Breast thermography is a 15 minute non invasive test of physiology. It is a valuable procedure for alerting your doctor to changes that can indicate early stage breast disease.
The benefit of breast thermography is that it offers the opportunity of earlier detection of breast disease than has been possible through breast self examination, doctor examination or mammography alone.
Thermography can detect the subtle physiologic changes that accompany breast pathology, whether it is cancer, fibrocystic disease, an infection or a vascular disease. Your doctor can then plan accordingly and lay out a careful program to further diagnose and /or MONITOR you during and after any treatment.
Normal
Good thermal symmetry with no suspicious vascular patterns or significant thermal findings.
Fibrocystic Changes
The very significant vascular activity in the left breast justified clinical correlation and close monitoring which returned an opinion of fibrocystic changes taking place. These changes can be monitored thermographically at regular intervals until a stable baseline is established and is reliable enough for annual comparison.
Early Stage Malignant tumor
This is the specific area of a small DCIS. We can see the vascular feed and the discreet area of hypothermia that is displacing the surrounding hyperthermia.
Thermography is a painless, non invasive, state of the art clinical test without any exposure to radiation and is used as part of an early detection program which gives women of all ages the opportunity to increase their chances of detecting breast disease at an early stage. It is particularly useful for women under 50 where mammography is less effective.
Thermography's role in breast cancer and other breast disorders is to help in early detection and monitoring of abnormal physiology and the establishment of risk factors for the development or existence of cancer. When used with other procedures the best possible evaluation of breast health is made.
This test is designed to improve chances for detecting fast-growing, active tumors in the intervals between mammographic screenings or when mammography is not indicated by screening guidelines for women under 50 years of age.
All patients thermograms (breast images) are kept on record and form a baseline for all future routine evaluations.
This patient's thermograms have remained stable for two years. These patterns are like a thermal fingerprint which will only change if pathology develops.
Baseline
3 Month Follow-up
First Annual
Second Annual
With the new ultra-sensitive, high resolution digital infrared cameras available today a technology that has been developing over the past 20 years is now becoming more accessible.
Thermography as a physiologic test, demonstrates heat patterns that are strongly indicative of breast abnormality, the test can detect subtle changes in breast temperature that indicate a variety of breast diseases and abnormalities and once abnormal heat patterns are detected in the breast, follow-up procedures including mammography are necessary to rule out or properly diagnose cancer and a host of other breast diseases such as fibrocystic syndrome, Pagets disease, etc.
Canadian researchers recently found that infrared imaging of breast cancers could detect minute temperature variations related to blood flow and demonstrate abnormal patterns associated with the progression of tumors. These images or thermograms of the breast were positive for 83% of breast cancers compared to 61% for clinical breast examination alone and 84% for mammography.
By performing thermography years before conventional mammography, a selected patient population at risk can be monitored more carefully, and then by accurately utilize mammography or ultrasound as soon as is possible to detect the actual lesion - (once it has grown large enough and dense enough to be seen on mammographic film), can increase the patients treatment options and ultimately improve the outcome.
It is in this role that thermography provides its most practical benefit to the general public and to the medical profession. It is certainly an adjunct to the appropriate usage of mammography and not a competitor. In fact, thermography has the ability to identify patients at the highest risk and actually increase the effective usage of mammographic imaging procedures.
Until such time as a cure has been found for this terrible disease, progress must be made in the fields of early detection and risk evaluation coupled with sound clinical decision making.
Thermography, with its non-radiation, non-contact and low-cost basis has been clearly demonstrated to be a valuable and safe early risk marker of breast pathology, and an excellent case management tool for the ongoing monitoring and treatment of breast disease when used under carefully controlled clinical protocols.
Call my office in Wilmington (815) 476-5210 or Lombard (630) 627-3700 to set up an appointment or email me at jones.gretchen@gmail.com
Tuesday, April 27, 2010
Development, Structure, and Function of the Ovary
The gonads in utero exist in an undifferentiated state until the seventh week of fetal life, at which time the primitive ovary can be differentiated from the testis. Estrogen formation in the ovary begins between weeks 8 and 10, and by 10 to 11 weeks of gestation, some oognia in the developing ovarian cortex begin developing into primary oocytes.
