What Is Thermography?
Advanced digital infrared technology (thermography) is an FDA approved imaging technique that is used to evaluate breast health. It measures heat emitted by tissue cells that are excessively metabolically active and exhibit other variant behaviors characteristic of abnormal (cancerous or pre-cancerous) cells. Suspicious clusters of cells begin to generate blood vessels and follow growth patterns that are unique from surrounding healthy tissue – characteristics that generate more heat and can be detected by advanced digital infrared equipment.
What are The Benefits of Breast Thermography?
Thermography is a safe, non-invasive and painless procedure that does not expose the individual to any radiation. There are no adverse effects or contraindications, and it can be used at any age, but is most appropriate for women age 18+.
There are many benefits in using thermography to evaluate breast health:
- For some individuals, it can be used as an alternative to more invasive procedures (such as mammography and ultrasound). If there is an area of concern, it can be closely monitored with thermography while the patient makes some lifestyle, dietary and nutritional modifications – as appropriate and as directed by their naturopathic doctor or integrative medical doctor. Not only does this method avoid or minimize harmful radiation exposure and undue psychological stress, it avoids the additional – and more significant – harms of potential over-diagnosis and over-treatment. Recent evidence from long-term studies evaluating the harms and benefits of routine mammography demands review of current standards of practice in breast cancer screening. Studies reveal that, in most age groups, routine mammography causes more harm than benefit – quite the opposite of long held beliefs of the medical community and public. For more information on the subject of risks associated with routine mammography, read: Routine Mammography Proves No Benefit and May Even Increase Your Risk – What are Your Options?
- If there is an area of particular concern, the patient and the doctor can then discuss further evaluation using structural testing (mammogram, ultrasound). This allows for doctor and patient discuss individualized recommendations breast cancer screening based on the person’s risk factors, thermography evaluation, clinical breast exams and other applicable information – rather than a ‘one size fits all’ approach to breast cancer screening that, again evidence is mounting, causes more harm than benefit. To learn more about the subject of personalized recommendations for breast cancer screening, read: Breast Cancer Screening: A Need for Personalized Recommendations
- Thermography can be used to clarify findings of a mammography report before more invasive – possibly unnecessary – steps are taken, such as a diagnostic mammogram (involving more radiation exposure), ultrasound and/or biopsy. All of these procedures carry additional risk. There is also the significant and often overlooked issue of added psycho-emotional stress for women who are suddenly faced with the possibility of a cancer diagnosis and often have to wait several weeks-to-months before further tests can be performed. This is a common scenario for women with dense breasts (or fibrocystic breasts), breast implants and microcalcifications (tiny deposits of calcium) in breast tissue. Unlike thermography, mammography cannot accurately distinguish microcalcifications from cancerous tissue. If the mammogram reveals microcalcifications, the next step is often ultrasound and diagnostic mammogram, possibly followed by biopsy. Often the end result is “negative” on biopsy. The woman has just undergone significant stress, trauma and disproportionate concern over an inconclusive mammogram report resulting in unnecessary invasive procedures that have now (as a result of stress, radiation and disruption to the delicate environment of the breast tissue) raised the level of risk of developing breast cancer in a woman who did not have that risk in the first place. I have witnessed this exact scenario multiple times in my practice and I cannot emphasize how damaging it is for the woman on a physical, emotional and spiritual level.
- Thermography appears to be superior to mammography at detecting DCIS – the most common form of breast cancer.
- Thermography can often detect changes in breast tissue before a tumor forms and reveals hormonal influences that can contribute to cancer development or recurrence. Mammography can only detect a potential cancer once a sizable tumor (at least 1 cm in diameter, consisting of 1 billion abnormal cells) has actually formed. In addition, mammography is not sensitive to fast-growing tumors in the pre-invasive stage. At this stage, the temperature variance detectable by thermography can provide valuable information for early intervention using non-invasive strategies.
- Thermography can help point patient and physician in the direction of appropriate course of treatment and it can be used to monitor changes in breast tissue. When hormonal influences and unhealthy metabolic or vascular activity is revealed by thermographic evaluation, the individual can discuss intervention options and treatment strategies to reverse the changes and actually help prevent cancer from occurring in the first place. While some women may continue to use the old “I’ll wait-and-see if a mammogram tells me I have cancer and then I’ll have to do something about it” approach, I think if given the option most would choose to take a more empowering and proactive approach to their breast and overall health – and thermography can help facilitate the latter choice.
Can Thermography Diagnose Breast Cancer?
