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Please browse the questions below, to view the answer, please click the question.

Does Digital Infrared Imaging replace mammograms?

No. No. Digital Infrared Imaging and mammography are screenings based on two completely different principles. DII has the ability to detect asymmetrical temperatures and heat patterns emanating from the surface of the breast tissue. These physiologic changes produced by diseased breast tissue may be one of the signs that allows for early detection.
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How Does Breast Thermography Compare to a Mammogram?

Both are screening tests that do not specifically diagnose breast cancer, but screen for changes in local tissues due to various causes. Both are superior to clinical or self-examination for detecting early pathological changes. Mammography detects anatomical changes and is more precise than Breast Thermography in identifying the exact location of a lesion. Thermography detects thermal signs of metabolic or physiological changes associated with cancerous tumors. One of the most important changes is angiogenesis, or new blood vessel formation. Angiogenesis is one of the processes necessary to sustain the growth of a tumor.Breast thermography may be the first thermal signal that such a possibility is developing.
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How Often Should Breast Thermography Be Done?

For most patients a thermogram should be done once a year. If you are working with the Proactive Breast WellnessTM program, and your doctor wants to include thermography along with the other tests he or she elects to monitor your progress with, you could repeat the scan in 4-6 months. It is important to work closely with your health care professional and to follow their advice as to when you may need to do further structural studies in addition to mammograms, ultrasounds, MRIs and any surgical evaluation that they feel is prudent to pursue.
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I mentioned Digital Infrared Imaging to my doctor and was told that the procedure is outdated and useless, is this true?

Unfortunately, many physicians either do not know about this technology or are knowledgeable about a single poorly performed (with regards to DII) research study; the BCDDP (Breast Cancer Detection Demonstration Projects). The BCDDP was a large study done in the 1970's that collected data from many centers around the United States. Three methods of breast cancer detection were studied: physical examination, mammography, and thermography. With regards to thermography, the BCDDP was seriously flawed in four critical areas: (1) Completely untrained technicians were used to perform the scans. (2) The study used radiologists who had no experience or knowledge in reading infrared images. (3) No standardized reading protocol had yet been established for infrared imaging. (4) Proper laboratory environmental controls were completely ignored. In fact, many of the research sites were mobile trailers with extreme variations in internal temperatures. Of considerable concern was the reading of the images. It wasn't' until the early 1980's that established and standardized reading protocols were introduced. Considering these facts, the BCDDP could not have properly evaluated infrared imaging. With the advent of known laboratory environmental controls, established reading protocols, and state-of-the-art infrared technology, a poorly performed 20-year-old study cannot be used to determine the appropriateness of DII.

According to a recent article published in the American Journal of Surgery, October 2008, v; 196 (4):523-6 Digital Infrared technology was found to be a valuable adjunctive procedure to mammography and ultrasound, especially in women with dense breast parenchyma. Results showed Digital Infrared Imaging identified 58 of 60 malignancies, with a 97% sensitivity.This study was done out of Cornell Medical School and they were using the same Flir infrared camera that we have at our center. Click here to see full article.
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What if I live a long way from your offices but I am still very interested in learning more about breast health?

So far we have had 6 women drive 5 hours from Seattle and two women drive 8 hours from Idaho. Most of the modern infrared camera technology equipment is located in imaging centers near research facilities and medical schools. Hopefully this will change in the next few years. To our knowledge we believe there are only 2 other camera systems of this caliber in Oregon. We are grant writing to have portable units that can do more traveling to other locations in the future.
This is one of the reasons that Infrared Breast Health has been developing the Proactive Breast WellnessTM program teaching module for women who may not have easy access to cutting edge thermography/infrared equipment but still want to pursue a healthier approach to their breast health with more of a prevention focus. SEE our link to the Proactive Breast WellnessTM programs to learn more and get your copy so you can start making healthy changes and to help limit your risk factors for developing breast disease.
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What services does Infrared Breast Health provide?

Infrared Breast Health provides two office visits as part of the evaluation: The first office visit is the day of the scan and is booked as an hour appointment. Information about your breast history, health, lifestyle and hormone use is evaluated. (See the "Patient Forms" link to print out the history sheets and patient preparation information for the breast exam prior to the exam and bring them with you to your appointment. It is VERY IMPORTANT to read the patient preparation sheet. There are several things like getting sunburned, having a fever or doing heavy lifting prior to you exam that may create a problem and we will have to reschedule you. There are other forms for pain or thyroid issues. If these do not pertain to you, then just print the breast forms). Please bring copies of any previous ultrasounds, mammograms or biopsy reports that you may have, if you wish to keep them as part of your medical record.

