Transcription of Breast Health #58
Lisa: This is Dr. Lisa Belisle, and you’re listening to the Dr. Lisa Radio Hour & Podcast, show number 58, Breast Health, airing for the first time on October 21st, 2012, on WLOB and WPEI Radio, Portland, Maine. As most of you are aware, October is Breast Cancer Awareness Month, also known as Pink Ribbon Month.
Breast Cancer has had a personal impact on my life. My mémé, which is French for grandmother, had breast cancer many years ago. She is a long-time survivor, fortunately. Unfortunately, many women don’t have this story. Breast cancer is an ongoing issue. It kills far too many women each year, which is why we have Pink Ribbon Month and Breast Cancer Awareness Month.
We wanted to talk about breasts from more than just a cancer standpoint. We also wanted to talk about health. On today’s show, we have Meredith Strang Burgess, a breast cancer survivor and Maine Cancer Foundation advocate, and also a member of the Maine House of Representatives. We have clinical thermographer, Ingrid LaVasseur, and we have Dr. Caroline Hodsdon, OB/GYN from InterMed here in Portland.
I would like to point out that breast cancer, like pretty much all cancers, there is some ambiguity about it. There is some difficulty understanding exactly what we’re supposed to be doing as far as prevention and detection and treatment. What we’re trying to offer on our show is a variety of different views and best guesses, best practices. Keep this in mind as you listen to the show. I think you’ll find it pretty informative as we talk to Meredith, Ingrid, and Caroline.
The Dr. Lisa Radio Hour & Podcast is pleased to be sponsored by the University of New England. As part of our collaboration, we offer a segment we call Wellness Innovations. This Wellness Innovation has to do with breast cancer research.
In findings that are fundamentally reshaping the scientific understanding of breast cancer, researchers have identified four genetically distinct types of the cancer. Within those types, they found hallmark genetic changes that are driving many cancers. These discoveries are expected to lead to new treatments with drugs already approved for cancers in other parts of the body, and new ideas for more precise treatments aimed at genetic aberrations that now have no known treatment. The study is the first comprehensive genetic analysis of breast cancer, which kills more than 35,000 women a year in the United States.
For more information on this innovation, visit doctorlisa.org. For more information on the University of New England, visit une.edu.
Speaker 1: This portion of the Dr. Lisa Radio Hour & Podcast has been brought to you by the University of New England, UNE, an innovative health sciences university grounded in the liberal arts. UNE is the number one educator of health professionals in Maine. Learn more about the University of New England at une.edu.
Lisa: Anyone who’s spent any time paying attention within the state of Maine to news events, or breast cancer awareness, or really just in general paying attention, will have heard the name Meredith Strang Burgess before. Meredith Strang Burgess is currently in the Maine House of Representatives. I think you’re finishing your final term there.
Meredith: I am.
Lisa: Yes.
Meredith: I’m there through December.
Lisa: Through December. In addition, you are a breast cancer survivor and an advocate for the Maine Cancer Foundation, and just have done so much in the field of breast cancer research, advocacy, all these things. We thought it would pretty important to bring you in and talk about, let’s just say, let’s call it breast health as opposed to breast cancer, during Breast Cancer Awareness Month. Thanks for all that you’re doing for this cause and for coming in and talking to us today.
Meredith: Thanks very much, Lisa. I appreciate the opportunity to talk to your listeners and talk about the importance of breast health. I think that’s a great way to view it. As we say, it’s about any human being that’s walking around with breasts needs to be paying attention.
Lisa: This has been important for you as a Mainer, because I believe you’re a fifth-generation Mainer. Is that right?
Meredith: At least. Absolutely.
Lisa: Your family is from where?
Meredith: My family is actually from, a core group is from Madison, Maine, logging industry way back. Actually, we can even trace back to Mayflower. There’s a tremendous amount of Mayflower lines that crisscross into Maine. Maine is so old and so interesting, and so I’m really lucky to do that. I was born and raised in Camden, which is a great place to be from. I’m very proud of that. Like a lot of Mainers, you have to migrate down to the city here, down to the big city of southern Maine, to make a living, and get home never enough.
Lisa: You have three sons. You live in Cumberland now?
Meredith: I live in Cumberland. I do have three, now almost-grown sons. My last one’s in college. It’s close.
Lisa: How was this for them? You had a breast cancer diagnosis in 1999, correct?
Meredith: That’s correct.
Lisa: How was it for them to be going through this experience with their mother?
Meredith: Telling the kids is the universally hard thing. As if cancer isn’t hard enough on a family, I think it has that extra twist when it’s a young family. My youngest was 7, and my other kiddos were 13 and 15. Three boys. As you can imagine, because of just the ages, and some of the guy thing, everybody took it different. Everybody handled that information different.
