To mammogram or not to mammogram? Controversy continues.

Breast Tests Beyond Mammograms: The Truth About It & What You Can Do To Prevent Breast Cancer

Dear Dr. Susan,

I'm a relatively new subscriber, and I read in one of your special reports that you aren't the biggest fan of mammograms. Can you tell me why? If not mammograms, then what breast cancer screening tools do you recommend? —Donna

Dear Donna,

Mammograms do have their place in the breast health programs of women who have a high risk of developing breast cancer, but I believe that there are safer screening tools out there for the rest of the population.

Let me tell you why.

A routine mammogram's sensitivity (how good it is at detecting suspicious tissue) varies. If a woman is still menstruating, her breast tissue is denser, which drops the sensitivity of routine mammograms to below 70 percent.

That means that as many as 30 percent of existing breast cancers are missed, which is troubling because cancers in younger women tend to grow faster. After menopause, a mammogram's sensitivity is better, but still not great.

(To find out what calcification means when it shows up on your mammogram, click here.)

Routine mammograms are hamstrung by the fact that any tumor smaller than about four-tenths of an inch across is less likely to show up, so a tumor might be just small enough to escape detection, and then have lots of time to grow and spread before the next mammogram.

On top of all this, human error in reading the films is also a very real possibility. Here's another problem with mammography.

Five out of six "suspicious" routine mammograms turn out not to be cancer. Those five women are undoubtedly relieved, but they also got the scare of their lives, under-went more tests, maybe got biopsies, and possibly even had surgery they didn't need.

The latest studies show that for every 2,000 women who get a routine mammogram, one life is prolonged (Cochrane Database Systematic Review).

If that seems mediocre, you should know that protecting any individual woman against breast cancer was never the goal of routine mammograms—it's well known that they miss too many cancers in the early, most treatable stage. As a routine screening tool, their purpose is simply to reduce the percentage of women who die from breast cancer.

For the best possible chance of an early diagnosis in an individual woman, I want a test that detects smaller tumors accurately, affordably, with less chance for human error, and without exposure to more X-rays. And there is such a test—breast thermography. I've written about this before, and I now have even more reasons to whole-heartedly recommend it.

The "Hot" Breast Cancer Test

When thermography was first introduced, it didn't perform well. Today, cutting-edge, high-resolution, digital infrared imaging is FDA-approved for breast cancer screening and is finally (though slowly) starting to catch on in the U.S. A normal breast thermogram for each woman is like her fingerprint: It's uniquely hers, and it doesn't change much over time.

And, in most cases, a woman's left breast is pretty close to a mirror image of her right breast. Because an adult woman's breasts are finished growing, they're normally cool, ther-mographically speaking.

Most tumors, on the other hand, like to grow. That's an energetic enterprise that requires more blood supply and usually generates extra heat—not enough for a woman to notice, but enough to show up on a thermogram well before a tumor is large enough to show up on a mammogram.

On a thermogram, tumors not only show up as "hot," but they either stay that way or get hotter over time. Noncancerous structures such as cysts and abscesses cool down, but a mammogram can't "see" that like a thermogram can.

And, because thermography doesn't involve radiation, a new spot can be reevaluated as often as necessary to monitor its behavior. By comparing the left and right breasts on a one-time thermogram, differences between the two can indicate suspicious tissue. But the key to getting the most out of this test is to get it done regularly—at least every couple of years, depending on your age and breast cancer risk factors.

That way, the latest thermogram of each breast can be compared not only to the opposite breast but also to previous thermo-grams. A spot on one breast but not the other might be a normal part of your "fingerprint" that's been there for years, or it might be entirely new—and clinically significant.

So, in addition to looking for asymmetry, the strategy is to look for change, such as new spots or older spots that have gotten larger or hotter. (Biomedical Engineering Handbook).

Some breast tumors are slow-growing and don't generate much of a heat signature, and therefore wouldn't show up on a thermogram.

Because they're slow-growing, they're generally less dangerous, and eventually they become large enough to appear on a mammogram. In short, mammography looks at the structure of a woman's breast tissue, while thermography looks at its behavior.

For this reason, my recommendation is that you choose thermography over mammography, unless you have a high risk of developing breast cancer.

(Such risks include having an extensive family history of the disease, genetic pre-disposition, and/or obesity.) If that's the case, then con-sider getting mammography and thermography done.

The Newest Thermography Technology

The Sentinel Breast Scan consists of the most advanced near-infrared imaging technology partnered with computer programming. It "reads" the image objectively, which virtually eliminates human error.

Because it's fast and doesn't require a highly qualified operator, it's also quite affordable. In a quick review of major facilities that offer this technology, I found prices ranging from $350 per scan.

 Most major insurance carriers are still calling thermography "experimental" and are refusing to pay for it, but I'm hoping this will change before long. If your health care provider is unaware of a thermography facility in your area, you can contact the International Academy of Clinical Thermology or Infrared Sciences Corp.  for help.

Breast Cancer News On the Horizon:

Hair Testing Research over the past five years has shown that specific changes occur in the architecture of scalp and pubic hair during the early stages of breast cancer, before tumors are visible by mammogram.

Furthermore, when the cancer is successfully treated, the hair returns to normal (Cancer Detection and Prevention). According to researchers, hair from a woman who has breast cancer has a ring of abnormal molecular spacing that is visible when examined with

a technique called X-ray diffraction (International Journal of Cancer). This possibility for a cheap, effective way to screen for breast cancer and monitor a woman's response to breast cancer treatment is now undergoing clinical trials in Australia.

I'll keep you posted on any news regarding this promising research!

Dr Susan

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