CONFIRMATION OF ABNORMAL SERIAL SCANS

Often women who have a consistently abnormal thermal scan are resistant to getting a mammogram when a structural test is needed. For whatever reason - be it the physician, the radiologist or the insurance company - getting an Ultrasound as the next step it usually difficult or impossible. Ideally an Ultrasound could be performed on the breast or the area of concern noted by the infrared exam. When the technician switches the imaging mode to Doppler - in order to analyze the blood flow during the exam - it helps to identify the suspicious blood flow detected by the thermogram. Doppler can determine if the circulation is consistent with normal blood vessels (by directional flow or the pulse due to heart beat) or if the flow is chaotic and abnormal, indicating a potential change in normal circulation.

The thermogram identifies changes in metabolism and the resulting change in circulation. A structural test is needed to determine if an abnormal growth is already present - or if thermography is detecting a metabolic change in advance of the structural tissue change. This is one reason that thermography and mammography act together to increase the efficacy of early detection. A serial positive thermogram with a negative mammogram warrants close observation. MRI with and without contrast is currently the ideal test to identify the neoangiogenesis associated with breast cancers. But again, the roadblock is in place to prohibit MRI unless a significant family history is present or the patient has a history of multiple biopsies and abnormal mammograms with negative biopsies. Cost of this test is one reason that insurance companies usually withhold precertification when it is requested. Even if a patient wanted to self-pay for the test it is withheld.

For these reasons – I’ve been encouraging women with repeatedly abnormal thermal scans to consider another option for early detection. This option is not medical imaging, but the detection of very significant protein markers found in the Cancer Profile exam (blood and urine analysis) conducted by American Metabolic Laboratory of Hollywood Florida. This very sensitive test can identify multiple markers – that when elevated indicate the presence of cancer in the body. Having consistently abnormal thermal scans and abnormal cancer markers help the women determine how aggressive she must be in seeking medical intervention. Additionally – with negative cancer markers – the abnormal thermogram can be followed and diet and lifestyle can be altered to change hormone influence on the breasts (although this is usually the first step following abnormal thermal scans.)

Dr. Emil Schandl, Ph.D. of AML has developed and structured this analysis (Cancer Profile Plus) to find the human growth hormones associated with early cancer and other proteins and enzymes, including serum thymidine kinase – which aid in the replication of cancer cells and the metastasis of the cells to distance sites. This test is highly accurate and detects cancer in the earliest stages – usually before structural imaging detects the multiplication of abnormal cells into a tumor. Mammograms detect cancer when the cells have sufficient doubling to measure at least 200 cells. The Cancer Profile needs only 4-6 doublings (about 12-16 cells) for cells to emit enough metabolic enzymes (MMPs) for detection.

For anyone facing cancer concern via thermography or not the Cancer Profile Plus is your next step. www.americanmetaboliclaboratories.net

This article was in my Oncology Newsletter today.  This is VERY IMPORTANT INFORMATION for anyone interested in Infrared Imaging for breast health monitoring. Please read this article and keep in mind that IR detects this fine vascular network that provides the opportunity for breast cancer to metastasize.

