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30.6.08

Lets Start Screening For Breast Health

In the United States, American women are told to begin annual mammographic screening for breast cancer at the age of 40. Long before we've reached this age, we are advised to perform a monthly breast exam and see our doctors for a clinical breast exam (CBE) annually as well. However, the detection rate of breast cancer for CBE is only 47% when the tumors are less than 1 centimeter while mammography has given us a 70% detection rate. By the time a tumor is detected by palpation or found mammographically, it has already been growing and developing for 8-10 years.

Mammography has a high false positive rate. Only 1:6 biopsies are found to be positive for cancer when performed due to a positive mammogram or CBE. This places additional stressors on women who undergo these procedures.

Other risks of mammography include the radiation that each breast is exposed to during a mammogram. During a chest X-ray, a person receives 1/1000 of a RAD, or radiation absorbed dose. This type of X-ray is a high energy X-ray. During a mammogram, however, the X-ray used is a low energy X-ray and results in 1 RAD or a 1000-fold greater exposure than a simple chest X-ray. It has been suggested that the low energy X-ray used may cause greater biological damage which is cumulative over time. In a journal entitled Radiation Research and published in 2004, the author concludes that the risks associated with mammography screening may be FIVE times higher than previously assumed and the risk-benefit relationship of mammography exposures need to be re-examined.

In 1982, the FDA approved thermography as an adjunctive tool for breast cancer screening. Digital Infrared Thermal Imaging, also known as DITI measures heat emitted from the body and is accurate to 1/100th of a degree. Certified Clinical Thermographers follow strict guidelines and transmit their scans for interpretation by board certified thermologists. DITI examines physiology, NOT structure. It is in this capacity that DITI can monitor breast HEALTH over time and alert a patient or physician to a developing problem; possibly before a lump can be seen on X-ray or palpated clinically. There are no test limitations such as breast density. Women with cosmetic implants are great candidates for thermography which emits no radiation and no compression. Contact is never made during a thermographic scan.

Clinical research studies continue to support thermography's role as an adjunctive tool in breast cancer screening and the ONLY tool that measures breast health. There are now more than 800 publications on over 300,000 women in clinical trials. A recent finding published in the American Journal of Radiology in 2003 showed that thermography has 99% sensitivity in identifying breast cancer with single examinations and limited views. Scientists concluded that a negative thermogram is powerful evidence that cancer is not present.

In conclusion, women need to begin breast health screening early; as young as age 25. This can provide women with the earliest possible indication that further investigation is necessary. It takes approximately 15 years for a breast cancer to form and lead to death. If "early detection is the best prevention," let's start using technology that truly allows for the earliest possible alert to a developing problem.

Thermographic screening is not covered by most insurance companies but is surprisingly affordable for most people. For more information or to find a certified clinic in your area, go to www.proactivehealthonline.com.

By Brenda Witt


Screening For Breast Cancer With No Compression And No Radiation

Who would have thought that a technology for detecting breast cancer used today actually had its' roots dating back to 480 B.C.? Digital Infrared Thermal Imaging (DITI) is a fairly new technology that represents a practice that was once used by Hippocrates. This technology is based on a technique that Hippocrates would use as he spread mud over his patients and then watched to see which areas dried first. It was in those places on the body that could show a disease.

It wasn't until 1957 that the first modern application of thermography came into existence when a Canadian doctor discovered that the skin temperature over a breast tumor was higher than that of healthy tissue. By 1982, the Food and Drug Administration approved thermography and classified it as an additional diagnostic tool for the detection of breast cancer. However, DITI was introduced as a diagnostic tool before strict protocols were established for both the technicians who performed the scans and the doctors who interpreted the scans. Shortly after its initial beginnings, DITI fell out of favor as a diagnostic tool in the medical community.

There are now stringent protocols both for testing and interpreting. Perhaps due to these guidelines, thermography (as with all digital technology) has exploded in its technique and capabilities. Thermal cameras detect heat given off by the body and display it as a picture on a computer monitor. These images are unique to the person and they remain stable over time. It is because of these characteristics that thermal imaging is a valuable and effective screening tool to determine changes that could point to trouble down the road. As we all know, early cancer detection is important to survival.