The woman undresses from the waist up and needs to cool in the climate controlled room kept at 68-72 degrees for 15 minutes. The infrared scan is done as well as a breast exam. We have female staff who are Certified Thermography Technicians, CTT.

On the second visit we will go over your scan results and customize a program/ treatment plan based on your health challenges. Recommendations are based on the Proactive Breast WellnessTM program. This clinical research project that we have been doing has been showing promising results in women being able to reverse the inflammatory changes in a 6-12 month period as shown by hormone testing in about 70% of the time if they stay on the protocol and make nutritional and lifestyle changes. We feel that this empowers women to feel that they can make a difference in their health and may provide an approach that is prevention based. Most of the women who have come to our center have been frustrated with their healthcare. The majority of the healthcare in our country is treatment based and not prevention based. We also see younger women who fear that they might become a statistic due to the fact that they have a female relative who has been diagnosed with breast cancer. Our center strongly feels that there needs to be more energy focused on education and prevention. This is why we encourage our clients to have the scan and the educational follow up for their first appointments at our center to customize their care.
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What if I live more than an hour away from your office, I am elderly or cannot afford to take another whole day off from work to come back to do the second one hour visit?

We understand that many of our clients come from a distance. If you are able to come for the scan but live far away, we have been offering the one hour follow up visit as a phone consultation by appointment. Mention the issue of distance when you book the scan and then you will be given the follow up packet for the Proactive Breast WellnessTM program to take with you. When the interpretation has returned to our office after being read, we can mail, fax or email the results to you and then we can go over the results and the care plan by phone in detail.
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What else happens on the second office visit?

You will go over the scan results and the Proactive Breast WellnessTM program. You will be meeting with Ingrid Edstrom, FNP, M. Ed. who will help guide you in customizing your care plan. Based on the testing she may suggest or advise and order the following: hormone saliva testing from ZRT Labs (see links), or serum hormones testing through your local laboratory/ lipid panels/thyroid panels /morning cortisol /Vit D3 levels, if your personal care physician has not done them recently. All testing can also be made available to your physician if you request this. Ingrid Edstrom FNP, primarily acts as a consultant for your breast care and menopausal concerns and your primary care physician, Naturopath or established medical center may continue to follow you for other issues. Ingrid also works with hormone balancing and can discuss the pros and cons of hormone replacement if this is necessary or desired. Our center also provides book lists and educational materials to expand your knowledge base on issues that affect women's health surrounding peri-menopause and menopause. To learn more about hormone balancing or how to find a provider near you who works with Bio-identical hormone replacement if you live far from Eugene Oregon follow this link to Women's International Pharmacy.

You will also go over your current supplement regimen and suggestions are made to lessen health risks and to customize what you are currently taking. The Proactive Breast WellnessTM program protocol and supporting documents on the data disc help guide you during home study to find an excellent combination of supplements that may help with your individual health challenges. We have made an arrangement with Emerson Ecologics to provide our clients with a 20% discount on all the supplements if you choose to order through the link on the "Store" page. Emerson provides brand name products to MDs and Naturopaths and has over 125 multivitamins available from different manufactures to choose from. Depending on your scan results and physical exam Ingrid Edstrom FNP,M. Ed. may also advise and order structural testing including mammograms, ultrasounds or MRIs. These tests may be arranged at Oregon Imaging Center which is located at the new Riverbend Medical Center in Eugene Oregon or at a local hospital or imaging center if you live elsewhere. Surgical evaluations may also be facilitated through our offices if this is a pressing concern or is warranted.

Other issues that are addressed on the second visit include holistic approaches, nutritional counseling and other modalities that may benefit your breast health, lessen your risk of osteoporosis, lessen inflammation in the body that may be adversely affecting conditions such as hypothyroidism, fibromyalgia, irritable bowel, arthritis or heart health. Ingrid Edstrom, FNP has also worked in providing clients with information and approaches to Stress and Pain Management and issues with insomnia using Mind Body and other Holistic approaches. A relaxation CD and DVD product that Ingrid has created entitled "Waves of Serenity", is included in the Proactive Breast WellnessTM program 5 CD teaching module product offered on the "Store" link. Ingrid created these relaxation products after studying Relaxation Response techniques with Herbert Benson,MD at the Mind Body Medical Institute in Boston. Single copies are also available for your friends/family who have stress, insomnia or post operative issues.
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Can partners come to the visit?