My 7-year-old, I always remember when I finally was able to tell them. It wasn’t easy, I took them all out to dinner. We made it way past dessert before I could finally have that conversation. He was sitting beside me and snuggling away, and he immediately recoiled, looked at me, and said, “Don’t breathe on me. I don’t want to catch it.” We had to talk about how that works. My 13-year-old was basically like, “If we don’t talk about it, then it didn’t happen.” My 15-year-old had an understanding of it, because he was in the fire department and had taken some EMT courses. He pretty much internalized it. It was interesting to see how that plays out, even years later.
A fun thing, my sons would kill me but the 13-year-old who didn’t want to talk about it, when he turned 21, got a tattoo. I wasn’t particularly thrilled as the mom. In explaining why he had gotten a tattoo, which I had not seen, went into this whole thing about my cancer, and what an effect it had on him at that time, and all of these feelings that he had never expressed before. I said, “Gosh, I’m not quite sure exactly what this has to do with the tattoo, unless, of course, you had a pink ribbon tattooed on your chest.” That’s exactly what he did.
Lisa: You now have a son who is walking around, a grown son, that has a pink ribbon tattooed on his chest in honor of his mom.
Meredith: That’s right. He said, “I can’t wait to tell my children and my grandchildren why I have this tattoo and what it means to me.” Pretty cool. He has a pink plate on his car, too.
Lisa: Let’s go there a little bit. Is this pink plate from Maine?
Meredith: This pink plate is from Maine in 2008, in October 1st, for Breast Cancer Awareness Month in ’08. We kicked off a new program for a Maine specialty license plate that’s called the Pink Ribbon Specialty License Plate. It benefits three different independent organizations or, I should say, organizations that are based here in the state of Maine, so all the money stays here. We’re funny up here about that. We like to keep our money local.
It benefits the three parts, if you will, of cancer, which are prevention … We benefit the Maine Breast and Cervical Health Program. They provide free mammograms and Pap tests for women who are uninsured or underinsured, with the message being that if there’s any woman out there that needs to have a screening mammogram and cannot afford to do that, that is not a reason to not get screened. Maine Breast and Cervical Health Program. There are 800 numbers all over the place. Someone can find it, certainly, online at maine.gov. We fund for mammograms for women who are 40 to 50, because that’s an age group that tends not to be funded by the federal government. We fund those.
The next part of cancer is, if you have cancer, you need help, and you need more than just medical help. You sometimes need help paying the bills. You need help paying for the gas. You need help paying for that CMP bill, or the oil bill. You need 300 dollars, you need 800 dollars, you need something like that, not that world. We have this great program that’s run by the Maine Breast Cancer Coalition. It’s a 100 percent volunteer group, and they have this patient service fund so that women can apply. Like writing-a-letter apply, this isn’t a fancy application , for literally 300 dollars’ help here to do that.
We support, the license plate supports, one third to the Maine Breast and Cervical Health Program, one third to the Maine Breast Cancer Coalition, and one third to the Maine Cancer Foundation, who funds actual bench scientific research here in the state of Maine. It’s a great program. We’re trying to make a difference for the big, long-term picture. That’s just way cool, because not only are we hopefully going to change the equation for cancer research and find some better answers to our treatment and ultimately what causes cancer. It all happens here in the state of Maine, and it’s also creating Maine jobs. It doesn’t get any better than that.
That’s why the pink license plate is out there. So far, we’ve funded, those three organizations have received over 540,000 dollars to date in four years. Now we’re trying to extend it to motorcycles. We’ve just gotten permission to create a motorcycle license plate.
We’re looking for 500 wonderfully thoughtful folks who have a motorcycle to go online to mainecancer.org and be willing to buy, for 25 dollars, a pink license plate that’s going to be for motorcycles. We hope to bring it out next spring around time for Mother’s Day and motorcycle season. I’m looking for those 500 people who are willing to go online and sign up in advance. After that, it’ll be available at DMVs all across the state of Maine. We’re looking for those pink motorcycle riders.
Lisa: Good. They can go to mainecancer.gov if they’d like to sign your petition.
Meredith: That’s correct. They can sign up. They need to have a motorcycle. When we bring the plate out, they will get one of the first license plates to come out. Besides, there’s not a single motorcycle specialty license plate. Imagine having a nice, snappy-looking pink license plate on your big Harley.
Lisa: I think that sounds great. Anybody who’s listening, be sure to do that.
Meredith: Please.
Lisa: Also, why you’re there, you could find out more about some of the other things that the Maine Cancer Foundation is doing, some of the other events, which we’ve talked about on our show before.
Meredith: You have, thank you.