Another advantage is that, unlike mammography, there is no radiation and no compression of the breast; two significant reasons some women refuse mammography. Thermography measures temperature changes in the body. Tumors create their own blood vessels. Where there are more blood vessels, there is more heat. It is in these areas on the body that the camera detects changes in heat or temperature.

Medical doctors who interpret the breast scans are board certified thermologists.

Thermography can be utilized by women of all ages. It is not limited by breast density and is ideal for women who have had cosmetic or reconstructive surgery. Cancer typically has a 15 year life span from onset to death. Ideally, women should begin thermographic screenings by age 25. A woman diagnosed with breast cancer at age 40 possibly had the cancer as early as age 30. Since most women do not have a mammogram until age 40, there is a critical time period from age 25 to 39 that thermography could be extremely beneficial.

Thermography does not replace mammography. However, it is an additional tool that is available to women. By combining both technologies, the detection rate increases to 95-98%, surpassing either technology as a stand-alone therapy.

Thermographic screening is not covered by most insurance companies but is surprisingly affordable for most people. For more information or to find a certified clinic in your area, go to www.proactivehealthonline.com.

By Brenda Witt


Mammogram and Breast Cancer Screening

Cancer screening
The term screening is commonly used for a test that is used for evaluation of a person for possible disease without the person ever having any symptoms or signs of the disease. Screening tests are usually undertaken in a target population, which has significantly high risk of developing the disease. Mammogram is a screening technique used for breast cancer, and the target population for mammogram is women who are aged 40 and above. PSA testing is a screening test for prostate cancer and the target population is men over 50 years of age. Screening tests cannot be employed in all diseases. In some cases a useful screening test may not be available, and in some other cases it may not be worth screening for a disease because screening and finding out the disease early may not change the natural history of disease. The later is probably true in case of screening of lung cancer. From the studies so far published, there is no clear evidence to suggest that screening for lung cancer in high-risk population (smokers) would improve survival.
Breast cancer screening
Unlike lung cancer, breast cancer can be screened using available techniques with beneficial results. Mammogram is the only accepted screening test for breast cancer. Mammogram till this date may have saved lives of thousands of women, by detecting the disease at a very early stage, when it is mostly curable. Screening for mammogram does not prevent the occurrence of breast cancer, but instead it provides a very simple and useful technique to detect breast cancer at a very early stage. Mammogram is capable of detecting breast cancer at a stage prior to infiltration of the tumor to the surrounding structures, called stage 0 breast cancer or carcinoma in situ. Recommendations for breast cancer screening vary from country to country and within the same country according to the views of different organizations who recommend the screening. American Cancer Society recommends that "women age 40 and older should have a screening mammogram every year and should continue to do so for as long as they are in good health."
What is a mammogram?
Mammogram is just an X-ray photograph of your breast, and works in principle the same way as your chest X-ray. The breast tissue is compressed between two plates and an X-ray picture is taken. Doctors would look at the X-ray and determine if there are any abnormalities in the picture. Breast cancer usually appears in the form of calcifications, architectural distortions, or abnormal densities. Since mammogram uses X-rays, there may be slight risk associated with exposure to radiation in women who get mammograms. However the amount of radiation associated with mammogram examination is very small and is strictly controlled by regulatory agencies like National Department of Health and Human Services. Very strict regulations are enforced by this agency to make sure that mammography equipment is safe and uses the lowest dose of radiation possible. The dose of radiation used by the modern mammogram machines does not significantly increase the risk of breast cancer.
Digital mammography
Digital mammograms are similar to conventional X-ray film mammograms except that the pictures are produced in the digital media in a computer. Digital pictures have the advantages of manipulation of light and contrast and hence would be more useful for the studying the mammography picture. It was claimed in the past that digital mammogram is superior to conventional mammograms in terms of accuracy, however a recent study has shown that digital mammography no better than regular mammography.
Computer Aided Detection (CAD)
CAD is sophisticated computer program that can compare areas of the digital mammography picture and aid the physician to more easily detect breast cancer. Studies have shown that CAD system improved diagnostic accuracy by about 20 percent.
Clinical breast examination and self breast examination
An article on breast cancer screening will not be complete without mentioning clinical breast examination and (CBE) and self breast examination (SBE). CBE and SBE are useful adjuvant to mammogram for detection of breast cancer. It is also to be mentioned that about 10 percent of all tumors that can be felt by the physicians may not be seen in a mammogram, hence if the physician feels a tumor, the absence of abnormality in the mammogram does not ensure absence of a breast tumor. Such patients should be evaluated by biopsy.
Self-breast examination as the name implies denotes examination of breast by women, without the help of a physician. This can be undertaken in the privacy of their home. Probably the best time to do a self-breast examination is while taking showers. Women can ask their physicians to teach them the technique of self-breast examination. American Cancer Society recommends "women in 20s and 30s should have a clinical breast examination (CBE) as part of a periodic (regular) health exam by a health professional preferably every 3 years. After age 40, women should have a breast exam by a health professional every year." Regarding self-breast examination, American Cancer Society gives the following recommendations: "BSE is an option for women starting in their 20s. Women should be told about the benefits and limitations of BSE. Women should report any breast changes to their health professional right away."