The ovary contains a finite number of germ cells. The maximal number of about 7 million oogonia being reached by the fifth to sixth month of gestation. Afterward, the germ cells decrease in number through a process of atresia such that only 1 million remain at birth, 400,000 are present at the time of menarche, and only a few remain at menopause. Two X chromosomes are required for normal development of the ovary. In individuals with a 45,X karyotype, ovarian development occurs, but the rate of atresia (ovarian dealth) is accelerated so that only a fibrous streak remains at the time of birth.
Final maturation of ovarian follicles commences during puberty. The two major hormones that regulate follicular development are the pituitary gonadotropins - follicle stimulating hormone (FSH) and luteinizing hormone (LH).
As the time of puberty nears, a decrease in the sensitivity of the hypothalamic-pituitary system allows for increased secretion of FSH and LH, possibly secondary to increased episodic or pulsatile secretion of luteinizing hormone releasing hormone (LHRH) by the hypothalamus. An increase in estrogen secretion subsequently exerts a positive feedback which leads to an exaggeration of the pulsatile release of LH and eventually to ovulation and the menarch, after which average plasma gonadotropin concentrations reach adult values in which day and night levels are similar.
The culmination of puberty is the onset of predictable, cyclic menses. The average time between the beginning of breast development and the onset of menses is 2 years. During the first few years after menarche, menstrual cycles are often irregular and unpredictable due to anovulation (similar to perimenopause). The age of menarch is variable and is determined in part by socioeconomic and genetic factors as well as general health. The mean age in the United States has decreased at a rate of 3 to 4 months per decade over the last 100 years and is now around 13 years old.
Call my office in Wilmington (815) 476-5210 or Lombard (630) 627-3700 to set up an appointment or email me at jones.gretchen@gmail.com
The ovary contains a finite number of germ cells. The maximal number of about 7 million oogonia being reached by the fifth to sixth month of gestation. Afterward, the germ cells decrease in number through a process of atresia such that only 1 million remain at birth, 400,000 are present at the time of menarche, and only a few remain at menopause. Two X chromosomes are required for normal development of the ovary. In individuals with a 45,X karyotype, ovarian development occurs, but the rate of atresia (ovarian dealth) is accelerated so that only a fibrous streak remains at the time of birth.
Final maturation of ovarian follicles commences during puberty. The two major hormones that regulate follicular development are the pituitary gonadotropins - follicle stimulating hormone (FSH) and luteinizing hormone (LH).
As the time of puberty nears, a decrease in the sensitivity of the hypothalamic-pituitary system allows for increased secretion of FSH and LH, possibly secondary to increased episodic or pulsatile secretion of luteinizing hormone releasing hormone (LHRH) by the hypothalamus. An increase in estrogen secretion subsequently exerts a positive feedback which leads to an exaggeration of the pulsatile release of LH and eventually to ovulation and the menarch, after which average plasma gonadotropin concentrations reach adult values in which day and night levels are similar.
The culmination of puberty is the onset of predictable, cyclic menses. The average time between the beginning of breast development and the onset of menses is 2 years. During the first few years after menarche, menstrual cycles are often irregular and unpredictable due to anovulation (similar to perimenopause). The age of menarch is variable and is determined in part by socioeconomic and genetic factors as well as general health. The mean age in the United States has decreased at a rate of 3 to 4 months per decade over the last 100 years and is now around 13 years old.
Call my office in Wilmington (815) 476-5210 or Lombard (630) 627-3700 to set up an appointment or email me at jones.gretchen@gmail.com
The Estrogen Dilemma
In the April 12, 2010, New York Times article The Estrogen Dilemma, researchers are discovering that estrogen, a hormone produced in your brain, keeps your mind healthy and helps diseases like Alzheimer’s and heart disease kick the boot. The key here is the Timing Hypothesis, which is, "the proposition that estrogen could bring great benefit to a woman who starts it in her 50’s while having the reverse effect on women ten years older…other scientists know there are ways estrogen improves and protects the brain when it is added to healthy tissues.”
Thus stating estrogen when added to a healthy happy body can heal your body, where taking estrogen in a tired unhealthy body can hit cells that are already sick, thus not replenishing or strengthening the woman’s body.