Lisa: Go ahead and tell us about some of the things that the Maine Cancer Foundation does to raise awareness and funds for breast cancer.
Meredith: The cool thing about the Maine Cancer Foundation, from my personal perspective, is that it’s 100 percent Maine-grown. It’s an independent organization, and it has this very strong medical background, if you will. It’s been around since the late ‘70s, so it’s not new. We did jazz it up a little bit in the last ten years. They’ve gotten involved with some fabulous programs and events that really are about wellness and have a lot of positive energy going out forth.
We started the Breast Cancer For ME Luncheon in 2002. We just had our 11th annual luncheon to do that. That was obviously a little bit more about the pink, but Maine Cancer Foundation is certainly for all cancers. We’re trying to solve the big cancer conversation here in supporting bench research and patient education. We’re also doing some scholarships for even some of the oncology nurses. It’s turned out to be an amazing, amazing program. Last year, they gave out, I believe, it’s 1.2 million dollars that we actually distributed here in this state for different programs. It really is starting to make a difference.
Of course, the real crown jewel is a program that got started five years ago, which is called Tri for a Cure. I know you folks have talked lots about that. The way cool thing, Julie Jordan Marchese was really the moving force behind that. Julie had dragged me off to do a triathlon a few years before that. We did the Danskin down in Massachusetts, and that’s for cancer. We’ve done a few events. She was very much into the whole health, and got very much bitten by the triathlon bug.
You know what’s so wonderful is when that happened, we had hundreds and hundreds of women all over the state that participate. Around in the Portland area, people were coming together and having really a different conversation. It happened in my office. I said for all the women, “I’ll put you down for a free registration. Just do it.” Obviously, it’s a huge commitment. I had a number of women in my office join in and participate. Gosh, people started training, and the training is whatever you want it to be. Instead of the conversations in my office, instead of, “Let’s go to margaritas,” it was, “Let’s go run Back Bay, and then go to Margaritas.”
Overall, it was just a wonderful, healthy thing. I know many different towns around here have brought women’s groups together. They bike-ride together. They train. It’s created a whole economy, actually, around health and wellness. That’s all fabulous, because the better healthy you can be, and good food, and exercise, and all that, hopefully puts your body in the best position to never get cancer.
Lisa: That’s almost cancer prevention at its most basic level.
Meredith: Exactly.
Lisa: To the extent that we can influence cancer through healthy behaviors.
Meredith: Set yourself up for success. You don’t have control, perhaps, over your genetics. You don’t have control over certain things. Why cancer happens in me and not somebody else, who the heck knows. I really do know that we’re going to figure that out. We’ve come a long way. Now, we just have to really work on ways to be better tuned to our bodies and screening, which is a whole other big conversation that’s happening right now, which is around, “To mammogram, or not to mammogram. That is the question.”
That’s a question that’s also come into the political world, as to what’s the mandated, correct thing, what insurance companies are willing to pay. I think women know that there’s been a lot of conversation. A year ago, it came out that said … We’d been in the, if you’re 40 years and over, you had a mammogram every year. Then the message came out last year to say, “Well, maybe you don’t need to do it that often, or maybe you should do it different.” I think from there, the message was very unclear to people. I think women are pretty confused and frustrated by that message.
What I’ve come to understand around that message is that the real issue is breast density. What’s happening is that for a lot of women, once you go through any medical thing, you become rather smart about the issues. You talk to lots and lots of people. That’s one thing women do, is we talk and we help each other. It’s so important. It’s so, so important to talk to someone who’s been there, done that. We’re really good at doing that. It’s really interesting, in all the different talk and all the different things that we do, we haven’t really talked about density.
What it really simply means is that. Go back to what happened. I think when people are 40 years old, Dr. Susan Love’s book, which is the complete breast health guide, should just drop out of the sky for all of us. Who would ever have known that these breasts, that we all just couldn’t wait to have, would turn into such a pain? I have this great shirt, and across the front of my t-shirt, it says, “Yes, these are fake. My real ones tried to kill me.” It gets a lot of attention when I wear it and sparks a lot of conversation, which, again, all conversation is good.
What happened was I was diagnosed in ’99. I had just turned 43. Dense breasts have nothing to do with, really, your age or the size of your breast. However, having said that, they tend to be a little on younger people. Firm, as we all work out more and more and more. In the old days, it used to be by the time you were 40. Think back what our parents looked like when they were 40, and what we look like when we’re 40. We think, “Oh my God, we look 20.” Women probably didn’t work out quite so much, and whatever.
If you have mammograms, radiologically, a non-dense breast, or a breast that has a lot more fat tissue in it, radiologically, mammogram’s pretty much dark. Cancer, radiologically, is white. If the more dense your tissue is, the more fat you have. Radiologically, when you look at that breast, it’s basically white tissue. If cancer is white as well, then it’s the proverbial snowball in the snowstorm. It’s not that mammograms aren’t effective, it’s that mammograms are not effective on dense breasts.