Mammograms Are No Joke - They Can Save Lives!

There are so many jokes about mammograms! Have you heard the one about the fridge door ?or the bookends ?or the garage floor? Thanks to all the jokes, "Mammogram" has become a household word, and it's not that I don't have a sense of humor, but as a mammography technologist, I've heard the jokes many times. I think the jokes are embarrassing for women and demeaning with regard to their physical bodies. Many women say, "If men had to do this, there would be a better solution" - this may or may not be true. Most people agree that mammograms are not perfect, but until there is a better solution, I think it's time to look at mammograms in a different light.

In May of 1985 and 1986 I asked my doctor to order a mammogram for me and he refused both times saying I was too young. There were no screening mammography centers to which I could refer myself, so that was that. In December of 1986 at the age of 42 I felt a lump in my breast and had a mammogram the same day. It turned out to be Stage II breast cancer with 4 positive lymph nodes. I had a lumpectomy, a mastectomy and chemotherapy but chose not to have radiation. I obviously wasn't too young to have cancer.

In May 1985 a mammogram cost less than $60.00 and would have resulted in my having minor surgery to deal with a small lump. Delaying the diagnosis until December 1986 raised the cost of the medical care I received both in dollars and the amount of human suffering we faced. I say "we" because a diagnosis of cancer affects the family, friends and community of the person with the disease. A timely mammogram would have saved us all a lot of grief.

The common perception is that having a mammogram is a negative experience; I think this is a bad rap. Mammograms are quick and easy breast X-Rays; which usually means two views of each breast - one from the top and one from the side. They are performed by friendly, knowledgeable technologists who do their best to help women feel at ease. The technologists' goal is to get the best films possible and also to make the experience as quick and painless as possible.

When people go for a mammogram the most important thing to know is that relaxation of the upper body is the key to a positive experience. I know it's hard to relax when you're apprehensive, but this is why I believe we need to lessen the public apprehension of this test. It is easy to relax by taking some deep breaths before you have the test. By relaxing your muscles you will be much more comfortable through the test than if you are tense. An added bonus is that the films will be of higher quality, as it is easier to image the back of the breast close to the chest wall if the pectoralis muscles are relaxed. When it's done, you may hear yourself saying, "That wasn't bad at all!"

Some women are embarrassed to have a mammogram because they don't want anyone other than their partner to see and touch their breasts. The mammogram jokes add to their fear of pain and embarrassment making it harder for them to manage, and I know of some women who avoid having a mammogram for this reason. The test is done in privacy; no one but a female technologist will be present. Technologists, for the most part, are sensitive people who will do the test as quickly and professionally as they can. Many women who have resisted the test for a long time are amazed at how simple and painless it can be.