The study also goes on to feature the evolution of hormones from horse urine to yam/plant based topical creams. At the Wake Forest University in North Carolina researchers have found that estrogen has had a tremendous influence against heart disease in women alone.
In T.S. Wiley’s Book, Sex, Lies, and Menopause, she states the Dying of Cancer is something we all fear. Having a heart attack, although seems more remote, because we don’t hear about it on television everyday would probably kill us where we stand. A doctor interviewed in the article stated that, “Heart disease ultimately kills many more women than all cancers combined, some doctors had also taken to urging older women, even those past menopause to start hormones for cardiac health purpose.”
The overall dilemma that most women face is how do they get prescribed hormones and where. What type of hormone is right for them? Is it estrogen, progesterone, testosterone or all of them?
The Wiley Protocol is the answer. The Wiley Protocol restores your hormones back to the way you had them when you were young, in the way you had them when you were young, rhythmically
Call my office in Wilmington (815) 476-5210 or Lombard (630) 627-3700 to set up an appointment or email me at jones.gretchen@gmail.com
Thus stating estrogen when added to a healthy happy body can heal your body, where taking estrogen in a tired unhealthy body can hit cells that are already sick, thus not replenishing or strengthening the woman’s body.
The study also goes on to feature the evolution of hormones from horse urine to yam/plant based topical creams. At the Wake Forest University in North Carolina researchers have found that estrogen has had a tremendous influence against heart disease in women alone.
In T.S. Wiley’s Book, Sex, Lies, and Menopause, she states the Dying of Cancer is something we all fear. Having a heart attack, although seems more remote, because we don’t hear about it on television everyday would probably kill us where we stand. A doctor interviewed in the article stated that, “Heart disease ultimately kills many more women than all cancers combined, some doctors had also taken to urging older women, even those past menopause to start hormones for cardiac health purpose.”
The overall dilemma that most women face is how do they get prescribed hormones and where. What type of hormone is right for them? Is it estrogen, progesterone, testosterone or all of them?
The Wiley Protocol is the answer. The Wiley Protocol restores your hormones back to the way you had them when you were young, in the way you had them when you were young, rhythmically
Call my office in Wilmington (815) 476-5210 or Lombard (630) 627-3700 to set up an appointment or email me at jones.gretchen@gmail.com
Let's talk about the hormone cycle. What happens physiologically?
Under the influence of gonadotropins (FSH and LH), a group of primary follicles (eggs) is recruited, and by day 6 to 8 of the menstrual cycle, one follicle becomes mature or "dominant," a process characterized by acceleerated growth of granulosa cells and enlargement of the fluid filled antrum. The recruited follicles not destined to ovulate begin to undergo degeneration, similar to the atresia observed in other follicles during embryogenesis. Just prior to ovulation, meiosis resumes in the ova of the dominant follicle, and the first meiotic division is completed with formatino of the first polar body. (okay enough with the medical talk). Rapid enlargement of the antrum (up to 10 to 25 mm in size) occurs with an associated increase in follicular fluid (we women feel pain!!). Ovulation from the dominant follicle occurs some 16 to 23 hours after the LH peak or 24 to 38 hours after the onset of the LH surge as the result of rupture of the follicular wall at the area of the stigma, followed by expulsion of the ovum together with a mass of surounding granulosa cells called cumulus cells. The rupture is believed to result from the action of hydrolyzing enzymes on the surface of the follicle, possibly under the control of prostaglandins. The second meiotic division begins after the egg is fertilized by a sperm.
Following ovulation, the formation of the corpus luteum begins in the retained remannt of the ovulated follicle (the corpus luteum produces the progesterone in the early stages of pregnancy). The principal estrogen secreted by the ovary and the most potent naturally occurring estrogen is estradiol. Estrone is also secreted by the ovary, but the principal source of estrone is from extraglandular conversion of androstenedione in peripheral tissues (aromatase in your abdominal fat cells). Estriol, is the most abundant estrogen in urine, arises form the 16-hydroxylation of estradiol and estrone.
