Thermography – A Non-Radiation Breast Cancer Screening Option

Thermography – Too Early is Never Too Late…

Imagine (client #1) having breast cancer a year ago resulting in surgical removal of the left breast, then finding a “lump” in the remaining right breast, and having to wait a few weeks (which feels like a few years) to get a biopsy to diagnose it? Imagine (client #2) having been told your mammogram was negative but your breast ultrasound showed something, and you were left with a nagging feeling everything wasn’t as clear as it could be? Imagine (client #3) having been diagnosed with breast cancer, having treatment, and then having to “wait and see” for the next five to ten years to determine if your treatment had been successful? These are just a few of the stories being told in Colorado Springs and Denver by women who have benefited from the availability of a non-radiation option for breast screening called thermography.

Thermography involves the use of infrared (IR) thermal imaging

A non-radiation, non-contact (no squishing), accurate, and safe breast screening method. It involves over 30 years of research and development history and has been FDA approved since 1982. Ongoing advances in digital and infrared technology, as well as continued advances in computer technology, have continued to develop the technology, especially over the last 10 years.

Infrared thermography cameras detect heat that is given off by the body and displays it in picture format onto a computer monitor. Scans are then sent to doctors trained and certified to read thermal images, called thermologists, who report on the findings. IR scans are unique to each individual and remain very stable over time, which makes them effective as a screening tool for changes that may occur. An initial scan is taken to determine any possible concern which may suggest abnormal pathology, and need for further clinical evaluation. On-going thermal imaging may then be done to monitor any treatment which may be initiated. Following the initial scan, a three month follow-up scan is done to insure stability of the individual pattern. This second scan serves to establish a baseline to compare subsequent yearly screening results.

From a personal perspective, let’s look closer at actual client situations to understand how thermography is being utilized. The following clients represent a growing body of health conscious women who take primary responsibility for their own health, and who seek collaborative healthcare providers willing to be on their team. They listen, they learn, they question, and they take final responsibility for their treatment and for the outcome.

Client #1 came to Clinical Thermography of Colorado after having heard of a “new” breast screening device which may give her, and her frantic husband, information which could help them wait for her scheduled biopsy appointment. The client was taken to a temperature regulated room, which also controls for external light, She removed her clothing from the waist up behind a privacy screen, put on a gown, and she and her husband sat for 20 minutes discussing her medical history and concerns with the nurse thermographer (person trained to take thermographic images) After her body temperature adjusted to the specified room temperature required for thermal imaging, six scanned images were then taken and immediately reviewed with the client. Colorful images were shown one by one on the screen and discussed. The nurse thertherm_pic4mographer made sure the client understood that the images needed to be interpreted by a trained doctor (thermologist) who would provide a written report she could share with her existing healthcare providers.

The scanned images showed areas of color that ranged from white (the hottest area) to blue (the coldest area). The area of greatest concern on the part of the client was the area containing the lump in the right breast. This area looked completely blue in color, indicating the absence of heat. Given the fact that tumors develop their own blood supply (often for many years before a tumor is even felt), and given that this increased blood supply produces heat at the site of the tumor, and given that heat shows up as a warm color (i.e. white, red, orange) on the thermal image, the obvious blue appearance of the right breast was a welcome sight! After a blissful moment of relief came the panic thought “I don’t see the lump . . . this machine doesn’t work!” The nurse comforted the client with the knowledge that thermal imaging looks at physiology not anatomy. It detects heat coming off the body and translates it into a picture. If there is no excessive heat in an area being scanned the area will not show up on the picture. The scan was sent for interpretation and came back stating “Regarding the area of concern over the right breast, particularly the site of the location of her palpable mass at 7 o’clock , there are no significant or suspicious thermal findings.” The breast biopsy done later by her surgeon agreed with the thermogram report, and revealed a non-malignant fibroid. In addition, this client now also has a tool which can be used to monitor the mastectomy site on the left side of her chest for possible recurrence of cancer, since mammography is no longer an option for her there.

Client #2 came with a recent mammogram reading that was negative, but with an ultrasound report that “showed something?” She consulted with her surgeon who “thought it did not appear to be cancer.” She proceeded to have a thermogram done as a sort of “tie breaker” to help decide if further clinical investigation was necessary. When she took the concerning thermography report to the surgeon he “thought thermography was not reliable” and wouldn’t proceed with further investigation. She disagreed and found another surgeon who, in her words, “was open and found my thermogram scan to be of value even though he had never seen one before.” The thermogram report described an area in the upper left breast as “highly suggestive of abnormal pathology.” In addition, the area under the left breast was reported as being more hyperthermic (warmer) than the right, and even the right breast showed specific areas of possible concern. Because the previous surgeon had “ruled out” the area of primary concern in the upper right breast, the client and her new surgeon decided to do a biopsy under the left breast as an initial clinical approach. Stage 1 cancer was found under the left breast. The client immediately wanted to have both breasts removed. This seemed a bit radical for a Stage 1 cancer diagnosis, but the client was adamant. Fortunately, and unfortunately, the client was right. The pathology report following surgery showed even more serious findings than the Stage 1 cancer found under the left breast on biopsy. It diagnosed the concerning area in the upper left breast highlighted by the thermogram report, as well as the areas commented on in the right breast. The results showed that “The upper area on the left breast was Stage 3 invasive cancer, multifocal with a positive sentinel lymph node, and the tissue of the right breast showed a lot of pre-cancerous cells.” The client’s surgeon and her oncologist both stated the “the thermogram matched what they found out with the pathology report.” To this client “thermography is absolutely valid.”