If you have a partner or support person who wishes to accompany you to the appointment, they are welcome to be present. Since we need to have a climate controlled room kept between 68 and 72 degrees and temperatures vary with the seasons, your partner will probably be able to see the scan results when finished. Multiple people in the exam room change the temperature, so depending upon the conditions they may be able to watch the exam as well but that is a judgment call by the technician.
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What about children coming?

Small children cannot be left unattended so bring a friend/partner to watch them or make arrangements to leave them with a sitter at home. If they are over 6 years old and want to be with you on the other side of a screen in the exam room and they are content looking at books quietly, we might be able to accommodate that. Discuss this if there are concerns at the time of booking your appointment.
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How can I make an appointment?

Currently Infrared Breast Health sees clients in Oregon in the following cities Eugene, Milwaukie and Roseburg. Please see the contact section for maps and how to reach us. Please see the contact section for maps and how to reach us.
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How will I get my report for the scan?

You will be given color images of your scan on photo paper at the time of your first visit to take with you. This will be helpful to compare with your interpretation which comes as a dictated report in about two weeks. The images and report together will help you monitor your progress and are also then available to show radiologists or surgeons if that becomes necessary.
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How long does it take to get the results?

Your images are sent to a board certified thermologist for review. It usually takes about two weeks from the day of your appointment to get the report to you. You can also have a copy of your report sent to your physician. If you wish to have your results quickly, your report can be ready in 24 hours for an additional $60.00 as a stat charge.
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Who is qualified to take and interpret Digital Infrared Images?

Interpretation of thermographic images for a clinical impression should only be made by health care providers who are licensed to diagnose and hold credentials as board certified clinical thermographers, diplomates, or fellows from a recognized organization. Any individual wishing to perform DII in their office with the images sent for outside interpretation should be certified as an infrared imaging technician by one of the same organizations. Infrared Breast Health is a certified technician imaging center.
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Who reads my scan?

We are very pleased to have Dr William Amalu as our center’s interpreter. As the President of the International Academy of Clinical Thermology, Dr. Amalu instructs physicians worldwide on the science and interpretation of thermal imaging. Dr. Amalu brings over a decade of thermal imaging experience to patient care. In partnership with William Hobbins, MD, FACS, FABCT, of Thermal Image Analysis, our center provides over 40 years of clinical excellence in thermographic analysis and interpretation.

William Amalu, DC, DABCT, DIACT, FIACT
Board Certified Clinical Thermologist
Diplomat, International Academy of Clinical Thermology
Diplomat, American Board of Clinical Thermology
Diplomat, American Board of Medical Infrared Imaging
President: International Academy of Clinical Thermology
Please go to Dr Amalu’s web site at www.breastthermography.com to learn much more about infrared thermography.
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Will my insurance cover the infrared procedure/ test and the office visits?

At the present time, some insurance companies cover the procedure, while others consider it investigational, experimental or a contract exclusion. At the time of your appointment we will ask you to sign an advanced beneficiary notice allowing our office to perform the thermogram and you are aware you may be responsible for the charges. The advanced beneficiary notice can be printed from the patient's breast forms links section. Please bring this form and the other history questions to your visit. The majority of the insurance companies are covering the office visit charges minus your co-pay and/or deductible. It is like going to the doctor's office and they say go down the hall for an EKG test which is considered a "procedure ". Our office now accepts about 25 different insurances here in Oregon and the insurances will pay for the office visit and the one hour educational visit when it is coded as related to menopause, fibrocystic breasts, breast lump or family history of breast cancer etc. Only a few of the insurances have been paying for the "procedural " part of the thermogram. We have been sending packets to the medical directors to get them to change their policy which is occurring but slowly. Our policy is to receive payment in full for the infrared thermogram scan at the time of service. We will submit the appropriate charges to your insurance company to seek reimbursement. If your insurance company pays for any part of the thermogram cost we will refund you that amount. The appropriate procedure code for breast thermography, thyroid/ carotid and other parts of the body is 93740, if you would like to check with your insurance regarding coverage prior to the visit. You are given a receipt for your visit which can be used as a medical expense for your taxes.
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How much does a Digital Infrared Imaging cost?

Our center's fee for the procedural portion of the breast scan is $160.00 which includes imaging, the interpretation fee, a dictated written report and a set of colored images on photo paper. Scans that are provided outside of a 100 mile radius from Eugene are $190 due to additional costs for lodging, medical space rental and transportation.