Like other steroid hormones, ovarian steroids are derived from cholesterol. The ovary can synthesize cholesterol from circulating low density lipoproteins LDL. Virtually all ovarian cells are believed to possess the complete enzymatic complement required for the conversionm of cholesterol to estradiol; however, different cell types within the ovary contain different amounts of these enzymes so that the principal asteroids produced differ in the various compartments. For example, the corpus luteum forms progesterone and 17-hydroxyprogesterone predominantly, whereas theca and stromal cells convert cholesterol to the androgens androstenedione and testosterone. Granulosa cells are particularly rich in the aromatase (an enzyme) responsible for conversion of androgens to estrogen and utlize as substrates for this process from the androgens from the theca and stromal cells.
Estrogens promote development of the secondary sexual characteristics in women and cause uterine growth, thickening of the vaginal mucosa, thinning of the cervical mucus, and development of the ductular system of the breasts.
Progesterone is the principal hormone secreted by the corpus luteum and is responsible for progestational effects, namely, induction of secretory activity in the endometrium of the estrogen-primed uterus in preparation for implantation of the fertilized egg. Progesterone also induces a decidual reaction in endometrium. Other effects include inhibition of uterine contractions, increased viscosity of cervical mucus, glandular development of the breats, and increase in basal body temperature.
A normal menstrual cycle is usually divided into a follicular (or proliferative phase) and a luteal (or secretory phase). The secretion of FSH and LH is fundamentally under negative feedback control by ovarian steroids (particularly estradiol) and probably by inhibin (inhibits the release of FSH by the hypothalamic-pituitary unit), but the response of gonadotropins to different levels of estradiol varies;
FSH secretion is inhibited progressively as estrogen levels increase - typically negative feedback. In contrast, LH secretion is SUPPRESSED maximally by estrogen in low amounts and is ENHANCED in response to a rising and sustained elevation of estradiol - so called positive feedback control. Negative feedback of estrogen involves both the hypothalamus and pituitary, whereas positive feedback operates primarly at the level of the pituitary (both located in the brain).
The length of the normal menstrual cycle is defined as the time from the onset of one menstrual bleeding episode to onset of the next. In women of reproductive age, the menstrual cycle averages 28+-3 days, and the mean duration of flow is 4+-2 days. Longer menstrual cycles (usually due to anovulation) occur at the start of menarche (puberty) and prior to menopause (perimenopause). At the end of one menstrual cycle and in the face of a waning corpus luteum, plasma levels of estrogen and progesterone fall, and circulating levels of FSH increase concomitantly. Under the influence of increasing levels of FSH, follicular recruitment is initiated to effect development of the follicle that will be dominant during the next cycle.
Just prior to ovulation, estradiol secretion reaches a peak and then falls. Immediately thereafter, a further rise in the plasma level of LH mediates the final maturation of the follicle, followed by follicular rupture and ovulation 16 to 23 hours after the LH peak. Plasma progesterone also begins to rise just prior to midcycle and facilitates the positive feedback action of estradiol on LH secretion.
At the onset of the luteal phase, plasma gonadotropins decrease and plasma progesterone increases. A secondary rise in estrogens causes further gonadotropin suppresion. Near the end of the luteal phase, progesterone and estrogen levels fall, and FSH levels begin to rise to initiate the development of the next follicle (usually in the contralateral ovary) and the next menstrual cycle.
The endometrium lining the uterine cavity undergoes marked alterations in response to the changing plasma levels of ovarian hormones. Concomitant with the decrease in plasma estrogen and progesterone and the decline of corpus luteum function in the late lteal phase, intense vasospasm occurs in the spiral arterioles supplying blood to the endometrium, followed byan eschemic necrosis, endometrial desquamation, and bleeding. This vasospasm is caused by locally synthesized prostaglandins. (thus by taking motrin or advil can decrease prostaglandin synthesis and symptoms)
Call my office in Wilmington (815) 476-5210 or Lombard (630) 627-3700 to set up an appointment or email me at jones.gretchen@gmail.com
Following ovulation, the formation of the corpus luteum begins in the retained remannt of the ovulated follicle (the corpus luteum produces the progesterone in the early stages of pregnancy). The principal estrogen secreted by the ovary and the most potent naturally occurring estrogen is estradiol. Estrone is also secreted by the ovary, but the principal source of estrone is from extraglandular conversion of androstenedione in peripheral tissues (aromatase in your abdominal fat cells). Estriol, is the most abundant estrogen in urine, arises form the 16-hydroxylation of estradiol and estrone.