June 17, 2013

How dormant breast cancer tumor cells become metastatic

The long-standing mystery about what activates dormant disseminated breast cancer tumor cells after years and even decades of latency may have been solved. Dormant cancer cells have been found to reside in the microenvironment surrounding microvasculature, which are the small blood vessels that transport blood within tissues. When these blood vessels begin to sprout, the new tips produce molecules that transform dormant cancer cells into metastatic tumors.
In a small but significant number of breast cancer patients, cancerous cells can move through the bloodstream from breast tissue to secondary sites in other parts of the body. There, they may remain in a dormant state that is clinically undetected for an extended period of time before they suddenly become metastatic. It has been difficult if not impossible to predict if and when metastases will occur.
“Our study reveals that a stable microvasculature constitutes a dormant niche, whereas a sprouting neovasculature sparks micrometastatic outgrowth,” said cell biologist and lead investigator Mina Bissell, PhD, of Lawrence Berkeley National Laboratory in California. “Sprouting is meant to coincide with tissue growth, but if a tumor cell happens to be in the wrong place at the wrong time, then it comes under the influence of the factors deposited by tip cells and it starts growing.”
“Some patients may experience metastatic relapse within months, other patients may go several years or even decades without distant recurrence,” Bissell says. “The recent discovery of tumor-promoting milieus, referred to as metastatic niches, that are established at distant sites prior to or upon the arrival of disseminated tumor cells could explain cancer cells that relapse early, but in late relapsing populations, what tumor cells do from the time of dissemination to the time they become clinically detectable has been a big question.”
The research team discovered that the protein thrombospondin-1, which is prevalent in stable microvasculature, creates a dormant niche by suppressing the growth of breast cancer cells. When the tips of blood cells begin to sprout, the thrombospondin-1 proteins give way to tumor necrosis factor-beta 1 and periostin proteins in the neovasculature. This turns it into a metastatic niche that both permits and accelerates the growth of breast cancer cells.
The identification of dormant niches in basement membrane microvasculature and how those niches become metastatic in the neovasculature holds important implications for future breast cancer therapies. These research findings, published in Nature Cell Biology (2013; doi:10.1038/ncb2767), will support future models that will allow therapies to be screened that impact tumor dormancy and metastasis.

From news release at ChemotherapyAdvisor.com [info@email.chemotherapyadvisor.com]

Six-Month Intervals for Post-Lumpectomy Mammography Do Not Improve Detection Rates for Breast Cancer Recurrence

(ChemotherapyAdvisor) – Scheduling follow-up mammography every 6 months after breast-conserving treatment (BCT) offers little benefit over a schedule of annual follow-up mammography for breast cancer survivors, according to a retrospective single-institution study published in the Journal of Surgical Oncology.
“Mammography yield of cancer in the study population was not greater than the general population,” and there was “no difference” in tumor recurrence detection rates among patients complying with 6-month follow-up recommendations, reported senior author David McNaul, MD, of the University of Missouri's Department of Radiology in Columbia, MO, and coauthors.
The authors studied medical records of 399 patients who underwent BCT lumpectomies between 1997 and 2009, and who were followed for 2 years after surgery. Cancer yields from follow-up unilateral mammography were compiled and two comparisons were made: First, BCT patients' mammography-detected tumor recurrence was compared to mammography cancer yields in the general screening population. Second, yields were compared between BCT patients who were compliant or noncompliant with instructions to undergo follow-up mammography every 6 months for 2 years.
Yields were similar in both the BCT follow-up population and the general screening population and the study found “no difference between the compliant and noncompliant groups regarding tumor recurrence,” the authors reported. In the group of 67 noncompliant patients, no local tumor recurrences were identified.
Among the 399 patients instructed to undergo follow-up mammography every 6 months instead of annually after BCT, the authors noted, “the extra interval unilateral mammograms (at 6 and 18 months) only detected one local recurrence. Based on the 6-month surveillance mammography schedule, a large number of additional mammograms were performed without obvious benefit.”
“Mammography yield was 0.94 and 2.87 per 1,000 (95% CI: 0.0-0.0028) for the first and second years, respectively, following surgery,” they noted.
The study's findings are consistent with ASCO's guidelines, which recommend annual mammography after BCT, rather than the every-6-months follow-up mammography recommendations observed at some cancer centers like their own, the authors concluded.
Abstract

Breast Cancer and the Environment

I just received this newsletter and this is an excellent article. No link - so this is a direct copy

Breast Cancer and the Environment and Environmental Health Policy

by Susan Luck, Educational Director, Earthrose Institute 

In today’s world, many people experience unexplained symptoms that eventually drive them to our office seeking a diagnosis and treatment. Common complaints presented include unexplained onset of allergies, chronic fatigue and fibromyalgia, mood and behavioral changes, hormonal disruption, and immune and autoimmune issues.

