Is breast thermography safe?
Yes. Thermography is FDA approved in the US and has been used in Europe and in many countries around the world for over 30 years. Thermography is a non-invasive test, which means nothing is sent into your body. Images that are created by this technology are simply measurements of the heat that naturally radiates from your body. There is no contact of any kind, nor is there any pain or radiation.
Can breast thermography diagnose breast cancer?
Thermography cannot, and does not, diagnose breast cancer. This is also true for anatomical tests, such as mammograms, ultrasounds, and magnetic resonance imaging. Such tests provide information on the different aspects of the disease process and identify the need for further investigations. A biopsy of the breast and accompanying histological evaluation is the only definitive diagnostic test for breast cancer. Many of our patients come in after an equivocal “lets watch this area” mammography, and correlate the area to be monitored with a thermographic image of the same area. If the thermography findings appear high risk with the same area of interest, the patient will have more information with which to make an informed decision.
Does OHIP or Medicare cover breast thermography?
No. However, many private insurance companies cover the cost of this examination.
Have any studies been done regarding the accuracy of thermography?
Absolutely! Hundreds of studies have been written up in peer-reviewed medical journals over the years. For a list of these studies, please go to our Studies Section http://www.thermographyclinic.com/study-index
Do I need a referral from my family doctor?
No. A referral is not necessary.
How long does a thermography scan take?
This procedure, including time to acclimate in the room, takes 30 minutes.
How often would I need to repeat this procedure?
This depends on your initial findings. With low risk findings, and depending on your age and general level of health, we will recommend annual or bi-annual screening. If your findings fall into the higher risk category, you will be asked to repeat this examination in 6 or 9 months to compare to the baseline. Because the thermogram of a healthy woman remains remarkably constant, serial thermograms can assess tissue changes over time. A healthy initial thermogram can, therefore, serve as a baseline to compare future thermograms against.
What happens if you find something suspicious?
We will ask you to escalate to structural tests to make sure that nothing is being missed at that time. In the event that your other tests come back with negative results we will continue to monitor you with greater frequency (please see the answer above) to make sure that there are no changes compared to your baseline images. We will also advise you to look at some of the risk factors that may be elevating your rating. These may include hormonal issues, diet, nutritional disturbances, endocrine disorders, and lifestyle modifications, just to name a few.
Does thermography replace mammography?
No. Thermography is not a stand-alone diagnostic test when it comes to breast cancer. Thermography differs from mammography in that it provides information on the biological activity of the breast versus the gross internal anatomy. Infrared imaging is a functional test, whereas mammography is a structural test. We recommend that, when necessary, thermography be used in conjunction with other structural examinations (mammography, ultrasound, or MRI) for the most comprehensive screening and the earliest possible detection of malignancy.
I have breast implants, is it safe to use thermography?
Yes. Breast thermography is painless and safe, using no radiation or compression. It can be used effectively and safely for all women, including pregnant or nursing women, women with dense breast tissue, women with fibrocystic condition, and women with breast implants.
Why do we have you plunge your hands in to chilled water?
(Cold challenge test)
During your thermography test, you will be asked to plunge your hands into 10C water for 60 seconds. Your thermography technician will then repeat the process of imaging, providing before (baseline) and after (functional) images. Under normal, healthy conditions, your blood vessels will constrict, which a normal physiological response. However, high-risk areas will not respond to this challenge at the same rate as the healthy surrounding tissue. The cold challenge test provides us with additional information that aids in our comprehensive analysis of your images. Thermography is a test of physiology that measures physiological response (dynamic testing vs. static testing), thus a cold challenge test provides us with additional physiological assessment. Breast thermography clinics that do not perform a cold challenge test are making a grave mistake and doing a disservice to their clients by not following international standards and, in effect, performing only half the test.
Please note, if you have Raynaud’s or any other condition that would prevent you from taking the cold challenge test during your thermography session, please inform your thermography technician, who will provide you with an alternative protocol that will not affect your condition.
How come thermography is not embraced by mainstream medicine?
