Page 2 - Thermography Medical Imaging of Acadiana

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What happens during a breast thermography exam?
The whole exam takes place in a private imaging lab. You will not be directly touched by the clinician. The only discomfort from the exam may be chilliness, as the room has to be kept at a specific cool temperature for the pictures to be accurate. The clinician will instruct you to disrobe from the waist up. You will be asked to sit with your hands on your hips (hands not touching your breasts) for about 15 minutes, while your upper body cools. You breast images will then be quickly taken with your hands on your head and turning in different directions as instructed.
Thermography: Safer and Earlier Detection of Breast Cancer
AUTHOR Annette Chlumsky, RN

Thermography has been a controversial detection tool for breast cancer for quite some time. It has been used since the 1960s; however, the cameras back then were not very sensitive and therefore not as reliable as they are now.
Thermography in 2016 has a vastly improved heat-sensing scanner technology using highly sophisticated infrared cameras that make over seventy-six thousand digital measurements with each image. In addition, the field of thermography has developed an extensive scientific clinical research data bank of over 800 published research papers, that includes the testing of more than 300,000 women. This has helped the field of thermography to gain ground among more progressive practitioners.

Even though there is reliable technology existing today, there is limited awareness and insufficient education. This has resulted in the underuse of thermography in clinical practice. In 1981 the FDA listed breast thermography as an adjunctive diagnostic procedure for breast cancer and reaffirmed this position in 1998. The National Cancer Institute lists breast thermography as a diagnostic procedure for breast cancer detection and described it as “probably the earliest indicator for breast cancer.”

Breast thermography measures differences in infrared heat emission from normal breast tissue, benign breast abnormalities (such as fibrocystic disease, cysts, infections and benign tumors) and breast cancer. It does this with a high degree of sensitivity and accuracy. It is a non-invasive measurement of the physiology (function) of the breast tissue, rather than the anatomy (structure) which other imaging such mammography, sonograms, and MRIs may identify.

Tumor tissue does not have an intact sympathetic nervous system and therefore it cannot regulate heat loss. When the breast is cooled in a room kept at 68 degrees Fahrenheit, blood vessels of normal tissue respond by constricting to conserve heat while tumor tissue remains hot. Thus, tumors emit more heat than their surrounding tissues and are usually more easily detected. As the disease progresses, cancerous tissues stay hot, they do not cool down. In contrast, other conditions such as fibrocystic breasts, infections, inflammation disorders cool down as they resolve.
Breast thermograms find highly specific thermal patterns in each individual woman. They provide a unique “thermal signature” that remains constant over years unless there is a change in an underlying condition. For this reason it is important to have a benchmark early in a woman’s life, beginning at age 25. Then, over time it is possible to differentiate between cancer and benign conditions.

Most breast cancers do not become palpable until they are larger than one centimeter and often by that time 25% have already metastasized. Thermograms detect changes that precede breast cancer. An asymmetrical increase in temperature is a diagnostic sign. At least five studies published between 1980 and 2003 document that thermal imaging is a major advancement in identifying breast cancers, not only with greater sensitivity and specificity, but also years earlier than with any other scientifically tested medical technology. False-positive results are a criticism of breast thermograms; however, the positive result may actually be a forewarning indication of developing malignancy, warning of tissue changes that precede breast cancer, but cannot yet be picked up on radiological or ultrasound imaging.
Mammography has been the state-of-the-art screening test for several decades. However, considerable controversy remains regarding its value, particularly in women under the age of 50. For younger women, mammography is more likely to miss the  aggressive breast cancers that are typically diagnosed in this age group, especially in women with dense breast tissue who are at a significantly increased risk for developing breast cancer. For women between the ages of 40 and 44, breast cancer is the leading cause of death according to the American Cancer Society. Thermography is more sensitive for recognizing abnormalities in the younger and/or denser breast tissue. Other difficulties in reading mammograms can occur in women who are on hormone replacement therapy, nursing, fibrocystic, large breasted, or with breast implants. These situations are compatible with thermography which is more diagnostically sensitive.