Your insurance company may not pay for the breast scan. We do expect your insurance to reimburse for the following office visit portions minus your co pay or deductibles. There are two codes billed on the first visit, the office visit AND the scan / procedure code. (As an example: you see your doctor for an office visit and he sends you down the hall for an EKG which is also billed as a procedure done that day).

Breast Scan (Estimated Cost: $160 in Eugene/Roseburg or $190 when in done in Portland, in case you have to pay for them yourself or through other insurance. That code is 93740.

New patient consultation is billed at $250.00 (Billing code 99204, for a one hour visit) the day of the scan.

Extended office visit is billed at $175.00 for patients that are out of town and unable to do a follow up visit in the office two weeks later so they stay an additional one to one and a quarter hours after the scan to do the Proactive Breast WellnessTM program. The Extended office visit will be in addition to the new patient consultation at your first time of service and the day of the scan (Billing code 99354).

Follow up office visits for local patients, cost $165.00 (Billing code 99214) to do a one hour visit to go over the Proactive Breast WellnessTM program when the infrared report is back. Other issues like labs, prescriptions, referrals to other offices etc.are managed during this visit. If this is a repeat scan, it is billed as this code of 99214.

As a courtesy, the maximum you will have to pay for each office visit if applied toward deductible, will be a reduced rate of $85.00 per office visit.

Patient reimbursement If you pay for the scan at the time of service and later your insurance pays for all or a portion of the scan (93740 scan code), then our office will send you a refund check if we were paid twice for the scan code amount.
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I am worried about finances can you do installments?

Yes. Some women request to pay the interpretation portion of $60 on the day of the visit and then pay the remaining $90 due in $45 amounts over the next 2 months for the scan cost. There is also the charge for the new patient/established office visit that we can make arrangements with as well. If you need to pay something towards your second visit, if for example you have a large deductible, we can do that in installments to make it easier.
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Do you take credit cards?

Yes. We take Visa, Master Card, American Express and Discover Card. We also accept HSA debit cards.
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What if I do not have any insurance?

The cost of the scan is still $160 and the new patient office visit and follow up visits are fee for service discounted to $85 for the one-hour appointment.

An example of the charges would be the following:
Self Pay New Patient office visit $85.00
Breast Scan $160.00
Self Pay follow up office visit $85.00

If scans are provided in Portland there is an increased charge of $190 for the scan due to lodging, medical space rental and transportation costs. In our area the Naturopaths charge $90-$125 an hour for their time but we feel that the education portion and the Proactive Breast WellnessTM program is very important and uninsured women should also be able to afford a follow up appointment so they too have access to this prevention program. We have been writing grants to help provide scholarships for under served women, but at the moment we have not obtained that funding. If you cannot come back to the office easily due to long distances or scheduling issues, we provide fee for service phone consults to go over any hormone prescription changes/ supplement questions that might arise. If Ingrid can not answer your question immediately when you call because she is with another client, we can arrange the consult by appointment, so please leave a number clearly twice and a good time to call. These fees also apply to Fee For Service short office visits. A short follow up consult of 15 minutes or less is $35 and a 30-minute follow up consult is $50. We accept Visa/MC/ HSA accounts.
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I am out of state or want more information or to pay for the Proactive Breast WellnessTM programs.

You can go to the "Store" section and in the "Coming Soon" Proactive Breast Wellness section, please leave some contact information so we may contact you with the finished 5 CD product which is still in the last editing process prior to release. You can also call us if you are wanting a more exact date of release.
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Does my insurance company view Infrared Breast Health Center as a Preferred Provider Center?

You can call your insurance company and ask if Ingrid Edstrom FNP, M. Ed. is a preferred provider for your plan. If I am not on the panel I may be considered an Out-of-network provider. Given some extra time you can also ask your insurance company to contact us so we can apply to different insurance carriers to be on their panel as a provider in their system. This sometimes takes some time however but this is the way we expand our services to more clients.
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Do I need a referral or Prior Authorization?

Most insurances do not require a referral but if you have a plan that requires one, please contact your physician and have them fax the referral preferably 2 days prior to the scan to 541-302-6565 for a breast evaluation or menopausal evaluation. Tri-Care and some Medicare PPO Plans require a prior authorization. Pacific Source requires a prior authorization for the scan but not for the office visit. If there is a question as to whether you require one, it is better that you call your representative and find out so the insurance company will pay for your office visit portion. The scan part and what is paid or not paid is quite variable
Reasons for the visit might include: dense fibrocystic breasts in women under the age of 50 where mammograms are not effective, strong family history of breast cancer, cancer survivors, pregnancy/ nursing or sensitive to radiation.
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Is breast thermography safe, even for pregnant or nursing women?