Mammograms include compression of the breast with a plastic plate to produce a high quality image with the least amount of radiation. Breast compression is meant to be tight, but it should not be painful and it only lasts for a few seconds. If you think about looking at a bunch of grapes - it's hard to see them all from one spot. If you spread the grapes out, you can see more grapes. Similarly with the use of compression, more breast tissue is visible when the breast is spread out. With a flatter, thinner layer of tissue the amount of radiation required is less than if the breast is not compressed. The amount of radiation you get is as low as can be achieved if adequate compression is used, and also if good quality control is maintained at the mammogram facility.

In the U.S.A. the cost of a mammogram runs between $50 and $150.00. There is financial help available from insurance companies, state and local programs, and from some employers. Please do not let the cost deter you from having a mammogram as the cost of not having a mammogram can be much higher both financially and emotionally. Check for information on the internet.

In most places in Canada, women can book their own appointment for a free screening mammogram; a doctor's referral is not required. In places without a screening program, mammography is available with a doctor's referral and is covered by health insurance. Approximately 7% of women will be asked to have further testing. Most of the time, follow up testing involves an additional mammogram with a different view to separate the breast tissue in a particular area to get a better image. In my analogy of the bunch of grapes, it's like having a few grapes on top of each other and separating them out in a different way in order to see them better.

There is controversy about the age bracket for women to have a mammogram. On a mammogram film, normal breast tissue in young women usually appears to be dense; normal breast tissue in older women usually turns to fat and appears less dense. Reading mammograms on young women is like looking through a tree which is full of leaves in summer. Reading mammograms on older women can be compared to looking through a tree in winter. You can see why reading mammograms on young women is more complex than reading films on older women and this is the main reason why screening mammography is more effective as women mature.

The fear of being diagnosed with breast cancer will often prevent a woman from having a mammogram. My personal experience is that it is much better to be diagnosed earlier rather than when the cancer has had chance to spread. The amount of fear, pain, embarrassment, and emotional anguish from having a mammogram does not even come close to that of being diagnosed with an advanced cancer. A mammogram takes about 10 minutes; an early cancer can be dealt with in a reasonable amount of time, while an advanced cancer is much more of a time commitment. The amount of fear that comes with a cancer diagnosis is astronomical compared to that of a screening mammogram.

It is often recommended that women have a screening mammogram every two years, but many people believe it is better to have mammograms on an annual basis. It is probably best if women can consult their doctors and make the decision on an individual basis. A number of factors affect the decision such as age, family history, general health, and previous breast problems. Between appointments, whether you choose to have a mammogram every year or every two years, it is important to be aware of any breast problems. If you notice anything unusual it is wise to contact your doctor. This applies even if your mammogram was negative because there are a certain percentage of cancers that do not show on a mammogram.

The Canadian Breast Cancer Foundation promotes a three-prong approach to breast health:

? annual clinical breast exam by a doctor or trained health professional
? screening mammogram
? monthly breast self exam

Breast self-exam can be a controversial issue. Many people do not recommend monthly self-exams, yet many women have found their own breast cancers this way. The important thing to remember is if you choose to do self exam, to do it right:

? learn the proper method from a doctor or trained health professional
? be disciplined and practice it regularly
? pick the same time of your menstrual cycle or the same date each month
? get to know your normal breast "architecture"
? make notes of your findings, draw pictures and record dates
? make detailed notes of unusual findings including dates
? check with your doctor if you find anything worrisome

Following these steps will give you confidence and put you in charge of your breast health. Some health professionals are concerned that women will be unnecessarily alarmed if they find a problem with their breasts. I believe that an educated approach to breast care will reduce the fear that many women live with, and they can consult their doctors in a more rational manner. Most breast lumps are benign, but early detection of breast cancer is worth the extra cost of investigating lumps and other unusual findings.

Mammography is a peculiar test in some ways. However, it is the gold standard at present and until there is a better method of screening which is also cost effective it makes good sense to have regular mammograms. Finding cancer in the early stages before it has a chance to spread makes the treatment much easier and the cure rate much higher. Having a mammogram is not meant to be funny, or even fun; but a few minutes of discomfort rewards us with knowing we are taking action to help protect our breast health.