Now you’re into a specific detail of, should you, as a woman, you go and you get a mammogram each year, and no one ever says to you, “Wow, has anyone ever told you you have dense breasts?” Then of course, you say, “Gosh, no. Thank you,” or, “What does that really mean?”
That means that if you have any precursor of any cancer in your family, which is more than breast cancer … hormonal cancers or prostate cancer, the thyroids, all sorts of hormonal cancers, they all really need to be grouped together … then maybe you should think about a different way of testing. Maybe you need to have an ultrasound. Maybe you need an MRI. Maybe you need to have a PET scan. I know you’re going to talk more about all the different screening options. There’s a ton of them, which is the great news.
Then we have the next challenge, which is the political part of who pays for it, when is it medically appropriate and when isn’t it. That’s where the medical community, and the insurance community, and, if you will, the legislative community are coming together. We had a piece of legislation this past session to talk about the density.
For example, a woman comes in now, gets a mammogram. In theory, you’re supposed to, and it’s not a legal “supposed,” but a doctor is going to send you a note, whether it’s a postcard, whether it’s a letter, to say, “Your mammogram came back totally normal. See us again in one year.” Should it say on there, “Your breast density is high/medium/low,” and then, what does that mean.
That’s the conversation that’s going on. We decided not to legally, legislatively, mandate it, but we are in the process. I’ve been participating this summer and fall with Dr. Sheila Pinette, who’s the head of the CDC and a number of other doctors and radiologists who are working on talking about, “How do we communicate this to women?” It’s funny, they all say, “We’re worried we’re going to scare women.” I say, “You know what? We’re already scared. We’re already confused. How about just some straight information?”
We’re working on that. Women right now, if you’re listening to this, and you’re saying, “I don’t know if I have dense breasts or not,” you should know that, because it’s not that you should or shouldn’t have a mammogram, it’s that the mammogram that you’re getting may or may not be effective. Mammograms, for a woman that has some fat tissue in their breasts, mammograms are phenomenal. They really, really, really are our best frontline screening tool that we have. It’s that if you have dense breasts, then perhaps you should use a different screening tool.
You need to talk to your doctor and ask those questions, because you need to find out where you are on that scale. As you get older, you probably, the mammograms you see become more effective at really finding a cancer. It’s not that mammograms don’t work. They do, absolutely do. But, if you can’t see anything radiologically, then it’s not going to work yet for you.
Lisa: It’s about knowing to ask the question in the first place.
Meredith: And having an open, talkative relationship with your medical provider, whether that’s your GYN doc, whether it’s your primary care doc, however you happen to access your women’s care, you need to ask those questions. It comes back to, we all have this body that we’re given. It’s about personal responsibility. The whole conversation about healthcare and all, I really am a huge believer of that. It’s up to ourselves. You’ve got to be educated.
You read the instructions manual when you get a new gadget or you get the new TV, and you figure out how it works. Shouldn’t you do the same thing for your body? As you get older, there are certain issues that happen. We’ve learned so much about stretching and exercise. You have these breasts. You need to have a basic understanding of what you need to know about them.
Speaker 1: A chronic ache. Sleepless nights. A feeling of something being not quite right. You can treat the symptoms with traditional medications and feel better for a little while, and continue on with your busy days, but have you ever stopped to consider the “what” that’s at the core of a health issue? Most times, it goes much deeper than you think. When you don’t treat the root cause, the aches, sleeplessness, and that not-quite-right feeling come back.
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Lisa: One of the things I didn’t mention earlier is that you’re the founder of Burgess Advertising & Marketing, which, I think, many people recognize as being one of the more influential firms in the state for what it does. Clearly, you’ve been about having a voice for many years. Why has it been easier for you to have a voice, or has it been easier for you to have a voice, than it is for many women?
Meredith: A great question, Lisa. I think it’s one of those things where basic communications. Things happen for a reason. I have different viewpoints of my reasons and different things, but bottom line is, you are given something, and you have a choice. You can either pull the covers over your head and just pretend it’s not there, make it go away, or whatever, or you can deal with it head-on.
You need to have a stubborn, New England, Maine streak in you, ornery enough to go, “I can stare this thing down,” because the process, the treatment process, it really sucks. That’s just all there is to it. It’s not a fun thing. I tell a lot of the folks I talk to that it’s kind of like joining a fraternity or a sorority. The hazing is really rotten, really bad, really bad, but once you’re over that, it’s a pretty special club. People are very supportive of each other and that no one should feel that they’re alone.