Although environmental factors contribute to up to 80% of those seeking medical services, many practitioners do not have the information or tools to include an environmental assessment as part of their work up and therefore may be missing key information into the environmental triggers and what may be needed for an effective prevention strategy and treatment protocol.

It is estimated that currently there are 100,000 synthetic chemicals registered for commercial use in the world today with several thousand new ones being formulated every year. Few have been tested for human safety and while many are known to be potentially toxic and carcinogenic, new research is just beginning to show how low dose exposures over time impacts our health. We swallow, inhale, ingest, and absorb through our skin, plastics, pesticides, fire retardants, exhaust fumes, fragrances, and much more every day. They are ubiquitous and are in our homes, automobiles, cleaning products, cosmetics, clothing, children’s toys, and contribute to our continual exposure to many that have been classified  as endocrine disruptor chemicals or EDCs.

A growing pandemic of endocrine-related disorders, including ADHD, Parkinsons, Alzheimers, diabetes, obesity, early puberty, infertility and other reproductive disorders, and childhood and adult cancers, is seriously undermining the health and wealth of our nation. Recent data from the National Institute of Environmental Health Sciences (NIEHS) shows that all of these diseases can be caused by developmental exposure to EDCs in animal models.

Epidemiological evidence increasingly suggests that environmental exposures during critical windows of development including in utero, play a role in susceptibility to disease later in life, including breast and testicular cancers, and can be passed on through subsequent generations. Epigenetic modifications provide a link between the environment and alterations in gene expression that might lead to disease phenotypes.

Last month, the Center for Disease Control (CDC) issued their Fourth National Report on Human Exposure to Environmental Chemicals and concluded that Americans of all ages carry a body burden of at least 148 chemicals, some of them banned for decades. This  is the most comprehensive assessment to date on the exposure of the U.S. population to chemicals in our environment. The CDC measured 212 chemicals in people's blood or urine-75 of which have never before been measured in the U.S. population. The new chemicals tested include acrylamide, arsenic, environmental phenols, including bisphenol A and triclosan, and perchlorate.

Although the full impact of exposures to endocrine disruptors is still to come, there can be no denying that we are witnessing a spike in breast cancer, testicular, and prostate cancers along with a huge increase in infertility in both men and women.
Children, particularly vulnerable, continue to have rising rates of autism, childhood cancers, chemical sensitivities, allergies, asthma, and ADHD. Scientists and advocacy groups are leading the way to informing the public, urging health policy actions, and confronting industry on this urgent issue.

Banned in Europe, and defended in the US by the chemical industry, Bisphenol A is an example of a known endocrine disruptor originally developed to replace DES. Today, it permeates our products and our bodies and is commonly found in umbilical cord blood. For the first time, research indicates that early exposure to PBA is a predictor for breast cancer later in life.

Today, women in the United State face a greater lifetime risk of breast cancer than any previous generation, having tripled during the past 40 years, with estimates of one in six women having a diagnosis in their lifetime. Only about 5 percent of women diagnosed with breast cancer have a link to the “breast cancer gene”. This means that the vast majority of women never know what “caused” their diagnosis.

Currently, 216 estrogen disruptor chemicals have been identified. Global research estimates that women’s cumulative exposures to estrogenic compounds, both exogenous and endogenous, may be responsible for up to 50% percent of all breast cancers today.
Known environmental factors that contribute to the increase breast cancer risk include: exposure to radiation from chest x-rays in childhood, hormone replacement therapy, alcohol, tobacco and second hand smoke. Breast cancer rates are higher in women who are obese, and women who gain excess weight during adulthood. In a surprising reversal, at the annual meeting of the Radiological Society of North America this past month, a study was presented associating low-dose radiation from annual mammography screening  with an increase in breast cancer risk in women with genetic or familial predisposition to breast cancer.