Previous research has looked at the clinical validity of thermography in diagnosing benign or malignant (cancerous) disease. However, even with the advances made in thermography as of today, it is not capable of diagnosing malignancy – its benefit lies in the ability to detect the tissue changes that occur when a woman is at greater risk of malignancy or if malignancy is present. Therefore, I recommend this tool to monitor breast tissue as part of a complete breast health evaluation that also includes hormone testing, nutritional analysis, clinical breast exam and personal as well as genetic health history (i.e. risk factor assessment). When used this way, we can minimize the number of mammograms needed for a given individual (sometimes even avoid them altogether) and thereby help avoid a large percentage of unnecessary imaging and biopsies performed as a result of false positives from mammograms.
Findings published in the CMAJ (Nov 2011), support previous and subsequent evidence that routine screening with mammography does not reduce all-cause mortality (i.e. overall rate of death). Rather, the findings indicate that due to the high rate of false positives yielded by routine mammography, the number of invasive procedures (such as biopsy) occur at a high rate, thereby causing more harm (from overdiagnosis and overtreatment) than benefit. If findings on thermography are alarming – particularly if there is change from the baseline thermogram – further assessment using structural testing (mammogram, ultrasound) should be performed.
Another concern with thermography, is variability in assessment technique and accuracy of information from center to center. It’s important to do your research before choosing a center for thermography evaluation. The evaluator must be a board-certified thermologist and the equipment used should be advanced digital infrared technology. External influences must be controlled to reduce the influence of confounding factors (i.e. room temperature, clothing, pre-exam activities, etc.). Images must be taken from anterior and lateral views. In addition, results are more useful when another set of images are taken after a “cold challenge” is performed. The cold challenge induces a physiological response in normal cells that can further assist the evaluator and physician in distinguishing abnormal tissue activity.
What’s Your Attitude Toward Breast Cancer Prevention?
The decision to use or not use thermography, ultimately depends on your attitude around breast health and cancer prevention. What are your beliefs toward healthy living? How important is health to you? How much do you value quality of life? How long do you wish to live and do you wish to live those years in good health? Are you prepared to make the necessary changes that may be required to preserve your health (mind, body, spirit) and prevent or reverse malignant disease? Do you wish to be empowered with the knowledge that you can take a proactive approach to cancer prevention and treatment or are you of the mindset that you will wait and deal with it if and when the time comes that you are faced with a cancer diagnosis?
The decision to screen for breast cancer and how to go about it is currently a hotly debated topic in medicine. The evidence is clear that what we have traditionally been doing in North America does reduce death from breast cancer (for women aged 40-74) but the benefit is small and partially offset by harms caused by unnecessary intervention. As physicians and as patients, we need to appreciate the need for individualized recommendations and informed decision-making based on risk factors and most importantly, based on a philosophy that respects the patient’s beliefs, attitude and wishes.
With mounting evidence suggesting there is a significant environmental influence on cancer development and progression, breast cancer is largely a preventable disease. There are aspects of environmental, nutritional and genetic influence that are within our control and some aspects that are not. If you empower yourself with the knowledge of what you can do, then at least you can make sure you have done your part. I believe our role as physicians and health care providers is to guide you in this journey and facilitate the path to optimal health – mind, body and spirit.
To learn more about the services we offer, or to book a breast thermography evaluation at our clinic, call (604) 949-0077.
References
- Time To Stop Mammography Screening? CMAJ, November 22, 2011 183:1957-1958
- Recommendations on Screening for Breast Cancer in Average-Risk Women Aged 40-74 Years. CMAJ, November 22, 2011 vol. 183 no. 17doi:10.1503/cmaj.110334
- A Comparative Review of Thermography as a Breast Cancer Screening Technique. Integr Cancer Ther. 2009 Mar;8(1):9-16.
- Advanced Integrated Technique in Breast Cancer Thermography. J Med Eng Technol. 2008 Mar-Apr;32(2):103-14.
- Advanced Technique in Breast Thermography Analysis. Conf Proc IEEE Eng Med Biol Soc. 2005;1:710-3.
- Computerized Detection of Breast Cancer With Artificial Intelligence and Thermograms. J Med Eng Technol. 2002 Jul-Aug;26(4):152-7.
- A Reapprasial of the use of Infrared Thermal Imaging Analysis in Medicine. IEEE Trans Med Imaging. 1998 Dec;17(6):1019-27.
- Statistical Analysis of Healthy and Malignant Breast Thermography. J Med Eng Technol. 2001 Nov-Dec;25(6):253-63.