Yet, it’s an individual decision. There’s a small, small percentage of the people I talk to with any kinds of cancer that chooses to do it the other way. It’s a private thing. They don’t really want to talk about it and to do that. That’s a-ok. Whatever you decide for yourself is what you’ve decided. Overall, I think it’s a little healthier to reach outside and be part of a bigger conversation. Communication, it’s all about communication.
Maybe I was supposed to get this, and bring some communication and, really, ways to help us make a difference in the state of Maine and beyond with understanding of what cancer is, trying to do some research around making it stop, and also making sure that those that are in the heat of the moment feel that they’re not alone. I guess I got lucky, or cancer got unlucky.
Lisa: How do people who are listening today who are interested in breast health, in general, or breast cancer, how can they get more information about some of the resources that you’ve described?
Meredith: Great question. As we all know, the internet is certainly the answer to just about any question you have. That’s good news and bad news. A lot of times, we tell people when you first get cancer to stay away from the internet, because you can follow the information way out on a branch that may or may not be the branch that you’re going to have to hang on. At the same time, it’s wonderful, because you can get questions answered so quickly.
The American Cancer Society, which is cancer.org, is certainly by far the number one place to go. It has incredible information on all different kinds of cancer, all different kinds of treatments, all different kinds of health tips. They have food tips. It certainly is the real go-to place. Then from there, within the state of Maine, you really break down to each of the different kinds of cancer have their own websites, which have links to very specific things. There’s a lot of online … the word “chat room” isn’t correct, I guess, so much anymore, but there are support groups and folks in online communities, that’s the right word. Online communities that are out there for different specific types of cancer.
Then there are these wonderful, wonderful programs that have started all over the country. Maine is very lucky. We have the Cancer Community Center, which is in South Portland. All that is is a place that different cancer survivors come together and they have programs there that are absolutely at no charge to cancer survivors, and their families, and their caregivers, everything from nutrition, to yoga classes, to support groups, to outreach. That’s all going on.
Of course, everybody’s real now familiar with the Patrick Dempsey Center of Healing. That’s the same kind of program. It’s actually not a hospital. It’s actually a place where people can go. It’s become the center point for folks in the Auburn-Lewiston area to come together and have that kind of a programming. I know they’re doing the same thing in Augusta at MaineGeneral. Eastern Maine Medical Center and the Lafayette Cancer Center is working on really getting those programs up and going.
There’s some things in the county. There’s some stuff happening down in Calais. There’s networks all across the state for all these different kinds of cancers. Nobody should feel alone.
Lisa: The Maine Cancer Foundation website is?
Meredith: The Maine Cancer Foundation website is www.mainecancer.org.
Lisa: There’s a Facebook page as well.
Meredith: There’s a Facebook page as well. Those tend to be some activities that are going on out there. Right now, we’ve just finished our Pink Tulip Drive, to make the state pink next spring. They plant pink tulip gardens all across the state of Maine. There’s garden clubs all across that have bought these. I have to tell you, I’m very untalented when it comes to anything that’s growing. The tulip bulbs, they bloomed for me. They were the most amazing, unusual variety of tulips, I guess. It’s a very bushy tulip. It’s hard to explain that from a non-gardening person.
Funny thing, for each time I’ve run for the legislature, because going door to door, usually candidates pass out a pencil or something like that. I have always passed out tulip bulbs. Even though, it’s the perfect time, it’s the fall, you plant your tulips. I have to tell you, over the last six or seven years, every year, everywhere I go, women tell me, “Oh my God, your tulip came up. Even I could get it to grow.” The variety that we have is a very special variety and very hardy for Maine. Those are fun. We just finished with those. Then you can read about all the different research programs that are going on and the science that’s really happening right here.
Lisa: I appreciate your spending so much time planting bulbs and planting hope, and also growing hope within the state for breast cancer research and prevention. We’ve been speaking with Meredith Strang Burgess, who is currently in the Maine House of Representatives, and is also a breast cancer survivor and founder of the Burgess Advertising & Marketing agency. Thank you for coming in.
Meredith: Thank you very much for giving this subject some great air time. We appreciate it.
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Lisa: As many people are aware, October is Breast Cancer Awareness Month. The thing about breast cancer awareness is that it’s good to be aware of breast cancer, but sometimes that generates a little bit of fear. Instead, we’ve decided to call this breast health. Breast health show. This is what we’re doing. We have Ingrid LaVasseur with us. She is a certified clinical thermographer and has a practice in Falmouth, which actually is rebuilt after a building that she was in burned down. She’s got also an interesting story on top of that. Ingrid, thanks for coming in and talking with us about breast health.
Ingrid: Thank you so much, Dr. Lisa. It’s really great to be here.