Many women have avoided mammography screenings because of years of accumulating radiation exposure. Thermography provides an alternative screening option for women who may not have agreed to a screening mammogram. Breast thermography involves no radiation exposure or breast compression, is as easy to do as standing in front of the infrared camera, and is affordable.

Generally accepted breast cancer risk factors for which screening is particularly important are:
• having started your first period before age 12
• having gone through menopause after age 50                                     
• having your first child after age 30 or never pregnant
• on hormone replacement therapy or birth control pills
• consuming one or more alcoholic drinks per day
• having a family history of breast cancer
• having the inherited breast cancer gene
• postmenopausal
• postmenopausal weight gain
• sedentary lifestyles
• elevated insulin levels and type 2 diabetes.

Source: https://riordanclinic.org/2016/10/thermography-safer-earlier-detection-breast-cancer/?gclid=Cj0KCQiAkZKNBhDiARIsAPsk0WjnYXjdg5wwfHClb9YnW4mvAGZJ_PtoyxTe3Czk6UkzPRX-tnpw5twaAsNeEALw_wcB
Breast thermography, or thermal imaging, is a noninvasive and painless test that doctors sometimes use to monitor for early breast changes that could indicate breast cancer. It works by detecting increases in temperature.

Thermography does not involve radiation. Instead, it uses an ultra-sensitive camera to produce high-resolution, infrared photographs, or heat images, of the breast. Thermography first appeared in the 1960s, but it has struggled to gain ground as a diagnostic tool for breast cancer due to concerns about poor sensitivity and inaccurate results. The authors of a 2018 study noted that the sensitivity of infrared imaging technology had improved drastically in recent years. They concluded that it may show promise for the future but that, for now, people should only use it alongside other screening methods. Health authorities, including the Food and Drug Administration (FDA)Trusted Source, have issued similar recommendations.

Thermography uses digital infrared imaging to detect subtle changes in the breast by revealing areas of heat and cold. In the body, areas of high or fast blood flow will show on a thermograph as being warmer than other areas. When a tumor develops, cancer cells grow, and these cells need additional blood to reproduce.
When blood flow increases for this purpose, the skin in that area will become warmer. A tumor will, therefore, appear as a hot spot in thermography images. According to the American College of Clinical Thermology, thermography can detect changes that may indicate various conditions, such as:
  • cancer
  • fibrocystic disease
  • an infection
  • vascular disease
The test cannot confirm that cancer is present. It can only show that there are changes that may need further investigation.

However, the FDA do not recommend Trusted Source using thermography without another screening method.
They stress that “thermography is not an effective alternative to mammography and should not be used in place of mammography for breast cancer screening or diagnosis.”

What to expect
Thermography should always take place in a doctor’s office or another healthcare setting.
It will involve the following:
  • The person will stand about 6–8 feet away from the camera.
  • They will have a painless, noninvasive test that does not involve compressing the breast.
  • The procedure will last approximately 15 minutes.

The practitioner will look for clear differences between the breasts. For this reason, thermography might not be suitable for a person who has undergone a mastectomy or other breast surgery. Anyone who opts for thermography should ask a doctor to recommend a provider and also attend mammogram screening as the doctor recommends.

What thermographs detect:
  • A thermograph will not detect a lump, but it will show changes in body and skin temperature, which may be a sign of increased metabolic activity or blood flow in one particular area.
  • These changes happen as the cancer cells strive to maintain themselves and grow.
  • If the results show something unusual, this may not necessarily be cancer. The cause could be mastitis, a benign tumor, fibrocystic breast disease, or another issue.

Follow-up tests
If the thermography detects any abnormalities, the person should seek further screening, which may include a mammogram. If a mammogram confirms that a lump is present, the doctor may recommend an ultrasound or MRI scan and a biopsy.

Only a biopsy can confirm whether cancer is present.

Benefits
As a screening option for breast cancer, thermography offers the following benefits:
  • It is not painful.
  • It is not invasive.
  • It does not involve radiation.
Source: Medical News Today
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