As a stand-alone test, thermography has been criticized for its high rate of false negative and false positive results. Historically, infrared cameras lacked the sensitivity to detect subtle temperature changes necessary to identify and monitor disease. Since the 1990’s, major advancements in infrared technology, coupled with sophisticated computerized software programs, have resulted in a significant increase in the accuracy of thermal images. For example, a 4-year clinical trial by Parisky and colleagues demonstrated 97% sensitivity in the detection of breast cancer with the use of dynamic, computerized, thermal imaging. In another recent trial, modern digital thermography was also able to detect 97% of biopsy-confirmed breast malignancies.
The high incidence of ‘false’ positive results documented with thermography can often be a reflection of breast abnormalities that are not yet palpable through breast examination or detectable through mammograms. Early research assessing approximately 58,000 women has shown that a significant percentage (>30%) of abnormal thermograms, in the absence of any other breast abnormalities, eventually manifest at a later stage as cancer.
Because thermography cannot provide information on the exact anatomic detail of the breast or define a specific area that needs to be biopsied, it needs to be combined with an anatomical test, such as mammography. As a functional test, thermography cannot identify the specific cause of physiological changes to breast tissue. For this reason, it serves as a risk marker and complementary modality, rather than a stand-alone assessment tool.
Thermography is not a competitor to, or a replacement for, mammography. Rather it is an adjunctive tool that can identify areas of abnormal thermal symmetry, which are often associated with underlying pathology. When functional abnormalities are detected early, there is an opportunity for early intervention. Cure rates for breast cancer are thought to be as high as 95% when detected in the earliest stages. When combined with other anatomical procedures, thermography may contribute to the best possible evaluation of breast health.
What are the main benefits of thermography?
One of the key benefits of thermography is its effectiveness in women with dense breasts, making it suitable for:
- Younger women – approximately 18% of breast cancers are diagnosed in women during their forties. Women who develop breast cancer at a younger age tend to have more rapidly growing cancers that are more likely to metastasize (spread throughout the body).
- Women taking hormone therapy – results from the Women’s Health Initiative trial revealed a significant increase in invasive breast cancer in women taking synthetic hormone replacement therapy. Serial thermograms can also help monitor the effects of hormone treatment for fibrocystic breasts.
- Women with fibrocystic changes – fibrous breasts are very dense and can mask early cancers, particularly if no micro calcifications are present. Research has shown that approximately 40% of women with fibrocystic disease and an abnormal thermogram develop breast cancer within five years. Conversely, women with fibrocystic disease and a normal thermogram have a less than 3% likelihood of developing breast cancer.
Thermography can also provide early warnings of breast abnormalities and highlight potentially suspicious cases, particularly when mammographic and clinical exams are equivocal or non-specific.
- Thermography as an independent risk marker – An estimated 60-70% of women diagnosed with breast cancer have none of the obvious risk factors. For this reason, breast cancer has been considered an equal opportunity killer. According to a number of researchers, a persistent abnormal thermogram is thought to be “the single greatest indicator of breast cancer risk” and is considered 10 times more important than a positive family history for the disease. Because physiological changes over time are known to precede morphological changes, an abnormal thermogram can often be the first warning sign of an increased risk for breast cancer.
- The value of thermography as a complementary tool – An increase in the detection rate of breast cancer has been demonstrated in a number of peer- reviewed studies with the combined use of clinical breast examination, mammography, and thermography. In one study using high-resolution thermography, an abnormal thermogram, coupled with a positive mammogram and clinical breast exam, was associated with a 98% sensitivity rate for breast cancer detection. Results from a recent 2010 trial showed an 89% sensitivity rate for the detection of breast cancer in women under 50 when thermal imaging and mammography were combined.
The increase in sensitivity relates to the fact that mammography and thermography do not always identify the same lesion. For example, Gamagami’s research revealed that thermography is able to detect changes in breast temperature and vascularity in 86% of non-palpable breast cancers. This research also concluded that thermal imaging was able to detect 15% of cancers not visible through mammographic assessment. Based on the extensive research by Gautherie and Gros, approximately 10% of breast cancers can be detected at an earlier stage with the combined use of thermal imaging.