Lisa: Let me just start , since I already set you up for this. You were in a building that was in Yarmouth that just randomly burnt down.
Ingrid: It wasn’t random. It was arson.
Lisa: Random for your life, how about that?
Ingrid: Sure. It was a shock. It was a shock and a surprise. There were 26 of us there, and we all moved on and set up shop somewhere else. I was fortunate enough to land in Falmouth on Fundy Road, and it’s been a great spot for me, great location. My patients are happy that I’m closer to Portland.
Lisa: You’ve also had some sort of changes that have been pretty significant in your life previously. You’ve had some sort of burning down of your past lives and moving on.
Ingrid: Oh, absolutely.
Lisa: I think that’s sort of metaphorical for you.
Ingrid: Yeah, no, absolutely. A 28-year-old marriage dissolved. That’s a long time to be married. It’s another shock to the physiology, certainly. It was out of that marriage that really this business developed initially. It was great just to be starting something fresh on my own that was just about something I was creating by myself. It was a great thing.
Lisa: Before this, you spent time working with Deepak Chopra.
Ingrid: I did, back in the ‘80s when he was still in Massachusetts. He was at the Ayurveda Health Center in Lancaster, Massachusetts. That was just an amazing time, because it was when he was really coming into the forefront with Ayurvedic medicine and was appearing on all these shows. Media from all over the world were descending on Lancaster, Massachusetts, to find out about Ayurvedic massage, and cleanses, and things like that. It was an amazing time in my life.
Lisa: How did you get into working with him, or an interest in health?
Ingrid: My interest in health stemmed from a family tree that’s just riddled with cancer and heart disease. Even at a very young age, I felt there had to be something that I could do proactively to not follow in the footsteps of my family. Also at a young age, at the age of 19, I learned transcendental meditation. It was from there, that connection, and becoming a teacher of meditation, that I then found out about the opportunity to work with Dr. Chopra.
Lisa: How did you transition that into clinical thermography, which is a very interesting and unique, well-researched approach to breast health and early detection of breast cancer?
Ingrid: It was really a very personal thing. I was of the age where it was time for me to have a mammogram, and I really was thinking, “There must be something else.” It was the whole man-on-the-moon idea, that we’ve put a man on the moon, and what have we done to promote women’s breast health? I’d heard about this thing called thermography, didn’t know much about it, started looking into it, and realized that that was certainly a good thing that I wanted in my toolbox of how I take good care of myself. It certainly resonated with me on many levels. Then, certainly, once I was divorced, and it just seemed like the right time for me to venture out with this.
Lisa: Describe what thermography is.
Ingrid: Thermography is a means of detection that uses the heat that is produced by the body. If you think of things as the difference between anatomy and physiology, anatomy is more looking at structure, which your mammogram does. It’s looking for a lump. What’s the size? What’s the shape? The thermography is looking at the heat, at the thermal pattern. That means, what’s the physiological activity that’s going on in that breast that might support the growth of a tumor? Really, mammography and thermography are completely different technologies. They’re not looking at the same thing. The mammogram, the mammography, is really just structural, and the thermogram is more physiologic, more physiologic.
Lisa: What I understand from having talked to you before coming in is that thermography is something that has to be done over time.
Ingrid: Yeah. We feel that if you can look at the breast health over time, what we ideally would like to see is stability over time. We’re certainly looking for change over time. The way we do that is a person, if they’re coming for breast screening, would come initially, they’d come again in three months.
The purpose of that is we’d want to see, is there any change that occurs in that short timeframe, in that three-month timeframe? Because the average doubling time of cancer is about 90 days, hence the three-month window. If we have stability in that three-month period, then we say, “Come back in a year or so.” Ideally, we’d want to see the person annually. Each time, with those annual visits, we’d be looking for, hopefully, stability over time, but potentially, change over time. If we saw some change that was quite dramatic, “Let’s see you again in three months.” Let’s see, is this stabilizing now at this different place, or is it going back to something?
When I had my own thermograms done, my first one was what it was. The second one came back different, so I had to come a third time again, another three months. That first one and the third one were more of a match. When I went back later to look at what was going on in that timeline, it was during that second one that my husband had left and that we had split up. Even as much as I thought I was keeping it all together and I was handling things quite nicely, there’s still that emotional turmoil in my life was being reflected in the health of my breast tissue.
Lisa: Is it something, and I know people will ask, because they always ask me this question – is this something that’s covered by insurance? Is this something that gets paid for? From a cost standpoint, how does it compare?
Ingrid: The cost is very reasonable. The charge is 160 dollars. That includes the interpretation by the medical doctors who read the scans. Once the patient has paid me, I pay those doctors directly, and the patient never receives a bill from the interpreting physician. Some insurances do cover it. The ones that do tend to be national plans. For instance, Federal BlueCross BlueShield seems to cover it. I’ve heard Cigna sometimes covers it. People check with their own healthcare provider.
