Skip to content
Link copied to clipboard

Ask Dr. H: Thermography can't replace the mammogram

Question: I would like to know if you recommend breast thermography instead of getting a traditional mammogram. My breasts are sore for days after my mammograms and thermography doesn't hurt.

Question:

I would like to know if you recommend breast thermography instead of getting a traditional mammogram. My breasts are sore for days after my mammograms and thermography doesn't hurt.

Answer: Mammography, with its squeezing and pressing against the image plate, can be very uncomfortable for women with sensitive breasts.

Thermography is a new technique that some tout as a gentler and safer alternative to digital or traditional mammography. There's no radiation because it uses infrared technology to produce an image of the breasts that shows the patterns of heat and blood flow in the tissue. While proponents of the technology have claimed that it can replace traditional mammography as a screening tool for breast cancer, the experts from the Food and Drug Administration, the American College of Radiology, and the Society for Breast Imaging do not support thermography as a stand-alone replacement for mammography.

Thermography imaging has not been shown in multiple large studies to be either sensitive enough or specific enough to replace mammography. It does have a role as an adjunctive imaging tool - just as breast ultrasounds are. The FDA has sent warning letters to Meditherm, health columnist Dr. Mercola, and Central Coast Thermography in California to stop making misleading claims about thermography.

Here's more background on why thermography cannot replace mammograms: www.sbi-online.org/displaycommon.cfm?an1&subarticlenbr83

nolead begins

Differing recommendations on follow-up colonoscopy

Q:

Five years ago, I had a routine colonoscopy in which a small polyp was removed. My family doctor is advising me to have a follow-up colonoscopy now, but the gastroenterologist's office says I don't need another one for five years. Whom should I believe?

A: Based on the recommendation from your gastroenterologist, I'm assuming that the polyp removed was "hyperplastic." That means it was a completely benign growth of tissue, and would not have transformed into cancer if left alone to grow.

In that situation, your risk of colon cancer is the same as that of the general population. The current screening guidelines recommend a routine colonoscopy every 10 years beginning at age 50 in folks of average risk.

Colon cancer does not occur rapidly; transformation from a precancerous polyp to cancer takes 10 to 15 years.

An article in the May 9 Archives of Internal Medicine found that screening for colon cancer is sometimes overused, with 25 percent of Medicare patients in a database who had normal colonoscopies receiving a repeat colonoscopy in five years and 46 percent receiving a repeat colonoscopy in seven years. Additionally, a third of the patients 80 and older with a normal initial colonoscopy had a repeat procedure within seven years, despite the recommendation against screening after age 85.

If the polyp had been precancerous, or labeled an "adenoma," a follow-up colonoscopy would be advisable in five years as long as its size was less than 1 cm in length. This guideline also applies if a second small precancerous colon polyp was removed at that time. If no more adenoma polyps were found on repeat colonoscopy, the next (third) colonoscopy could be scheduled 10 years later. Regardless of size, if three or more precancerous polyps are identified, a surveillance colonoscopy is needed in three years. If that follow-up colonoscopy were to be normal, that person would be considered of average colon cancer risk and could wait 10 years until the next colonoscopy.