March 18, 2010

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Thermography article ‘irresponsible’

I’m writing in response to the article, “Ex-Hill physician favors Thermography over mammograms,” published in the March 4 issue of the Local.  As a fellowship-trained physician specializing in breast imaging, I found the article irresponsible. 

The article stated that the only downside to thermography is that insurance companies do not pay for the procedure. The article also stated that thermograpy has a lower false negative rate and “a higher degree of success in identifying breast cancer in women under the age of 55.”

In truth, there has been no recent randomized clinical trial to test the ability of thermography to detect breast cancer.  The studies performed back in the ‘70s and ‘80s showed that thermography missed the great majority of cancers, and many of the cancers it found were already palpable, rendering the study moot. 

As breast imagers, we work every day with inherently flawed tools, using probabilities to help detect cancers in their early stages.  It is an imperfect science, but the best we have.  Much of what was released by the recent task force article and the ACS is true.  There are missed cancers and overtreatment. But the ACS also says Thermmography  is not a substitute for mammogram.

The medico-legal system in this country tends to magnify this as perfect diagnosis is expected, even with imperfect tools.  That leads to too many studies and over treatment. All the while, there are still plenty of cancers that cannot be detected with conventional imaging.  Unfortunately, these seem to occur more in younger women who tend to have more aggressive cancers.

I hope the next time I read a medical article in the Local, it is better researched.  I have no problem with letting the public know about alternatives. I do, however, have a problem with an article that misleads the public to thinking that the method being touted has been proven effective.

For info see ACS Web site:

Susan Garrett Trevisan, M.D.
Chestnut Hill


Mammogram’s still necessary

I read with interest your recent article on thermography and applaud you for bringing alternative medical evaluations to the public eye.  However, I was somewhat disturbed by the overall impression that the article delivered about mammography.

Technology is constantly advancing and presenting better ways of acquiring information about and treating various medical conditions. Screening mammography is still the standard of care in early detection of breast cancer.  A proponent of thermography stated “Breast thermography offers women information that no other procedure can provide.  However, breast thermography is not a replacement for or alternative to mammography…”

Thermography is simply one more way to get information.  How that information is used is the important point.  Patients with a “positive” thermogram will need additional testing such as ultrasound, MRI, mammogram, or biopsy.  There may be associated anxiety or “harm” from those tests.  There is no firm data that thermography is an adequate screening tool to detect early breast cancer.

Yes, there is a debate going on after the recent USPSTF’s evaluation of mammography.  Yes, mammograms are not perfect.  Yes, there is evolving technology.  Most importantly, yes, mammograms save lives.

So, for women without an increased risk of breast cancer, I believe mammograms should be performed every one to two years from age 40 to 50, yearly after 50.  When should a woman stop?  That is a difficult question, but as long as your life expectancy is more than five years, you may want to consider a screening mammogram. 

Women at high risk need yearly mammograms and to discuss their regimen with their doctor.

Alternative therapies and diagnostic modalities can be valuable tools, but screening mammography is still the best and most proven study to detect early breast cancer.

Patricia M. Bailey, M.D.
Medical Director, Women’s Center
Chestnut Hill Hospital


Take a walk, it’s good for you

I’ve always enjoyed walking. Recently, I decided to see if despite my 92 years, would I still be able to undertake a “really big walk?”

I started down the Avenue. Block after block passed by. And still, I didn’t feel tired, so I continued on. Once I did stop to rest at a convenient bench. I asked a passerby what the area was. “This is called Mt. Airy,” he replied. And then I started to walk back. By the time I came home, it was late afternoon. The only after-effect I felt was a good appetite!

So, good friends, young and old, follow my lead and become a walker.

Gerald Samkofsky
Chestnut Hill


High rents = high vacancy: facts vs. ‘rumors’

 I can’t tell if the commentary written by Anne Hart in last week’s Local is a calculated, feel-good, point-of-view typical of “a consultant, coach and speaker” or just a naïve person who wants to feel good by “circulating positive, inspiring stories about our community.”

 There is a difference, and that difference is driven by personal gain.

The crux of the debate is found in the middle of her article … four alleged rumors, the first two distinguished by their absurdity, meaning we intuitively know they are false. The third is false by a revelation by statistics and the fourth – the most important – judged false by association with the preceding three, but without any support.

The issue is [if] “Our commercial rents here are higher here than anywhere else ...” By reference to the preceding examples, this is implied to be equally false. Ms. Hart says statistics are available but lists none. “Higher than anywhere else” is a failure in relative returns. I trust that New York’s Fifth Avenue, the Ginza in Tokyo, the Galleria in Milan, Rodeo Drive in Beverly Hills and even Chestnut Hill, Mass. have higher rents, but provide higher returns.

Knowledgeable tenants make business decisions devoid of emotion. Rents and revenues are expressed in terms of $ per sq. ft. What is the rent and what is the expected return? If the return … the number of shoppers … and how much they spend is sufficient, a lease is signed and a store is born. If not, no deal and the vacancy continues.

We don’t need to debate if our commercial rates are “higher than anywhere else.” They are apparently “higher than anywhere that makes sense.” Why? Because we see no deals, no occupancy and no new shopping opportunities.

This is not rumor, it is fact, and coaching won’t help.

Ed Budnick
Chestnut Hill


Local labeled ‘so responsive’

Wow, what a nice article in this week’s issue. (“Wyndmoor author finishes 2nd book in ‘Jesus’ trilogy.”) I got a call from a friend, Julie Moat, about it before I even realized it was in this issue.