By Lynn


A Tool for Early Breast Cancer Screening

Who isn't familiar with the expression, "early detection is the best prevention?" We hear this term throughout the year and most everyone is familiar with this "catch phrase" as it relates to breast cancer. Obviously, a woman's chance for survival improves when a cancer is found early. We hear that simple rhyming statement but are women really offered early detection?

Our "gold standard" for breast cancer screening is mammography, clinical breast exam and self-breast exam. Other techniques are used but ALL current technologies examine structure; something is formed and large enough to be seen or felt. However, it is well-documented that a mass that is detected by mammography has been growing for 8-10 years before it was detected. Is this early detection?

There exists a technology that can detect an issue YEARS before a tumor can be seen on X-ray or palpated during an exam and truly offers early detection. This technology has been approved by the FDA as an adjunctive screening tool since 1982 and offers NO RADIATION, NO COMPRESSION AND NO PAIN. For women who are searching for early breast cancer detection, digital infrared thermal imaging (DITI) may be of interest.

Historically, DITI fell out of favor shortly after its initial debut in the early 80s. When DITI was first introduced, strict protocols and trained technicians did not exist. Shortly after its initial beginnings, DITI fell out of favor as a diagnostic tool in the medical community.

There are now very strict protocols both for testing and interpreting. Perhaps due to these guidelines, thermography (as with all digital technology) has exploded in its technique and capabilities. Thermal cameras detect heat emitted from the body and display it as a picture on a computer monitor. These images are unique to the person and remain stable over time. It is because of these characteristics that thermal imaging is a valuable and effective screening tool. Tumors or other breast diseases measures warmer than surrounding tissue and can thereby alert a physician to a problem before a tumor is actually palpable.

Medical doctors who interpret the breast scans are board certified thermologists. Thermography is not limited by breast density and is ideal for women who have had cosmetic or reconstructive surgery, women who refuse mammography, or women who want clinical correlation for an already existing issue. Thermography, because it analyzes a developing process, may identify a problem several years before mammography. As we all know, early detection is important to survival.

DITI has an average sensitivity and specificity of 90%. An abnormal thermogram carries a 10x greater risk for cancer. A persistent abnormal thermogram carries a 22x greater risk for cancer. Thermography, as well as mammography is a personal choice for women. This decision ideally should be made in collaboration between you and your physician. However, thermography does not require a physician's order.

Thermographic screening is not covered by most insurance companies but is surprisingly affordable for most people. For more information or to find a certified clinic in your area, go to www.proactivehealthonline.com.

By Brenda Witt


Finding the Spirit - Identifying the Enemy

In the daily fight for survival our vision is blurred because our health is compromised. This is when the enemy attacks- we lose focus and become vulnerable. We doubt our inner strength and become discouraged and depressed.

Sometimes it seems like the fates are against us. However, life's obstacles should not deter us from our personal triumphs. We must forge upward and onward to meet our goals; not necessarily our destiny.

Be vigilant; protect the spirit. Remember the enemy is sneaky and dangerous. My enemy is Breast Cancer. Who or what is your enemy? Have you identified it? If you have, ask yourself a few questions and solidify a plan of action.

Cling steadfastly to beliefs. Sometimes it becomes our sole life line; our saving grace. During the darkest hours of the storm it can become impossible to hold on. But hold on we must. We must weather the storm. It may be necessary to go outside our comfort zone. It may be time to re- examine our lives, question our beliefs, and make life changing decisions.

Establish and develop a relationship with God. It is the single most proactive choice we can make. Faith is nothing if it is not tested and tried. Stand firmly on it; focus steadily on the enemy, and never lose site of goals. Rebuke the demon daily in the name of Jesus and through it all laugh; it is therapeutic.

We handle the things that we can and stay optimistic, trusting in our hearts and in our souls that God will bring us through the storm. If we believe and have faith as tiny as a mustard seed we will be able to move mountains. Stop worrying and feeling sorry for self; fight with every fiber of the being. Desperate situations call for desperate measures.

