Understanding Thermography
What is Breast Thermography?
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.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.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 utilizing 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 patient's 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.
Breast Screening Procedure
This procedure is totally painless and there is no compression or contact with the body. The test is non invasive, uses no radiation, and is F.D.A approved.
This quick and easy test starts with your medical history being taken before you partially disrobe for the scanning to be performed. This first session provides the baseline of your “thermal signature”.
A subsequent session assures that the patterns remain unchanged.
All of your thermograms (breast images) should be kept on record and once your stable thermal pattern has been established any changes can be detected during your routine annual studies.
Thermography offers the opportunity of earlier detection of breast disease than has been possible with breast self examination, doctor examination or mammography alone.
Breast thermography is a non invasive test. This means there is no contact with the body of any kind, no radiation and the procedure is painless.
Thermography detects 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 until other standard testing is positive. This allows for the earliest possible treatment.
Regular breast thermography screening can provide an early alert for possible referral to mammography, sonography, or MRI to improve early detection by your doctor.
It takes years for a tumor to grow, and the earliest possible indication of abnormality is needed to allow for the earliest possible treatment and intervention.
This patient was age 37 when her first baseline thermogram showed a slight hyperthermic asymmetry in the upper right breast. The follow-up study showed the pattern had become more well defined and although clinical correlation did not find anything remarkable it was decided to repeat the exam again in a further 3 months, when again significant changes were seen. Mammography was performed at this stage with the thermographic guidance of the locally suspicious area at 1 O’clock to the right nipple. The mammographic findings were inconclusive and the patient was referred for a repeat mammogram in 12 months. Thermographic monitoring was continued and at the fifth comparative study at 12 months significant changes were still evident and the hyperthermic asymmetry (temperature differentials) had increased.
Immediate further investigation was strongly recommended despite a scheduled mammogram in 6 months, and at the patients insistence a repeat mammogram was performed which clearly showed a small calcification (1 mm) at 1 O’clock. Within one week a lumpectomy had been performed with good margins and the pathology confirmed as a malignant carcinoma (DCIS).
This patient has now had stable thermograms for the last 2 years and is expected to remain healthy.
Baseline
3 Months
6 Months
9 Months
12 Months
NormalGood thermal symmetry with no suspicious vascular patterns or significant thermal findings.
Fibrocystic ChangesThe 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 TumorThis is the specific area of a small DCIS. We can see the vascular feed and the discreet area of hyperhermia that is displacing the surrounding hypothermia.
Inflammatory Breast CancerThe results of this routine study led to the diagnosis of inflammatory carcinoma in the right breast. There were no clinical indications at this stage. (Thermography can show significant indicators several months before any of the clinical signs of inflammatory breast disease, skin discoloration, swelling and pain). Inflammatory breast disease cannot be detected by mammography and is most commonly seen in younger women, the prognosis is always poor. Early detection provides the best hope of survival.
Ductal Carcinoma in SituThis 37 year old patient presented for routine thermographic breast screening, she was not in a high risk category and had no family history. No breast exams had been performed previously. The vascular asymmetry in the upper left breast and the local hypothermia at 11 O’clock was particularly suspicious and subsequent clinical investigation indicated a palpable mass at the position indicated. A biopsy was performed and a DCIS of 2 cm was diagnosed. Unfortunately this patient only survived for 12 months after diagnosis.
Male Breast CancerOne per cent of breast cancers are found in men. The survival rate is much lower than in women as most breast cancers in men are only detected in advanced stages.
This tumor was palpable at the time of imaging, there is a well established vascular feed which has even caused increased blood flow at the left brachial plexus and there is also drainage toward the sternum that extends to below the left breast.
Baseline
3 Month Follow-up
This patient's thermograms have remained stable for two years. These patterns are like a thermal fingerprint which will only change if pathology develops.
First Annual
Second Annual
Why is thermal imaging useful for breast imaging?
Digital Infrared Thermal Imaging (DITI) offers the opportunity of earlier detection of breast disease than has been possible with breast self-examination, physician palpation or mammography alone.
Each individual has her own thermal pattern (normally symmetric) that is accurate and static throughout her lifetime. Any changes to her normal “thermal fingerprint” caused by early cell changes (pathology) will become increasingly apparent. Monitoring changes over periods of time with DITI is the most efficient means of identifying subjects who require further investigation.