The degree of alarm within the scientific community concerning the dangers of radiation and hormone disrupting environmental pollutants is also apparent in a report recently released by the Health and Environment Alliance (HEAL), a European umbrella group of non-governmental research organizations. This report directly questions the growing tendency to label breast cancer a lifestyle and genetic disease and states, "We will not be able to reduce the risk of breast cancer without addressing preventable causes, particularly exposure to chemicals."

To compound the problem of our toxic environment, we have refined away much of the nutritional value of our food supply, and replaced it with imitation foods lacking essential elements and protective phyonutrients. Our modern poor quality diet, combined with agricultural pesticides and animals being raised on antibiotics, chemical feed, and growth hormones, may have predisposed many of us to experience a toxic body burden, stressing our body’s ability to detoxify and eliminate these substances.

The good news is that cancer can be reduced by avoiding or lowering exposures to environmental toxicants as well as by optimizing our immune surveillance systems and cellular energy metabolism with nutritional intervention strategies.

As part of an integrative wellness assessment, and to be more effective in our outcomes, asking our patients about possible environmental exposures in the workplace, home, community, diet, and personal care products, can assist us in addressing how cumulative toxic exposures can impact our health, immune system, and genes and guide our intervention strategies.

There has been no public health policy campaign to address these environmental issues until last month, when the Endocrine Disruption Prevention Act, legislation introduced by Congressman Jim Moran of Northern Virginia and Senator John Kerry of Massachusetts, (HB 4190) and (S2828) proposed a bill to explore links between hormone disrupting chemicals in the environment and everyday products. This legislation also emphasizes the dramatic increase of autism, hyperactivity, diabetes, obesity, breast cancer, prostate cancer and other hormone related disorders.

As citizens and as practitioners, we now have a tremendous opportunity to impact environmental health policy by contacting our U.S. Senators and Representatives and asking them to cosponsor this bill. We need to share this with our colleagues, patients, and community to take action for changing current environmental health policy.

Participate in Susan Luck's discussion about conducting environmental assesments and environmental healthcare policy.
For more information, including sign on letters, click here.

Additional Websites
www.ewg.org
www.earthroseinstitute.org
www.breastcancerfund.org
www.safecosmetics.org
http://www.cdc.gov/exposurereport/ 

First Breast Ultrasound Imaging System Approved

This is good news for those who require Ultrasound for dense breast tissue.

The FDA approved U-Systems Inc.'s somo-v Automated Breast Ultrasound System (ABUS), the first ultrasound device for use in combination with a standard mammography in women with dense breast tissue who have a negative mammogram and no symptoms of breast cancer. Dense breast tissue may obscure smaller tumors, which could delay detection of breast cancer.
http://www.chemotherapyadvisor.com/first-breast-ultrasound-imaging-system-approved/article/259776/?DCMP=EMC-CTA_Front&Visitor_ID=&cpn=cta_sutinl&spMailingID=4912796&spUserID=MTI0ODg0NTY1NTIS1&spJobID=55116620&spReportId=NTUxMTY2MjAS1

Thermography and DCIS

With use of mammography as the 'gold standard' imaging - more and more women are being diagnosed with DCIS   "Ductal Carcinoma In Situ".

This is, however, a double-edge sword.

Early diagnosis of breast cancer is the ONLY reason that women are willing to submit to mammography.  But along with early detection – are we truly identifying those who have a ‘true breast  cancer’ or  are we willing to sacrifice women with a general diagnosis of DCIS and commit them to surgery, radiation and possibly chemotherapy – in the chance they will – in the future –convert to invasive breast cancer?

The diagnosis of DCIS – is rarely discussed in terms of ‘not yet a breast cancer’.

Following the call-back after a diagnostic mammogram – the patient is usually in a state of shock – and presents with a ‘deer in the headlights’ condition.  Is this really the best time for a discussion to take place?  However – whether it is the ‘optimal’ time or not --- the only words women appear to hear is ‘breast cancer’.   There is no IN SITU explanation what-so-ever.