Yes, Infrared is non-invasive, does not use radiation, does not compress the breast and poses absolutely no harm to the woman whatsoever.
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Is Digital Infrared Imaging an approved procedure?

Yes, DII is approved by the FDA for use as an adjunctive breast cancer screening procedure since 1982. This was published in the Federal Register: Vol.147, No.20, pp.4419-4420, Jan.29,1982
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Does Digital Infrared Imaging replace mammograms?

No, DII and mammography are tests based on two completely different principles. They complement each other. The consensus among health care experts is that no one procedure or method of imaging is solely adequate for breast cancer screening. The false negative and positive rates for mammography are too high for the procedure to be used alone.DII can pick up many of the cancers missed by mammography. It is DII's unique ability to monitor the abnormal temperature (physiological) changes produced by diseased breast tissue that allows for extremely early detection.
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What Are the Advantages of Thermographic Imaging?

Thermography is the earliest method of breast pathology detection known. It is the best Risk Detection Tool available to modern medicine. It can identify changes in local physiology and blood flow before other clinical examinations or screening tests are able to detect a problem. Unlike mammography, accuracy of the test is not compromised by the denser breast tissue in women under 50 years old. Compared with X-Rays, CT scans, ultrasound and MRIs, digital infrared is unique in its ability to show physiological, thermal and metabolic changes. Infrared imaging is also very cost-effective in comparison to these other screening and diagnostic tools.
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Can Breast Thermography Diagnose Breast Cancer?

No. Like mammograms, it is a screening test. More specific diagnostic tests such as ultrasound, MRI or biopsy are needed to diagnose and stage breast cancer. Biopsy is the definitive way to diagnose cells as being cancerous.
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Can Thermography Be Used for Other Conditions?

Yes, there are a number of conditions where thermography has proven to be a useful to detect thermal signals that act as markers for the possibility of an underlying problem. Only a patient's doctor can render a diagnosis based on all the available examinations and tests. These conditions which include local pain conditions may be evaluated by thermography to give your physician added information:
� Arthritis
� Tendinitis and tenosynovitis
� Neurological conditions
� Atherosclerotic heart disease
� Carotid issues
� Deep vein thrombosis
� Vasculitis
� Raynaud’s disease.
� Thyroid issues
We can also do whole-body thermography to screen for circulatory and other physiological changes. Finally, licensed acupuncturists can use thermography to detect slight temperature variations which reflect disturbances in the flow of Qi and blood, which can result in pain and dysfunction. Concrete evidence that acupuncture therapy actually restores blood flow and normalizes disrupted temperature patterns has been evaluated by thermographic studies.
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I have heard that there is a new and better type of thermography, is this true?

There are always new health care technologies on the horizon, many turn out to be helpful while some are detrimental. We as clinical thermographers are always watching for ways to improve patient care through this technology. Unfortunately, there are emerging thermal imaging procedures that cause concern amongst professionals in this field. Some of these "new" types of thermography are just a renaming of what we currently do, or worse, resurrections of limited outdated technology. A few new thermal imaging technologies cause us concern due to their aggressive marketing of unproven procedures and, in some instances, omitting important diagnostic surface areas of the body from the images. Please be careful regarding these "new" thermal imaging procedures. Large scale studies will be necessary to change the proven and accepted standardized procedures that clinical thermographers currently use.
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What other centers perform Digital Infrared Imaging?

Because of the special training, technical expertise, and unique clinical environmental needs necessary to perform DII, many centers do not have this technology as of yet. Currently, independent digital infrared imaging centers and highly specialized independent breast clinics are the most common place to find this technology. They are also more available and connected to medical schools and research facilities.
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Why haven’t I heard of Digital Infrared Imaging before?

Due to a poorly constructed and performed (with regards to Breast Thermography) research study back in the 1970’s, DII was placed in a "further study needed" and "no improvement over mammography" category. Along with this study, health care politics and insurance cost-containment issues caused interest in this technology to be put on hold. However, with the combination of a multitude of large-scale studies performed in the 80’s and 90’s, and recent advances in technology, DII has become one of the most important front-line procedures in early breast cancer detection and risk detection.
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How can I find a Digital Infrared Imaging lab in my area?

You will find an up-to-date list of nationally, and internationally qualified breast thermography centers here: Qualified Centers.
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