Most of the insurance plans that people have in Maine, which tends to be BlueCross BlueShield, doesn’t tend to cover it for breast screening, though they have covered it for carpal tunnel. That’s a whole other topic. Generally not covered, reasonably priced. There also is a foundation that will help women pay for it as well.
Lisa: What foundation is that?
Ingrid: It’s called the United Breast Cancer Foundation, UBCF.
Lisa: People can …
Ingrid: Info, they can go there and apply.
Lisa: You mentioned just briefly that thermography is used for other things, like carpal tunnel.
Ingrid: Absolutely.
Lisa: Is this something that you do, or is this something other than thermography?
Ingrid: No, I can point the camera at any body part. Pretty easy to do. Sometimes people come in for head and neck issues. We can assess the carotid artery. Sometimes, particularly now that people are understanding that inflammation is so important, we can really get a sense of whether the carotid arteries are inflamed. It’s one thing to know that they’re blocked, which certainly you can find that out, but is that blockage inflamed? That’s a really key piece of information that we can get in an instant with a thermal camera.
Also, people, sometimes if they’re concerned with dental issues and if there’s some underlying infection that might not be evident on the surface, that will pretty much jump right out at us. I like to say with the thermography that you can’t hide. It doesn’t lie, and you can’t hide. You might not always understand why there’s heat here or in some particular spot, but you can’t hide from it.
Lisa: It sounds like you’ve had some significant fire in your life.
Ingrid: That’s right. It’s all about fire, about heat.
Lisa: It’s all about the heat and the fire. This building burning down in Yarmouth, and you’re now in Falmouth and comfortably there. It sounds like you had some fire in your personal life, and now things are better. I would like to encourage anybody who’s interested in thermography to get in touch with you. How can they reach you, Ingrid?
Ingrid: My phone number is area code 207, of course, 781-6060. I’m located in Falmouth at 5 Fundy Road, which is right off of Route 1, very centrally located. My website is www.myinnerimage.com.
Lisa: Thank you very much. We’ve been talking to Ingrid LaVasseur, who is a clinical thermographer and the owner of My Inner Image in Falmouth.
Ingrid: Thank you so much.
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Lisa: Recently, I had the good fortune to intersect again in my own personal life with a doctor that I trained with at the Maine Medical Center as a family practice resident. She was an OB/GYN resident. Now she’s out in clinical practice, doing full-time work in the field. This is Dr. Caroline Hodsdon of InterMed, who’s an obstetrician/gynecologist in the Portland area. I feel so fortunate to have you in here, because I know that you’re out there. You’ve been treating many women in this area for how long now? A decade?
Caroline: A decade, yeah. Almost 14 years.
Lisa: Fourteen years. You have a wealth of clinical knowledge and practical applications. This is why I wanted you to come in and talk to us about breast cancer screening, because there’s a lot of confusion right now. Women aren’t really sure, after last year’s findings, they aren’t really sure, what should we do? It’s not every year after 40 anymore. What do you talk to your patients about? How do you approach this?
Caroline: That’s probably one of the biggest questions that women have is, how often should I be screened for breast cancer, and what’s the best way to do it, and when do I start? If you look at a woman who has an average risk of breast cancer, I think that that is the most difficult. Women who are at high risk, for various different reasons, their screening is more obvious, but for a 40-year-old that comes in to the office to say, “Should I have a mammogram?”, it’s a little bit tougher.
The reason that it’s tougher is that there are many learned bodies out there that have recommendations on what to do. They range from a mammogram every year at 40, to having a mammogram starting at 50 and only having one every other year. It’s really hard to help women decide which option is best for them.
The reasons for the discrepancy is that the studies are not clear, just as you read in the newspaper about whether or not estrogen causes breast cancer. Some people say absolutely yes, and some studies say absolutely not. The same is true with how effective is mammogram for screening women, and what is the benefit and the harm? Different learned bodies think of those two things in a different way.
Lisa: Has there been some concern generated about the use of mammograms because of radiation exposure?
Caroline: There is concern about that. That is one of the reasons that the recommendations from the U.S. Preventive Task Force have changed. They now recommend starting mammograms at 50 instead of 40. There’s a couple of reasons for that. One reason is because of the radiation exposure. We know that the younger a breast is, the more estrogen that’s there. That does make a younger breast more susceptible to radiation exposure. An older breast has less toxicity from the exact same amount of radiation.
A younger breast also has less chance of getting breast cancer. The risk of breast cancer really increases most with age. That’s the biggest risk factor. If you start at 50, the breast is less sensitive, and there is a greater chance that you’ll find something.
