Breast Practices

There’s no answer to breast cancer, but is there an alternative to the “big squeeze”?

by STEPHANIE MACDONALD

My paternal grandmother’s warm bosom was always a welcome port as I navigated my way through childhood. Her embrace was constant, loving, and reassuring, not to mention comfortable—the woman was nothing if not well endowed. My sister and I were therefore slightly surprised to learn that the large foam cone we used as Smurf Mountain was intended to fill up one side of Grandma’s brassiere.

My normally garrulous grandmother broke her silence on this particular subject only once. When I was a young teen, she made me promise to always have regular mammograms when I got older, because early detection of her breast cancer had saved her life. I vowed that when my own impressive rack materialized, I would have it checked out regularly.

Disappointingly, my genes turned out to be more of the string bean than the voluptuous variety. Though I was indignant at first, after nursing two children into toddlerhood, I’m finally grateful. And now that I’m 35, stacked or not, it’s time to keep that vow to Grandma.

Or is it?

Mammograms may be encouraged by the medical establishment, but they’re not without risk. Doctors agree that no dose of radiation is harmless; exposure is known to be cumulative, so women who undergo mammograms once a year increase their risk accordingly. Additionally, 60 to 80 per cent of lesions recommended for biopsy are benign, resulting in a lot of unnecessary medical intervention (not to mention unnecessary freaking out). Finally, there’s the worrisome statistic cited by countless websites that 10 per cent of actual cancerous tumours get missed.

A 1992 Canadian Medical Association study involving approximately 50,000 low-risk women found those who underwent annual mammograms were actually more likely to die from breast cancer than those who did not. They concluded “there is no evidence that [mammography] screening for breast cancer is effective among women aged 40 to 49 years.” (Many follow-up studies have been done since, but no one refutes this study’s data.)

Although this conclusion leaves my breasts off the hook for another 15 years, I had to wonder: how can I be proactive in the meantime, and how can older women mitigate the risk posed by frequent x-rays?

It turns out I’m not alone. People have been interested in safer, less vise-y, more reliable alternatives to the mammogram for decades. Though no screening device has been found to be 100 per cent effective, breast thermography—also known as Digital Infrared Imaging—has come to the forefront of new screening technologies because it has a 90-per-cent accuracy rate (according to the International Academy of Clinical Thermography), and is painless and risk-free.

Thermagrams can detect problems up to eight years before a mammogram, and there's absolutely no squishing involved. Sign me up! Courtesy Dr. William C. Amalu, International Academy of Clinical Thermography

Thermography records minute variations in body temperature. It works under the principle that pre-cancer and cancer cells have higher metabolic activity than normal cells and are associated with higher vascular circulation—both of which contribute to a higher temperature relative to surrounding areas. Thermograms are equally safe and effective for young women; women with small, dense, or very large breasts; and even for women with breast implants. Research suggests thermograms can actually detect problems up to eight years before a mammogram, and there’s absolutely no squishing involved. Sign me up!

Breast thermography is widely used in Europe, Australia, and parts of Asia as a first-line screening procedure, but is still considered an alternative health-care option in North America. “It’s a consumer-driven market,” explains Dr. Paul Sian of the American Institute of Medical Sciences, an organization that assists foreign doctors in becoming licensed to practice in North America. “Until people start demanding it, thermography will not be considered a mainstream procedure.”

But when it seems like such a no-brainer, why haven’t North American women caught on? Especially when, according to the Canadian Cancer Society, one in nine Canadian women will get breast cancer?

“It is always difficult to change medical culture,” says Dr. Sian. “Big corporate interests, legal liability, and ingrained beliefs of medical professionals all play a role.”

Currently the procedure is available primarily from naturopaths and holistic health care providers and is not covered under MSP, but this could change as more people become aware of its benefits and request access. The cost varies, but is around $280 per session—a prohibitive cost for many, but a miniscule amount compared to what the government spends on treating women with breast cancer.

“The biggest advantage of thermography is that it allows women to detect potential problems while there is still time to take steps to reverse the progression of breast cancer,” Dr. Jennifer Deng tells me as I fill out a breast health history form prior to my thermogram at Finlandia Pharmacy. Despite my grandmother’s diagnosis, I am considered low-risk: I’m not overweight, I exercise regularly, I eat my veggies, I gave birth before age 35, and I breast-fed my children.

I assure Dr. Deng that I followed the pre-exam instructions of avoiding massage, acupuncture, strenuous activity, caffeine, and deodorant (sorry, co-workers!) for that day. Then I strip to the waist and try to relax in the exam room, which is slightly chilly to ensure the heat-sensitive camera gets the best reading. The session is uneventful, and basically requires me to sit there half naked and not move for about 20 minutes, half of which is spent with my arms over my head. The infrared camera simply records the heat coming off my body, and I can see the digital image on the computer screen in front of Dr. Deng—including one darker spot over my left breast, which has me concerned. Dr. Deng notices it too, of course, but nips my hysteria in the bud by explaining that though it is evident, it may be minor and something to do with hormone imbalance.

The only unpleasant part of the session is immersing my hands in freezing cold water for one minute before going in front of the camera one more time. This part of the exam is optional, but it helps reveal abnormal vessels and tissues; normal vascular flow will be constricted after exposure to cold. Then I put on my clothes and leave, with an assurance that my detailed results will be sent to me in three weeks.

Thermographic tests are given a value between one and five, with one being spectacularly healthy and five being the opposite. Dr. Deng says most of the patients she screens score a very acceptable two. Without careful scrutiny, she hazards a guess that mine will be a three, meaning I had better keep an eye on things, make healthy lifestyle choices, maybe take hormone-balancing supplements, and get it checked again in a year. If it is the same or worse next year, then she will recommend a mammogram, which can pinpoint a mass’s exact location.

Keeping up with yearly thermograms allows women under 50 the benefit of peace of mind, and the ability to limit their exposure to radiation. For women over 50, thermograms can be an important screening procedure when used in conjunction with mammograms. If this “hot spot” of mine goes away, I’ll be very happy; if it doesn’t, I’ll be grateful for the early notice and opportunity to catch it before it progresses too far.

I can’t help but think Grandma would be impressed.

Stephanie MacDonald is a Vancouver writer with no intention of providing her grandchildren with any inadvertent Smurf Mountains.

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