”

Objections to mammograms

Mammograms are uncomfortable (and for some women, outright painful) and come with their own risks — high levels of false positives (about 10% per mammogram, depending on the age of the woman, the center, and the radiologist), unnecessary invasive procedures, and increased anxiety and dread — that need to be factored into the equation.

When my patients relate some of the humiliating experiences they’ve had getting a mammogram, I don’t blame them for never wanting to go back — whatever the risk. Our breasts are very personal and many of us aren’t that comfortable touching them ourselves, let alone manhandling them for an X-ray machine and a bossy technician!

Can mammograms cause breast cancer?

No study has ever asked this question directly, but scientists have estimated the accumulated radiation from mammograms over 10 years could contribute to one extra death from breast cancer in 10,000 women. The numbers would most certainly be skewed the other way if getting mammograms caused significant deaths. It’s possible we may be over-treating some women and controversy abounds over ductal carcinoma in situ (DCIS), but that will be addressed in a future article

So, radiation from regular screening, including additional films beyond the norm, seems to be limited and acceptable for women 40 years and older. Some carriers of a genetic mutation are more susceptible to radiation damage and should have different screening. The radiation retained in the body from a mammogram can also be reduced significantly through complementary techniques, such as acupuncture or detoxifying foods like seaweed.

Nowadays, mammograms lead to the diagnosis of more cancers, particularly in situ cancers, without an increase in mortality. But are they actually saving lives? Yes, but not as many as you may have thought.

Breast cancer survival rates and mammograms

For every woman I see who declines the test I see one who wants a mammogram every month. Both ends of the spectrum are probably a bit too extreme about the issue. But the million-dollar question is, all things being equal (age, family history, general health), which of these patients is more likely to die from breast cancer?

Recently, a number of studies assert conflicting opinions on the subject of mammograms and survival rates. Keep in mind that studies can vary widely in scope, objective, quality of mammography and study design.

An overview article published in 2003 in the New England Journal of Medicine reviewed the literature and provided tables and graphs for doctors to help answer their patients’ questions. It dramatically showed that the number of lives saved through annual mammograms is much smaller than most women believe: two out of 1,000 women in their 40’s, four out of 1,000 in their 50’s, and six out of 1,000 in their 60’s.

I think that most women had assumed that the benefit of annual screening was much stronger and that mammograms were far more effective. Unfortunately mammograms don’t provide the direct protection and safety of seat belts or motorcycle and bicycle helmets. However, if you multiply by the millions of baby boomer women, these small percentages still add up to thousands of lives saved.

In another interesting study reported this July in the JNCI, researchers looked retrospectively at almost 4,000 women in the US between the ages of 40 and 69. Much to the surprise of the authors, the study found that women who underwent screening died at the same rate as women who declined a mammogram. Their results suggested there may be some benefit for women who are at an increased risk for breast cancer because of a family history or a prior atypical breast biopsy. (Click here for more information on breast cancer risk; this will link you to a free, interactive assessment tool; as recommended, please be sure to discuss the results with your doctor.)

Does the size of the lump matter?

A separate factor to consider is the size of the cancer — and there are plenty of studies that support the value of mammograms for early detection of small breast lumps.

A study conducted by doctors at Memorial Sloan-Kettering in New York City looked at over 260,000 breast cancer tumors from US cancer registry data. They found that improved survival rates over the last thirty years were the result of tumors being found at a smaller size rather than newer, advanced treatments. This was most dramatically true for women 65 years and older. The benefit was far less significant in women under 50.

The researchers did not have information on how many of these tumors were found on mammograms, but intuitively attributed the benefit to mammograms because mammograms can (but don’t always) find tumors smaller than those found during a breast self-exam or by a doctor.

So at this point, no one is ready yet to throw out mammography — except perhaps some insurance companies who see its rising cost — because early detection does appear to make a difference, however small. Just think if you were one of the two in 1,000 whose life was saved by a mammogram at 40.

But small tumors are often equated with early stage breast cancer. That’s not quite accurate either. Let’s take a closer look.

Just what is early-stage breast cancer?

The benefits of early detection of a breast lump make intuitive sense — get it early and the disease has less chance to spread. But perhaps this is too simplistic. Breast cancer is not one disease, but the umbrella term for a host of cancers — and tumor size can reflect a range of progression depending on the cancer.

Let’s take the symptoms of breast cancer out of the box for a moment. In the first place — what is early? The size of an invasive tumor found on a mammogram is at least 5 mm but usually greater than that to be clearly seen. While this is tiny (to be felt by the hands a tumor is usually at least 10 mm, or 1 cm — about a half an inch — and more often larger), estimates of cell growth indicate that it takes many years to get to that size, annual mammogram or not.