When all patients with ductal carcinoma in situ are considered, the overall

mortality from breast cancer is extremely low, only about 1–2%. When conservative treatment fails, approximately 50% of all local recurrences are invasive breast cancer. In spite of this, the mortality rate following invasive local recurrence is relatively low, about 12% with eight years of actuarial follow-up.

The management of ductal carcinoma in situ of the breast: Endocrine-Related Cancer (2001) 8 33–45 K A Skinner and M J Silverstein

92% of all newly diagnosed patients had nonpalpable lesions, most of which were detected mammographically [4]. High-quality mammography is capable of finding a range of nonpalpable, asymptomatic, noninvasive lesions, many smaller, of lower nuclear grade, and with subtler mammographic findings than had been seen in the past. The concept of DCIS as a single disease entity is clearly not valid. DCIS is a heterogeneous group of lesions with diverse malignant potential.

Ductal Carcinoma In Situ of the Breast: Controversial Issues. Melvin J. Silverstein. 1998  The Oncologist.

Until recently --- there is usually an opportunity for the woman to receive an MRI with and without contrast.  The MRI conducted in this manner would help to identify if the IN SITU identified by mammography was, in fact, the only area of potential abnormal cells or if there are other areas of ‘DCIS’ in the same or potentially both breasts that mammography did not detect.

I say until recently --- because a recent study sends the message that the MRI may not be needed.  “ Pre-op MRI ineffective in preventing further breast cancer surgery”     September 19, 2012 | By Susan D. Hall

But – the question that I pose is “not necessary” according to whom?

MRI with contrast not only identifies those areas of suspicious cells – but aids in the detection of neoangiogenic support.  According to most if not all medical literature – cancer is unable to grow without the expression of angiogenesis.  Mammography is UNABLE   to detect the presence and or the absence of neoangiogenesis for any mammographic abnormality.  The utilization of Doppler Ultrasound usually follows a questionable mammogram to identify blood flow associated with the questionable area.  If we are denied the Ultrasound and now denied the MRI prior to biopsy or surgery --- how is the extent of the cancer determined prior to the “first cut”?

The primary issue regarding the diagnosis of DCIS – is this: DCIS MUST BE IDENTIFIED BY THE CELL TYPE AND THE STAGE... Without this information and the education related to these facts the woman is making a treatment decision based on fear alone.  The radiologist or the surgeon that does not educate the patient with regard to the current cell status and the true potential for future invasive cancer is being deceptive.  They are treating DCIS as an invasive cancer when it very well may not have the propensity for conversion.

Prior to mammographic detection of DCIS – pre 1990’s almost all DCIS was treated by mastectomy.  The true reason for this is most women who presented with what was diagnosed as DCIS already displayed palpable lesions.  Most of the “DCIS” was growing and more than likely was already an invasive disease.  But with mammographic detection of non-palpable lesions, the only true way to discern the potential threat is by Grade and cell type. The biopsy will provide this information.  Ask about the Grade and the 'comedo subtype'.

“Danish studies estimated that about 25% of all women will develop in situ carcinomas, predominantly in the form of DCIS.  Only a fraction of these lesions will evolve into a clinical manifest form”

WOMEN – educate yourself about DCIS prior to getting a mammogram.  Statistically -- one in four women will be given this diagnosis.  Be prepared and ask questions – don’t be driven by fear.

Thermography is currently the only non-invasive way to detect the pattern of neoangiogenesis in an abnormal thermogram.  DCIS with no neoangiogenesis present has a higher probability of being Low Grade or benign. MRI with contrast will help identify the presence and extent of neoangiogenesis in the breast. 

Thermography as a monitoring tool can aide in identifying early changes that are potentially breast cancers.  MRI is currently the only definitive test for localization of neoangiogenesis within the structure of the breast. 

Next Blog: Detection of DCIS by Thermograpy: True or False?