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Thursday, December 9, 2010

Christiane Northrup blasted for speaking up about thermography

Writing in the Huffington Post, Dr. Christiane Northrup said she is disappointed that every October – breast cancer awareness month – that mammography is heavily promoted and nothing is said about the benefits of thermography: “I understand that mammography has been the gold standard for years. Doctors are the most familiar with this test, and many believe that a mammogram is the best test for detecting breast cancer early. But it's not. Studies show that a thermogram identifies precancerous or cancerous cells earlier, and produces unambiguous results, which cuts down on additional testing--and it doesn't hurt the body. Isn't this what women really want?”

However, reporter Nara Schoenberg of the Chicago Tribune, scolded Northrup: “If the Internet buzz about a pain-free, radiation-free alternative to mammography sounds too good to be true, there's a reason for that. Breast thermography… has never been proven effective for routine breast cancer screening in a large-scale, randomized study… the FDA has never approved it for that purpose and in 2009 issued a warning letter accusing an Idaho healthcare provider of marketing thermography as a mammogram replacement."

Dr. Grout’s comment:

Ms. Schoenberg seems quick to defend the mammography business status quo when so many others are starting to change their tune. She appears to be unaware of the Norwegian breast-cancer screening program which analyzed years of data from 40,075 women with breast cancer. Researchers found mammography had little benefit. Their results, published September, 2010 in the New England Journal of Medicine, found the relative reduction in mortality that can be attributed solely to screening mammograms is a surprisingly low 2%, indicating that the decline in mortality attributed to screening alone may be as few as 2 deaths prevented per 100,000 women screened. Dr. H. Gilbert Welch's accompanying editorial said this is so small it may as well be zero.

But there are randomized trials for mammography, and not for thermography as Schoenberg points out. Terrific. The more we study mammography, the more we prove it is woefully inadequate as a primary screening tool. Even the head of the American Cancer Society, Dr. Otis Brawley, told NPR in October: “You have to remember the limitations of mammography... It is not a very good test for younger women. It's very difficult for a mammographer to pick up a cancer in a breast in a woman in her 20s or 30s. It's difficult for mammographers to pick it up in their 40s, and it gets easier as a woman gets older. We need better tests is what I'm really saying, and we need to support research to develop those better tests. Thermography is something that some people have advocated, but it's not been tested in a prospective randomized trial… I think that we need to support some of the research in the many things like thermography…”

Schoenberg is inaccurate when she suggests that people like Northrup are saying we should do away with mammography in favor of thermography. Wrong. It is a matter of which technology is better at earlier detection. Thermography wins that debate hands down. Thermography can see the heat signature of a tumor's formation years earlier than mammography can see a lump. When you think you have something to investigate further, then the radiation and compression of mammography are well worth doing. If you need to do a biopsy, a mammogram can pinpoint the spot; a thermogram cannot.

It's time to drop the industry-sponsored dogma and look at what is best for women. Even JAMA in 2009 challenged the “still unquestioned value of mammography.” Deep pocketed companies like General Electric make mammography machines and can afford to conduct randomized trials. “Big business” doesn’t make thermography machines so no one has been able to afford randomized trials yet. However, there are 800 peer-reviewed studies on thermography, and the studies on mammography just continue to document its weakness as a screening tool. If we want to decrease the deaths from breast cancer, we must look at different technologies. Time for the ACS or the NIH to fund the randomized trials on thermography so the Schoenbergs of the world stop parroting that first line of defense in support of the old dogma. It’s women who suffer in the end.

1 comment:

  1. Great article. Well thought out and objective analysis of all sides. Thank you!