Many researchers are now trying to identify markers either in the blood, urine, or ductal fluid that could signal the presence of tumors at a really early stage. We now realize that not all 1 cm tumors are created equal either. Genetic micro array analysis of tumors is beginning to identify which tumors are the aggressive “bad” actors and which are the slow indolent type.

Likewise not all 2 inch or 5 cm tumors are the same. We had assumed that cancer cells and tumors grew in an orderly fashion from a pea to a grape to a walnut. But not all tumors fit this stereotype: some stay pea-like; some grow like weeds in springtime and lay dormant in the winter; others feed off hormones or starve for unknown reasons.

So while we can say that early detection is important and finding tumors at a smaller size is beneficial it is not the whole story. And mammograms can get it wrong because the technology is far from perfect.

Mammography and the “picture problem”

A number of difficulties exist in getting a quality image of the breast, otherwise known as what best-selling author, Malcolm Gladwell, calls the “picture problem.” In the 2-D world of mammography, two black-and-white pictures of each breast are taken. These contrasting views provide some dimension, but little more than what is up, down, medial, or lateral.

Up until the 1960’s basic X-ray equipment was used to look at the breast and chest cavity. Compression imaging was introduced in the early 1980’s, which simplified the process and provided a better view — opening the door to mass screenings. While the radiation doses have decreased significantly since the 1960’s, not much else has changed.

ly, I’m surprised we’ve progressed from color television to high-definition TV while women’s breasts are still being imaged with black-and-white X-rays. I comment to my patients on the quality of video games available to our children — all with better depth and detail than the average mammogram! Even my dentist has a computer next to each patient’s chair that shows a real-life image of each tooth. But decay in the mouth is now easier to spot than cancer in a woman’s breast.

Mammograms are clearest when imaging fatty breasts, which are more prevalent in older women — usually post-menopausal women not on HRT. Higher hormone levels cause breasts to be fibrous and hard to read on a mammogram — or “dense.” (Perhaps this is the reason mammograms are more beneficial for older women). How your breasts feel does not always correlate with how they look on mammograms; lumpy breasts can be dense or not to the x-ray machine.

A textbook cancer — or as some doctors would say, one that a medical student could see — would show up on a mammogram as an irregular or spiculated (jagged) white shape, often called a mass or a nodule. (Nodes are the little shapes seen up in the armpit on films.) The white shape shows up best on a background of gray or black, which is fat on a mammogram.

When I show my patients their films, which I do with all of them (and you should ask your breast specialist to show you yours; PCP’s do not actually see the films and instead rely on the radiologist's report and therefore could not discuss them with you), they often point to a black area with concern. I joke and tell them that X-rays did not read the book that said that white is good and black is bad, and that black area is actually good fat!

Dense breasts contain a lot of perfectly normal fibroglandular tissue that shows up as white areas on a mammogram. Part of the “picture problem” with mammograms of dense breasts is that the white areas created by those fibrous tissues can conceal a small cancer — especially one a medical student could not see.

Dense breasts and “dense mammograms”

Every woman should be told how dense her mammograms are. (I tell all my patients that they aren't dense, just their mammograms!)

Dense breast tissue is partially genetic and you won’t know if you’ve inherited it until you get a mammogram — but it relates directly to the likelihood of detecting a cancer with mammography, especially if you are under 50. It may take a bit of sleuthing because radiology reports are not easy to interpret and are not universally the same.

To offset the frustration of a dense mammogram reading, I recommend that women have their mammograms taken consistently at the same accredited site. (It’s against the law to provide mammograms without being accredited so it is rare that a center wouldn’t be.)

Women with family histories or other high risk factors should be screened at a breast center where they can be informed of their results the same day and have additional testing (if necessary) done at that same time or scheduled in a timely fashion. In an ideal world all women could have their testing done this way — what a lot of fear and loathing that would relieve! Unfortunately the cost of this kind of practice can be prohibitive and there are not enough dedicated mammographers (radiologists who specialize in the breast) to make it feasible for everyone.

Keep in mind that not all mammograms are double-read and all are subject to human error. Sometimes the person reading them can be tired or less experienced. Doctors are not going into mammography now for fear of being sued over dubious results that come from the imperfect technology. For these reasons getting a second opinion is always a good idea.

Are dense breasts a risk factor for breast cancer? The physiology is totally unclear; most likely this is more a matter of difficulty in reading the dense mammogram. If your mammograms are dense, annual screening in your 40’s is certainly going to be less helpful. Depending on your risk factors or personality you may want to forgo annual mammograms (perhaps go every two-three years) until age 50 or pursue other means of screening.

Can you make mammograms less dense? Unfortunately there is no simple answer here. Aging helps some, but if you want an immediate solution you can try having your mammogram right after your period when your hormones are lower. This can be somewhat difficult to schedule. We also know that taking HRT usually keeps pictures dense.

What are the alternatives to mammography?