DITI is a non-invasive test. There is no contact with the body of any kind, no radiation and the procedure is painless. The scanning system merely detects and records the infrared radiation that is emitting from the patient’s body.
Utilizing sophisticated infrared technology and innovative computer software, thermal imaging technicians simply capture a digitized image of the breast in the form of an infrared thermogram, or heat picture.
How accurate is thermal imaging for the detection of breast cancer?
Canadian researchers recently confirmed 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. The 84% sensitivity rate of mammography alone was increased to 95% when infrared imaging was added.
Is a thermal scan different than a mammogram or ultrasound?
Yes. Unlike mammography and ultrasound, Digital Infrared Thermal Imaging (DITI) is a test of physiology. It detects and records the infrared heat radiating from the surface of the body. It can help in early detection and monitoring of abnormal physiology and the establishment of risk factors for the development or existence of cancer.
Mammography and ultrasound are tests of anatomy. They look at structure. When a tumor has grown to a size that is large enough and dense enough to block an x-ray beam (mammography) or sound wave (ultrasound), it produces an image that can be detected by a trained radiologist.
Neither mammogram, ultrasound, nor DITI can diagnose cancer. Only a biopsy can diagnose cancer. But, when DITI, mammograms, ultrasounds, and clinical exams are used together, the best possible evaluation of breast health can be made.
Is thermal imaging a replacement for mammograms or ultrasounds?
No. While some women make a personal choice to use thermal imaging instead of mammography for breast screening, other women who cannot use mammography for a number of reasons can use thermography instead of mammography. Most women use thermal imaging in addition to mammography and/or ultrasound.
We believe that (DITI) should be viewed as a complementary, not competitive, tool to mammography and ultrasound. DITI has the ability to identify patients at the highest level of risk and actually increase the effective usage of mammograms and ultrasounds. Research confirms that DITI, when used with mammography, can improve the sensitivity of breast cancer detection.
The ultimate choice should be made on an individual basis with regard to clinical history, personal circumstances and medical advice.
Other FAQ's
Is there any harmful radiation in a thermal scan?
No. DITI detects and records the infrared heat radiating from the surface of the body. There is no contact with the body or harmful radiation.
Does it hurt to have a scan taken?
No. There is no contact with the body or painful breast compression.
Who should have a thermal scan?
Any adult can have a thermal breast scan. This test is designed to improve chances for detecting fast growing tumors in the intervals between mammographic screenings or when mammography is not indicated by screening guidelines for women under 50.
DITI is especially appropriate for younger women under 50 years whose denser breast tissue makes it more difficult for mammography to pick up suspicious lesions. This test can provide a ‘clinical marker’ to the doctor or mammographer, indicating that a specific area of the breast needs closer examination.
Breast cancers tend to grow significantly faster in younger women (under 50 years). The average tumor doubling time for women under 50 is 80 days compared to 157 days for women between 50 – 70 years. Secondly, the faster a malignant tumor grows, the more infrared radiation it generates. Therefore, for younger women in particular, results from DITI screening can lead to earlier detection.
All women can benefit from breast thermography screening. However, it is especially appropriate for younger women (30 - 50) whose denser breast tissue makes it more difficult for mammography to be effective. Also for women of all ages who, for many reasons, are unable to undergo routine mammography. This test can provide a 'clinical marker' to the doctor or mammographer that a specific area of the breast needs particularly close examination. It takes years for a tumor to grow thus the earliest possible indication of abnormality is needed to allow for the earliest possible treatment and intervention. Thermography's role in monitoring breast health is to help in early detection and monitoring of abnormal physiology. The faster a malignant tumor grows, the more Infrared radiation it generates. For younger women in particular, results from thermography screening can lead to earlier detection and, ultimately, longer life. Doctors do not yet know how to prevent breast cancer. However you can increase your chances of detecting breast cancer in its earliest stages by understanding the need for, and participating in an early detection program. Only about 20 percent of biopsied breast lumps are cancerous. And, if cancer is found early, there are choices for treatment. With prompt treatment, the outlook is good. In fact, most women treated for early breast cancer will be free from breast cancer for the rest of their lives.