Client #3 is in her 5-10 year “wait and see” period having been diagnoses with Stage 1 breast cancer and having completed her chosen medical treatment. In addition, she has significantly changed her diet and lifestyle, and has added clinically directed nutritional supplements to her prevention plan. She began to explore further prevention and monitoring options. “I read many books, talked to therm_pic6.jpgfriends, and searched the internet for information and learned about  thermography.” She informed her surgeon and oncologist that she would be having thermogram scans “for the purpose of checking my healing process and to look for any abnormalities that could be developing.” Her most recent thermogram report states, “Thermal patterns and temperature differentials have remained stable.” She has chosen to be followed with thermogram scans every 3 months for now. She states, “I am very aware of the advantages of early detection and I plan to continue to use thermography to maximize my options if another cancer develops. Thermography is not so expensive that I can afford to use it often as a tool to monitor my healing process, to reveal areas I need to be sure to check more closely with my self exams, and to watch for abnormal processes that could indicate new tumor growth that might need to be seen with a mammogram.”

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Early Breast Cancer Screening

Integrated Health Solutions (IHS) provides a breast cancer screening center dedicated to helping healthcare professionals and consumers discover and monitor breast health concerns, through the use of digital infrared thermal imaging.  Infrared (IR) imaging is a non-radiation, non-contact, accurate and safe screening method with over 30 years of research and development history.  It was FDA approved in 1982 as a clinical breast screening device.

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Too Early is Never Too Late

Digital infrared thermography cameras detect heat that is given off by the body and displays it in picture format onto a computer monitor.  Infrared scans are unique to the individual person and remain very stable over time, which makes them very effective as a screening tool to pick up changes that may occur.  To establish a client’s baseline, an initial scan is taken followed by an additional scan in 3-6 months for comparison. Once that stable baseline is established, yearly screening is all that is necessary, unless the client or their healthcare provider wants more frequent evaluations. A client who has active disease or who needs to monitor treatment may want to obtain more frequent scans.

IHS scanned images are evaluated by medical doctors who have been trained and certified by the American College of Clinical Thermology as Clinical Thermologists. Evaluations may result in the need for further clinical correlation and/or may suggest abnormal pathology. For instance, tumors develop their own blood supply by a process known as angiogenesis. Studies using IR technology have reported this process as hypervascularity, neovascularity, or hyperthermia in 86% of nonpalpable breast cancers. Angiogenesis is an early event and may occur before tumor cells acquire the ability to invade surrounding breast tissue.  Infrared scans can also pick up increased blood flow caused by tumor-induced nitric oxide vasodilatation, which produces heat at the site of the tumor. Standardized quantitative measurements of these heat differentials can be evaluated. A focal temperature change at a given area may vary by 1-3 degrees centigrade compared to other parts of the body. Other abnormal findings may include detection of unusual vessels that form clusters, loops, or aberrant patterns.

Thermography screens for physiologic changes in the body. Mammography screens for anatomic changes in the body, as does breast self exam, ultrasound and MRI.  It is important to note that physiologic changes occur before anatomical changes occur in the body. Therefore, a thermogram scan may detect the earliest possible signs of developing breast pathology. Thermography can detect subtle physiologic changes in the body that accompany cancer, fibrocystic disease, and infection.

Earlier detection offers a greater survival benefit due to earlier treatment. A breast tumor may take 5-15 years to develop into a palpable or detectable anatomic structure (a mass or calcification). However, physiologic changes in biochemistry, blood flow, and nervous system response occur early in the process of cancer development, and can be detected by thermography before anatomic structure is developed.  Studies have shown that an abnormal thermogram scan will detect smaller tumor size than those tumors detected by an abnormal mammogram scan.

Thermography, is a valuable complementary test to mammography.  Whenever possible IHS recommends both. However, there are certain cases where thermography may be the screening tool of choice. For instance, younger women (under age 40) with denser breasts who want to avoid long term cumulative radiation exposure while vigilantly screening for risk would benefit.  Also, women with breast implants, small-breasted women, pregnant women, women who are post-mastectomy, and women who have had chemotherapy and/or radiation are excellent candidates for thermography, as are men.  Approximately 10% of all breast cancers occur in men, and that number is increasing.

IHS is staffed with a nurse practitioner who is a Certified Clinical Thermographer, trained to obtain images based on standardized protocols. Protocols include keeping the temperature controlled within a specific range, and keeping the room free of drafts and natural light.  The patient must abstain from alcohol, coffee, smoking, exercise, deodorant, and body lotion prior to testing.

Breast thermography can be obtained by self-referral by anyone interested.  The initial visit for breast screening is approximately an hour in length. The initial visit for full body screening is approximately an hour and one half. Our nurse practitioner completes a comprehensive clinical history with the client, which accompanies the scan images to the certified doctors for interpretation.  A full report is received back in less than a week. When requested, reports may be obtained within 24 hours. Other clinical conditions utilizing digital infrared thermal imaging include: musculoskeletal disorders, neuromuscular disorders, pain, GI disturbances, and autoimmune disorders (i.e. fibromyalgia).

The client is given several copies of the actual scanned pictures and the report to give to their healthcare providers.  The certified doctors reading the scans, as well as the physician reviewer at IHS are available by phone to speak with the client’s physician to facilitate optimal use of the scan information.  The client’s doctor can use this information as part of their overall clinical assessment to determine diagnoses and treatment options.  Follow-up scans can be used to monitor the effects of those treatment plans and to follow the progress of a potential problem.  Since there is no radiation involved, there is really no limit as to the number of scans that can be taken.

Some insurance companies do cover thermogram scans, as CPT codes for billing do exist, and it will probably just be a matter of time before more companies come on board with coverage.  Nevertheless, the cost of thermography is affordable. Most importantly, Integrated Health Solutions (IHS) provides individualized attention, and collaboration with each client’s healthcare provider/s.