If your mammograms are dense or you do not believe in or want to have a mammogram, you may want to have ultrasound screening. For those women with a strong risk history, an MRI scan is another option. Not all centers will provide these services and they can be expensive, so not all insurance policies cover them.

Some institutions have digital mammography, where the pictures are stored on a computer (rather than film) and seen on a high-resolution monitor. The computer aids in analyzing the changes from year to year. Like all advanced technology, this equipment is upgraded yearly and is still very expensive. The benefits aren’t totally clear, but do allow a radiologist to view your file from a remote location (good for second opinions!). Regardless, not all mammography centers have bought into it.

Thermography and breast cancer detection

Thermography, or heat detection, is an old method which newer technology is bringing back. At this point, very few large studies have looked at thermography. I think it is still too early to advocate it for everyone.

I’ve encouraged women interested in the test to find an experienced institution that will correlate their findings with other testing. I personally have seen false positive and false negative results with different practitioners using different types of cameras. However, if you know of a healthcare provider accredited in thermography, it might be something to try. We’ll keep you posted as more information becomes available.

I still think I may be able to become the curator of a mammogram museum before I die, because technology is advancing by leaps and bounds and breakthroughs that make our current machines obsolete are sure to occur!

What is the bottom line on mammograms?

I think it’s prudent to continue annual mammograms, particularly for women over 50 and definitely those over 65, but it should always be a choice, not an obligation. If annual mammograms go against your belief system, reason, or common sense — don’t worry. You will not be arrested or ticketed and your likelihood of dying from breast cancer is still very small if you decline the test.

What you should take into account is your own individual health picture: your risk factors, age, breast density, and your threshold for anxiety and risk. Some women may be comfortable getting a mammogram only a couple times in their 40’s and 50’s; others may need more regular reassurance.

Our approach to breast health

Whatever you decide in regard to your annual mammogram, the following guidelines will help you build a core foundation of breast health. Even women with a genetic predisposition toward breast cancer may offset some of their risk through good nutrition, daily exercise, and positive lifestyle choices. Here’s what we recommend:

* If you still smoke, stop.

* Eat 5-9 servings of fresh fruit and vegetables per day, preferably organic or locally-grown produce, free from pesticides and synthetic fertilizers. Avoiding simple sugars and carbohydrates can help prevent insulin resistance, which may be linked to a higher breast cancer risk.

* Take a medical-grade nutritional supplement. Your breast health relies on a rich supply of nutrients, including antioxidants and essential fatty acids to help boost the immune system and soothe inflammation.

* Eat healthy, organic animal and dairy fats. The link between saturated fat and breast cancer is a hot topic — whether the risk comes from saturated fat itself or the biotoxins that accumulate in the fat cells of our food is still unclear.

* Drink alcohol in moderation. More than 1-2 glasses of wine or spirits per day has been associated with greater breast cancer risk because it interferes with your liver’s ability to metabolize extra estrogens.

* Exercise for 30-60 minutes at least 4 times a week. Try to shed excess body weight.

* Try to practice monthly self-breast exams or have a partner do them for you. Click here for information, directions, and visual guides on self-breast exams.

* Get annual well-woman exams, starting at age 20. Discuss with your doctor the appropriateness of annual mammograms for you, particularly if you’re under 50 or have dense breast tissue.

* If you have a family history or prior atypical biopsy results, check with your doctor and follow up at an accredited breast center.

In a perfect world

Mammography is definitely not as good as anyone thought it could be or as beneficial as we’d like it to be but we are still better off than we would be without it. However we shouldn’t think this is as good as it gets.

My hope or dream is that in the near future there will be a simpler, better test like blood or urine for breast cancer. If a woman turns up positive, she could then go on to have a diagnostic mammogram, ultrasound or MRI. Or better yet, maybe someday the innovation of the year will be a cream that a woman rubs on her breast: if it turns a particular color then she opens a different tube and rubs on another cream that makes everything all right! One

September 8, 2005

Hello, Lea!

I’m glad the article helped you. I battle whether or not to get them. I joke that I’ll see a growth before it is very large at all because I am not very busty. I know this isn’t true but it’s how I see it. My OB/GYN is adamant that I get them yearly. I’ll have to ask Dr. Leu his opinion.

Kenda

Good Morning Kenda:

Thank you for this article because my family doctor does not like me to have mammograms, due to the radiation. They always end up doing an ultra sound as well. My breasts, well one breast is just skin, but I always have so many cysts in both breasts. They want to do a mammogram every six months and I'm at a loss because someone should do a biopsy on of one of these cysts. He is worried about all the cysts too, but does nothing!

My doctor wrote a book called " For The Health of A Woman " , his name is Dr. Brown. did the editing on this book. www.trafford.com <http://www.trafford.com> follow links. I was the so-called editor and chief. He talks about breast implants, just a bit.

My mind is not working today, I feel so overwhelmed with everything.

Love you...Lea

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Re: Mammograms