Breast cancers tend to grow significantly faster in younger women under 50 / Source: Cancer 71:3547-3551, 1993
All women can benefit from breast thermography screening. However, it is especially appropriate for younger women (30 - 50) whose denser breast tissue makes it more difficult for mammography to be effective. Also for women of all ages who, for many reasons, are unable to undergo routine mammography. This test can provide a 'clinical marker' to the doctor or mammographer that a specific area of the breast needs particularly close examination. It takes years for a tumor to grow thus the earliest possible indication of abnormality is needed to allow for the earliest possible treatment and intervention. Thermography's role in monitoring breast health is to help in early detection and monitoring of abnormal physiology. The faster a malignant tumor grows, the more Infrared radiation it generates. For younger women in particular, results from thermography screening can lead to earlier detection and, ultimately, longer life. Doctors do not yet know how to prevent breast cancer. However you can increase your chances of detecting breast cancer in its earliest stages by understanding the need for, and participating in an early detection program. Only about 20 percent of biopsied breast lumps are cancerous. And, if cancer is found early, there are choices for treatment. With prompt treatment, the outlook is good. In fact, most women treated for early breast cancer will be free from breast cancer for the rest of their lives.
Breast cancers tend to grow significantly faster in younger women under 50 / Source: Cancer 71:3547-3551, 1993
If I have a suspicious mammogram or find a lump in a breast, should I have a thermogram?
Yes. The information provided by a thermography study can contribute useful additional information which ultimately helps your doctor with case management decisions. It is also important to establish a baseline for future comparison in order to monitor changes and the progress of any treatment.
Age | Average Tumor Doubling Time |
Under 50 | 80 Days |
50-70 | 157 Days |
Over 70 | 188 Days |
How often should I have a thermal scan?
Once a reliable baseline has been established, which normally requires two studies 3-months apart, you should have an on-going annual comparative study to detect any suspicious functional (physiological) changes, warranting further investigation. Depending on your personal history and risk for breast disease, your doctor can advise how often you should have a thermal scan repeated.
Have clinical tests been done on thermal imaging?
Yes! Over 800 peer-reviewed studies on breast thermography exist in the index medicus literature. In this database, well over 300,000 women have been included as study participants. The numbers of participants in many studies are very large (10,000, 37,000, 60,000, 85,000, etc.) Some of these studies have followed patients for up to 12 years.
These clinical trials have demonstrated that breast thermography:
- Detects the first signs of a cancer up to 10 years before any other procedure can detect it.
- Significantly augments the long-term survival rates of its recipients by as much as 61%
- When used as part of a multimodal approach (clinical examination + mammography + thermography), will detect 95% of early stage cancers
If breast thermography is so great, why isn't it more readily available and widely used?
When thermography was first explored for breast imaging, it was viewed as competitive to mammograms. It was tested and evaluated to see if it was safer and more diagnostically accurate than mammography. These comparisons should not have been made, as you can not compare tests of physiology and anatomy.
In particular, when thermography was tested on younger women, thermographic abnormalities were detected many times but mammograms did not detect any tumors. The results were considered “false positives”. The more patients of younger age screened with the so-called false positive, the more suspicion was placed on thermography. Years later, in re-call studies, a large percentage of these women had developed breast cancer or other breast disease, in the exact location of the abnormal “false-positive” thermogram, thus validating its early warning role. Thermography’s only “error” was that it was too accurate too early and the results couldn’t be corroborated at the time.
Secondly, thermography was being used in sports medicine, dentisty, podiatry, chiropractic, orthopedics rheumatology, and neurology in a variety of support or adjunctive diagnostic roles. It was soon realized that thermography could clearly, objectively, and easily demonstrate the physiological component of pain and injury, especially to the spinal column, due to car accidents, job injuries, and a host of other “tort” related law suits. Everyone involved had benefited from these positive test findings, which could be clearly shown to a jury. Everyone that is except the defendant insurance industry.
Needless to say, the insurance industry in the United States placed an all-out effort to diminish the value of thermography in courts of law due to high litigation costs. Eventually, lobbying efforts at the AMA’s House of Delegates and at Medicare, brought about the removal of thermographic coverage by most insurance companies and the greatly reduced utilization of thermography in the United States. This was most unfortunate for the patients who could clearly benefit from thermal imaging.
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