Like other steroid hormones, ovarian steroids are derived from cholesterol. The ovary can synthesize cholesterol from circulating low density lipoproteins LDL. Virtually all ovarian cells are believed to possess the complete enzymatic complement required for the conversionm of cholesterol to estradiol; however, different cell types within the ovary contain different amounts of these enzymes so that the principal asteroids produced differ in the various compartments. For example, the corpus luteum forms progesterone and 17-hydroxyprogesterone predominantly, whereas theca and stromal cells convert cholesterol to the androgens androstenedione and testosterone. Granulosa cells are particularly rich in the aromatase (an enzyme) responsible for conversion of androgens to estrogen and utlize as substrates for this process from the androgens from the theca and stromal cells.
Estrogens promote development of the secondary sexual characteristics in women and cause uterine growth, thickening of the vaginal mucosa, thinning of the cervical mucus, and development of the ductular system of the breasts.
Progesterone is the principal hormone secreted by the corpus luteum and is responsible for progestational effects, namely, induction of secretory activity in the endometrium of the estrogen-primed uterus in preparation for implantation of the fertilized egg. Progesterone also induces a decidual reaction in endometrium. Other effects include inhibition of uterine contractions, increased viscosity of cervical mucus, glandular development of the breats, and increase in basal body temperature.
A normal menstrual cycle is usually divided into a follicular (or proliferative phase) and a luteal (or secretory phase). The secretion of FSH and LH is fundamentally under negative feedback control by ovarian steroids (particularly estradiol) and probably by inhibin (inhibits the release of FSH by the hypothalamic-pituitary unit), but the response of gonadotropins to different levels of estradiol varies;
FSH secretion is inhibited progressively as estrogen levels increase - typically negative feedback. In contrast, LH secretion is SUPPRESSED maximally by estrogen in low amounts and is ENHANCED in response to a rising and sustained elevation of estradiol - so called positive feedback control. Negative feedback of estrogen involves both the hypothalamus and pituitary, whereas positive feedback operates primarly at the level of the pituitary (both located in the brain).
The length of the normal menstrual cycle is defined as the time from the onset of one menstrual bleeding episode to onset of the next. In women of reproductive age, the menstrual cycle averages 28+-3 days, and the mean duration of flow is 4+-2 days. Longer menstrual cycles (usually due to anovulation) occur at the start of menarche (puberty) and prior to menopause (perimenopause). At the end of one menstrual cycle and in the face of a waning corpus luteum, plasma levels of estrogen and progesterone fall, and circulating levels of FSH increase concomitantly. Under the influence of increasing levels of FSH, follicular recruitment is initiated to effect development of the follicle that will be dominant during the next cycle.
Just prior to ovulation, estradiol secretion reaches a peak and then falls. Immediately thereafter, a further rise in the plasma level of LH mediates the final maturation of the follicle, followed by follicular rupture and ovulation 16 to 23 hours after the LH peak. Plasma progesterone also begins to rise just prior to midcycle and facilitates the positive feedback action of estradiol on LH secretion.
At the onset of the luteal phase, plasma gonadotropins decrease and plasma progesterone increases. A secondary rise in estrogens causes further gonadotropin suppresion. Near the end of the luteal phase, progesterone and estrogen levels fall, and FSH levels begin to rise to initiate the development of the next follicle (usually in the contralateral ovary) and the next menstrual cycle.
The endometrium lining the uterine cavity undergoes marked alterations in response to the changing plasma levels of ovarian hormones. Concomitant with the decrease in plasma estrogen and progesterone and the decline of corpus luteum function in the late lteal phase, intense vasospasm occurs in the spiral arterioles supplying blood to the endometrium, followed byan eschemic necrosis, endometrial desquamation, and bleeding. This vasospasm is caused by locally synthesized prostaglandins. (thus by taking motrin or advil can decrease prostaglandin synthesis and symptoms)
Call my office in Wilmington (815) 476-5210 or Lombard (630) 627-3700 to set up an appointment or email me at jones.gretchen@gmail.com