The enemy must not take control of the mind, the intellect, and/ or the soul. Keep it at bay; pray, pray, pray. Stay optimistic and nourish the spirit regularly to keep it strong and centered.

The spirit is the core of the being- it needs sustenance. Let the spirit drink the nourishment provided by the Lord as it hungers for righteousness. Remember the spirit can grow weak but it will never die. Inner strength comes from the God within. It doesn't take an awful lot to revive the spirit. Prayer and meditation does; the Word of God fortifies the soul; they are free and always available.

Faith, prayers and the Word of God: therein lays the inner strength in the midst of our personal turmoil.

Faced with the challenge of life or death, I chose life and in doing so, I made a conscious decision to be a survivor of the dreaded disease - Breast Cancer. I let go and let God, knowing that He is well able to handle any circumstance. I put breast cancer behind me and God ahead of me, in the order it was meant to be, and God gave me the victory. Today I am living with the effects of Chemo and Radiation treatments but I am living cancer free.


Breast Cancer

In December of 2001, breast cancer was the furthest thing from my mind. I was busy. I had a loving husband, a nice home, three beautiful stepchildren, a good job. Then my perfect little world was suddenly turned inside out and upside down.

A routine, suspicious mammogram. A phone call. Mammogram #2. A stereotactic core biopsy.

My diagnosis: breast cancer, stage 2, infiltrating, ductal, HER2.

All of the above happened within the fearful, anxious, unbelievable time span of 7 days. And my life has never been the same.

The next nine months held a most strange quality of disbelief and exhaustion. It also held two surgeries, four chemotherapy treatments spaced three weeks apart, and 47 radiation treatments (spaced daily, over the course of 9 weeks).

It's been three years since my life was turned upside down and inside out?. Three years. My prognosis is very good. I hear this every three months depending on which doctor my appointment is with: breast surgeon, medical oncologist, or radiation oncologist.

Three years have passed. I look good. I feel good. And yet nothing has been able to quiet the storms of fear that threaten to overwhelm me from time to time. The insidious fear that the breast cancer might return. The intimidating fear of another potentially deadly diagnosis.

I have meditated and prayed about this. I have talked about it with my wonderful therapist and with other breast cancer survivors. I have tried guided imagery, journaling, and art journaling. These have all tempered the fear to some extent, but only for a very short while.

Then I began practicing SoulCollage? and my inner dynamics began to change.

SoulCollage? is a unique blend of spiritual practice and the fun of collage. Using our intuition and imagination, we create a deck of collaged cards where each card reflects a different aspect of who we are. The cards are then used to assist us to access our own deep wisdom and help us answer life's questions.

There are four suits in a SoulCollage? deck: The Committee (the inner voices in our minds), The Community (the family and friends who love us), The Companions (animal totems who lend us their energies) and The Council (archetypes who symbolize major life themes for us).

SoulCollage? cards are made using magazine images, scissors, a glue stick, and 5" x 8" pieces of mat board.

It turned out to be the best way for me to deal with the lingering fears that I was left with after my cancer treatments were over. I listened carefully inside of me to the voices that had something to say about my breasts, and my breast cancer, and I made three cards over the course of a few months.

The "voices" I named and then worked with in the coming months were: I am the one who fears breast cancer returning, I am the one who survived breast cancer and walked away from it (both of these voices were Committee members), and I am the one who gave you the courage to survive breast cancer (an archetype from my Council).

After making the cards, I journaled with them, asking each voice the following questions: Who are you? What do you have to give me? What do you want from me? How will I remember?

The entire process of making these SoulCollage? cards and then dialoguing with them led me deeper into my feelings about my diagnosis and all that I had been through on my journey since then. This led me to a very deep and powerful spiritual healing that is difficult to describe, yet very real in my life.

Now, when my fears of another cancer diagnosis threaten to consume me, I simply look at my SoulCollage? card that honors that voice inside of me and I acknowledge it. This voice, this fear will always be a part of me, but I do not have to allow it to control me. I am reminded of this because I also have the other two cards which speak to me of how I found the inner strength and courage to take the breast cancer journey.

By Anne Marie Bennett


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