Thank you so much. I am deeply touched by how much you included and so glad that you put in that part about encouraging other writers to persist. What a treat it is to have a local paper that is so responsive to the people in the community.

Betsy Otter Thompson


Photo leads to a double adoption

Drew Milliken, an agent with Chestnut Hill’s Prudential Fox and Roach office, thought he was going to adopt Blanche, the white long-hair cat found in a garbage can whose photo appeared last week in the Local, but he was smitten with her brother and sister, also pure white, and adopted them instead. He learned that they came as an inseparable pair since they were literally walking through the streets touching shoulders when first rescued in the December blizzard.

I saw that the female had a bad eye infection, but later learned that she was also deaf. (The eye had to be removed once she got stronger and the infection cleared.) These cats are lovers, but the tiny deaf, one-eyed female is so spunky and will melt anyone’s heart within seconds.

Her brother is shy until he gets to know you, but likes to fetch and retrieve balls until my arm is too tired to throw anymore. This is one happy ending for everyone, but Blanche remains unadopted. Thank you to the Local for helping make this adoption possible.

Brenda Malinics


Fox hunting for ‘rich and stupid’

Regarding the letter by Deb Welter in today’s Local (March 11) about the “humane fox hunting” lecture on March 21 by WHOA at the Northwestern Stables, I will not be attending this function.

I don’t understand how anyone can put the words, “humane” and “fox hunting” into the same sentence. How can chasing a small animal around until it has heart failure ever be considered “humane”?

I didn’t even think people still engaged in this “sport” that has always been one for kings, royalty and the rich and stupid. Why would you want to put any kind of a positive light on such a sport, especially for students and/or young children?

I volunteered for a wildlife rehabilitation organization for more than 20 years. Don’t we do enough harm to wildlife with our cars, our insistence on building more shopping malls and taking away their homes and all the other involuntary things we do that harm and deplete them?

Why go out of your way to promote such a cruel “sport” as this? How about dog fighting or cock fighting? Will that be the next thing on the agenda for WHOA (Wissahickon Horse-lovers Organization for Adults) for a pleasant Sunday talk? Please reconsider.

Maryanne E. Tobin


Another foe of fox hunting talk

In these stressed days and hard economic times, presenting a talk on “Humane Fox Hunting” is ludicrous and inappropriate. (I just read in the Local about the March 21 talk at the Monastery Stables.)

 It is an activity focused solely on the wants and needs of the participating individuals who justify boorish behavior at the expense of animals.

Foxes are smart and sensitive animals that feel the same terror as any person who is chased by a gang of criminals wielding weapons.

The hearts of the exhausted foxes can literally explode; they tear muscles and ligaments, get cuts and puncture wounds, suffer from dehydration and hyperthermia. They might have expended a month’s worth of essential calories in a chase, and to a nursing female this could mean lack of milk to nurse her kits who will die from starvation.

So the fox didn’t die, but is this chase humane? Promoting fox hunting is promoting insensitive, aggressive and violent behavior. Shame on WHOA (Wissahickon Horse-lovers Organization for Adults).

Jennifer Hunsberger


Why tolerate this cruel activity?

Talk about a contradiction in terms. Regarding the March 21 speech on “humane fox hunting” at the Northwestern Stables that you mentioned in this week’s Local, there’s no such thing as humane fox hunting, period.

Humans who exploit animals invariably come up with lame justifications for doing so, and here’s the perfect example. There’s nothing remotely humane about terrorizing an animal by setting loose a ravenous pack of dogs, followed by thundering horses and their riders to chase it down.

Whether the fox is killed or not is completely irrelevant. I can’t believe that this activity — note that I did not call it a sport — is tolerated, let alone encouraged by means of a talk. The speaker might believe that her stories are humorous and lively. I doubt that the foxes who were and will continue to be victimized by the activity would agree.

Laura Flandreau
Chestnut Hill


No dog breeding without a license

How well I understand the queasy feeling about pitbulls expressed by local residents recently in area newspapers.

Why? Because I was just like them in 2004. My son brought home a pitbull puppy, four weeks old, separated from its mom by a backyard breeder, way, way too soon. And what did I do?  I told him that he could not live in my house with one of ‘those’ dogs. So I tossed him out with his puppy, and of course, back he came several days later, with the puppy in tow.

I fell in love with that puppy and then decided that if I was going to have such a strong opinion, I should back it up with something. So I started to read everything, pro and con I could get my hands on. I then fostered an over-sized AmStaff-Pit-Mastiff mix; I went out to California to visit the Saturday morning Pit-Ed classes that BadRap does.

 BadRap is probably the most famous pitbull rescue in the country, having rescued more than a few of the Michael Vick dogs, appeared on Rachael Ray and involved nationwide in advocacy and education for the dogs.

I learned something. I learned that speaking about “those” dogs was sort of the same thing as saying I didn’t want one of “those” people in my neighborhood. I wasn’t proud of my prejudice. Now I devote my life to the rescue of “those” dogs.

Let’s try something different in Philadelphia. Let’s offer a reward to people who will report people breeding without a license. We don’t have to be breed-specific. There must be an unenforced law on the city’s books. You breed, you get busted, your dogs are seized, and you are fined heavily. Sounds like a very strong measure, but until we can decrease the population of this cash crop (and not by killing them in fighting pits or a shelter), this will not stop.

Dina Hitchcock
Chestnut Hill



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