CAN THERMOGRAPHY REPLACE OTHER DIAGNOSTIC TESTS?
Thermography should not be expected to replace physical exams or other diagnostic tests. In fact, rather than expecting a list of “diagnoses,” the report should prompt three questions:
1. Which of the above processes (inflammation, vascularity, neurologic dysfunction, or lymphatic congestion) might explain the findings?
2. What if anything needs to be investigated further or confirmed?
3. What strategies might best address the physiology involved?
HOW THE TEST WILL FEEL
The test takes place in a relaxed, peaceful & private room. The room air may feel cool as we adjust to room temperature before scanning but you will be lightly robed during the cooling process (about ten minutes). During the examination you will disrobe from the waist up for both imaging and to allow for the surface temperature of the body to acclimate with the room.
A female technician will take your images. Obtaining a thermographic image is like having your picture taken. There is no direct contact between you and the camera. There is no radiation, no injection, nothing to drink. The procedure is totally non- invasive and the camera does not emit radiation of any kind.
Unlike other parts of the body, thermography of the breast is a test of PHYSIOLOGY. It does not necessarily reveal anatomy or structure as it only reads the infra-red heat radiating from the surface of the body. Mammography, on the other hand, only shows ANATOMY. It looks at structure. When a tumor has grown to a size that is large enough and dense enough to block an x-ray beam, it produces an image that should be detected by a trained radiologist. By that time, the disease process has been present for many years.
Because pre-cancerous and cancerous masses are highly metabolic tissues, they need an abundant supply of nutrients to maintain their growth. As a result unhealthy tissue and the surrounding area is almost always hotter than normal breast tissue and results in an increase in regional surface temperatures of the breast detected by an infrared camera. By carefully examining changes in the temperature and blood vessel patterns, signs of possible breast cancer or pre-cancerous cell growth may be detected up to 10 years prior to being discovered using any other procedure. We now come to an important point. NEITHER thermography nor mammography alone or in combination diagnose breast cancer. They are both diagnostic tests that reveal different aspects of the disease process, which then guide further exploration. A biopsy must be performed to identify if the tissue is atypical or cancerous.
Thermograms also often help differentiate between cysts and tumors. For this reason thermography is useful in younger women, those for whom mammography would not be as effective. Thermography can also be used to monitor the results of treatment for suspicious lesions and cancer. Finally, breast thermograms show hormonal effects of excessive estrogen (hormone creams and pills).
DOES A THERMOGRAM REPLACE A MAMMOGRAM?
The thermographic procedure is not a stand-alone diagnostic tool, but an adjunct to be used with other clinical or diagnostic findings. The medical community investigated breast thermography quite extensively during the late 1970’s and early 1980’s. The FDA approved the procedure as an adjunctive tool in breast cancer screening, and many physicians, concerned about the radiation exposure of mammography, began to promote thermography as a replacement for mammography. This was an error. Thermography only provides a physiologic marker that some abnormality is present in the breast. Nothing more and nothing less. This is however, an extremely valuable and important finding, but it has historically been the interpretation of these findings that has been the problem, and is now the subject of the “responsible second look.”
Unfortunately, thermography is often viewed as a competitor to mammography, a role for which it was never intended. Breast thermography is complimentary to mammography and an adjunctive tool in detecting breast cancer. The proper role for Thermal Imaging is to use it to assess risk of breast pathology. Using this perspective, there are a large number of studies published demonstrating the clinical utility and reliability of thermography.
How often should a breast thermogram be done? How often to have a thermogram has not been determined. Most experts have suggested every 6-12 months for comparison. Since thermograms have shown early disease development as much as 10 years before a mass has been detected on a mammogram, at about age 20-25 a baseline exam should be done. For high-risk women, sooner.
The appropriate follow-up diagnostic and clinical testing may include x- ray mammography, ultrasound or other imaging tests, laboratory tests, nutritional and lifestyle evaluation and training in breast self examination. Of course, you must address any contributing factors such inflammation, hormones, lymphatic congestion, etc.
Numerous studies demonstrate that patients initially considered “false positive” on thermography (positive thermograms and negative mammograms) were determined by long term follow-up to have developed breast cancer in exactly the location thermography had demonstrated abnormal findings 5-10 years earlier. Thermography’s only error is that it is vascular changes show up too early to be detected by other diagnostic equipment. This is both exciting and frustrating for the clinician and the patient. A suspicious or abnormal thermogram gives the opportunity to intervene long before the cancer expands, invades or metastasizes. If there is no mass on mammogram, then the suspicion of cancer must be addressed in an aggressive pro- active fashion. On the other hand, it is frustrating to uneducated clinicians and patients, and poses quite a dilemma for those with a “wait and see” attitude. Sequential thermograms enable the physician-patient team to determine if the lifestyle modifications and therapy are effective in changing the breast physiology towards preventing not only cancer but all breast disease.
We are relying less on the quantitative temperature values and more on patterns and symmetry to provide greater insight into the health of your breasts and related tissues. For example, dental bone health, lymphatic congestion, vertebral nerve conductivity may directly influence breast health. As a result we no longer recommend limiting your images to the images to the breasts alone, but now include comments about your jaw and maxilla, neck (supraclavicular region), axilla (armpits), diaphragm, gall-bladder, spine, etc. which all greatly influence not only your breast tissues but may provide direction on effective management.