Having said that, the risk of radiation exposure is incredibly small. The National Council on Radiation Protection & Measurements stated that the risk of having breast cancer caused by mammogram, over a lifetime of mammogram, is about one in 1,000, and the risk of dying from breast cancer caused by radiation is about one in 10,000. Of course, you have to balance that against, what is the risk of your lifetime of breast cancer, which, if you lived a nice, long life, is going to be one in nine. They’re balancing the risk of radiation exposure and your chance of getting breast cancer when they’re making these recommendations.
Lisa: What about the use of other technologies, like ultrasound or even thermography?
Caroline: We know that mammogram is better than ultrasound for screening. Ultrasound is specific, so when you find something on mammogram, then you can really hone down on that abnormality with ultrasound and better characterize, what does this look like? Does it look like a fluid-filled cyst? Does it look like something more worrisome? You can’t get a good screening with ultrasound only, because the breast is just too big to look at completely.
As far as thermography goes, the American Cancer Society, the U.S. Preventive Task Force, the National Cancer Institute, none of them recommend thermography as screening alone. It’s unclear, I think at this point, because there is a high false-positive rate with thermography, how that is going to meld with other breast cancer screenings.
Lisa: By false positive, you mean something shows up, but it’s not necessarily cancer?
Caroline: Right. Many women have had that happen to them. They go in, and they see something on mammogram, but they don’t know what it is. They ask you to come back and look again. That happens much more frequently with thermography than it does with mammography.
That’s one other reason why the U.S. Preventive Task Force has recommended mammogram screening starting at 50, because a 40-year-old breast is very dense. It’s hard to see through that density, and so frequently, they don’t get the image that they want, and they’re unclear of what they’re seeing. That, again, becomes a false positive on mammogram, and you need to come back.
Lisa: I think that you are making it very useful for people, very user-friendly the way that you’re approaching this. What I’m hearing from all of this is that the recommendations, they’re out there. There’s still some discussion as to the best way of dealing with all of this. In the end, it’s about people taking responsibility for their own selves, their own bodies, taking responsibility for having a conversation with their own healthcare provider and really trying to individualize the way that they approach the screening.
Caroline: I think that’s an excellent summary. The risk of breast cancer is not zero under 50. All of us have friends that have had breast cancer in their 40s. It’s very, very worrisome for us. It makes a conundrum about, how do you handle that lifetime fear that this could happen to me, especially if they’ve told me for years I need mammograms? Now you’re saying, “Well, maybe you don’t.”
Lisa: Dr. Hodsdon, I’m so glad you’ve taken the time to come in here and try to clarify things to the extent that they can be clarified, because it’s a confusing discussion, to be sure. I appreciate your giving us the opportunity to hear more. We’ve been speaking with Dr. Caroline Hodsdon from InterMed, a local obstetrician/gynecologist and someone I’ve known for a long time. I appreciate your coming in.
Caroline: Thanks for having me.
Lisa: This is Dr. Lisa Belisle, and you have been listening to the Dr. Lisa Radio Hour & Podcast, show number 58, Breast Health, created in honor of Breast Cancer Awareness Month, first airing on October 21st, 2012. As part of our show today, we’ve welcomed Meredith Strang Burgess, breast cancer survivor, member of the Maine House of Representatives, and advocate for the Maine Cancer Foundation; clinical thermographer Ingrid LaVasseur; and Dr. Caroline Hodsdon, OB/GYN from InterMed here in Portland.
We hope you’ll take a moment to go to doctorlisa.org and find out more about our guests, and also visit iTunes and download this podcast or past podcasts, all for free. Please do find us on Facebook and like our Facebook page, and let us know how you think we’re doing. Also, let our sponsors know that you really appreciate their supporting this show. This is Dr. Lisa Belisle. Thank you for being part of our world. May you have a bountiful life.
Speaker 1: The Dr. Lisa Radio Hour & Podcast is made possible with the support of the following generous sponsors: Maine magazine; Mike LePage and Beth Franklin at RE/MAX Heritage; Sea Bags; Dr. John Herzog of Orthopedic Specialists; Marci Booth of Booth Financial Services; UNE, the University of New England; Tom Shepard of Shepard Financial; Apothecary by Design; and The Body Architect.
The Dr. Lisa Radio Hour & Podcast is recorded in downtown Portland at the offices of Maine magazine on 75 Market Street. It is produced by Kevin Thomas and Dr. Lisa Belisle. Audio production and original music by John C. McCain. For more information on our hosts, production team, Maine magazine, or any of the guests featured here today, visit us at doctorlisa.org. Download and become a podcast subscriber of Dr. Lisa Belisle through iTunes. See the Dr. Lisa website or Facebook page for details.