Thermograms vs. Mammograms: Which is Better for Breast Health?
What is better for your breast health, mammograms or thermograms? The two technologies are as different as night and day. That leads to scant opportunity for comparison, or substitution, for that matter.
Anatomy vs. Physiology
For starters, no screening is 100% effective. Thermography and mammography have completely different roles in monitoring breast health and they do this through vastly different technologies.
Mammograms reveal structures such as lumps or calcifications, (i.e. anatomy). Unfortunately, according to the American Cancer Society, one out of 5 breast cancers are missed by the mammogram screening. Mammograms use compression (measured at approximately 4 pounds per square inch) to spread the breast tissue over the imaging plate in order to separate tissue and better see any lumps or calcifications. During this compression of the breast, x-ray images are taken of the breast. This technology is not particularly effective for women with dense breast tissue; more on this in a moment.
Thermograms indicate metabolic activity; something new in the developmental process, (i.e. physiology). As a result, thermography can screen for early stages of breast disease; the stages where something may be in the process of becoming. Thermography is a screening tool that is highly sensitive to subtle differences in skin surface temperature. Unlike most screening modalities, thermography is non- invasive. It uses no radiation, injections or compression to achieve its images. It is less reliable for later stage imaging, when a lump is already palpated by the patient or provider.
The Principle of Thermography
Digital Infrared Thermal Imaging (DITI), better known as thermography or thermal imaging, is based on the principle that blood vessel activity in both pre-diseased tissue and its surrounding area is almost always higher than in healthy breast tissue. Lumps or masses in a pre-diseased state are highly metabolic entities which need a blood supply to maintain growth. They increase circulation to these diseased cells and create a new blood supply called neovascularity. The result of this process is an increase in the skin surface temperature at the affected site. This neovascularity only occurs during the early stages of the disease process. State-of-the-art breast thermography uses ultra-sensitive infrared cameras and sophisticated computers to detect, analyze, and produce high-resolution images of these temperature and vascular changes.
I often say, “Breasts are like snowflakes, no two are alike”. For instance, some breasts are dense (small amounts of fatty tissue present) and others are low density indicating the presence of more fat compared to breast tissue.
Breast density becomes a limiting factor when using a mammogram for screening. Dense breast tissue can actually hide cancer on a mammogram. Not only that, women with dense breasts may be at an increased risk of 4-6 times when compared to women with fatty breast tissue. Unfortunately, 35% of breast cancer can go undetected in women with dense breast tissue. Why is it that fatty breasts are more accurately screened by mammography than dense breasts? Both dense tissue and lumps appear white on a mammogram.
Surely you’ve heard the saying: it’s like finding a snowball in a snowstorm. It’s hard to see white anomalies when they are on a white background. Fatty tissue appears dark on a mammogram so the whiteness of a lump is more easily assessed with the contrast. Dense breast tissue is not a limiting factor in the reading or interpretation of thermal images. Thermal imaging can provide a clearer assessment for the person with dense breasts.
A study published in the American Journal of Radiology in 2003 demonstrated that thermography had 97% sensitivity in distinguishing benign from malignant growths. The conclusion stated: “Infrared imaging offers a safe, noninvasive procedure that would be valuable as an adjunct to mammography in determining whether a lesion is benign or malignant”.
Thermography as a Screening Tool
Thermography is a valuable screening tool for the early identification of situations where close follow-up is warranted, perhaps for even a few years. Thermography is completely free of radiation and pain-free. Medical doctors, who have been specially trained in the intricacies of thermography, read and interpret the scans from both an objective and subjective perspective. By carefully examining changes in the temperature and blood vessels of the breasts, earlier detection is now possible. Because of thermography’s extreme sensitivity, these temperature variations and vascular changes may be among the earliest signs of breast disease.
Breast thermography is backed by research spanning more than 30 years. Over 800 peer-reviewed breast thermography studies exist.
In this database, well over 250,000 women have been included as study participants. The numbers of participants in many studies are very large ranging from 37,000 to 118,000 women. Some of these studies have followed patients up to 12 years. Breast thermography has an average sensitivity and specificity of 90%. This means there is a 10% chance that pathology may be missed.
Studies show that:
- An abnormal infrared image is the single most important marker of high risk for developing breast cancer
- An abnormal infrared finding is 8 times more significant than a first order family history of the disease.
- A persistent abnormal thermogram carries with it a 22x higher risk of future breast cancer.
- When added to a woman’s regular breast health checkups, a 61% increased survival rate has been realized.
- Finally, when used as part of a multimodal approach (clinical examination + mammography + thermography) 95% of early stage cancers will be detected.
A positive thermal scan may indicate the presence of many different breast abnormalities such as mastitis, benign tumors, fibrocystic breast disease, inflammatory breast disease, and lymphatic congestion.
Thermography is as Unique as a Fingerprint
Each patient has a particular infrared map of their breasts, which over time can become as reliable as a fingerprint. Any modification of this infrared map on serial imaging (images taken over months to years) can constitute an early sign of an abnormality. In patients without cancer, the examination results are used to indicate the level of possible future cancer risk.
Consequently, in the absence of other positive tests, an abnormal infrared image gives a woman an early warning. By maintaining close monitoring of her breast health with annual infrared imaging, self breast exams, clinical examinations, and other tests, a woman has a much better chance of detecting cancer at its earliest stage and preventing invasive tumor growth.
Thermography does not have the ability to pinpoint the location of a tumor. Consequently, breast thermography’s role is in addition to mammography or ultrasound and physical examination, not in lieu of. Breast thermography does not replace mammography or ultrasound and mammography or ultrasound does not replace breast thermography. These diagnostic tests complement each other. Since it has been determined that 1 in 8 women will get breast cancer, we must use every means possible to detect diseases of the breast when there is the greatest chance for survival. Proper use of breast self-exams, physician exams, thermography, mammography and ultrasound together provide the earliest detection system available to date. If treated in the earliest stages, cure rates greater than 95% are possible.
Ingrid LeVasseur, BA, CCT, founded Inner Image Health Screening, LLC in 2006 to bring this adjunct screening technology to Maine. She is grateful to the women who have chosen thermography these past 13 years, making Inner Image Health Screening the longest serving thermography clinic in the state of Maine. Inner Image Health Screening provides medical thermal imaging at 14 locations, from Kennebunk to Bangor. Her permanent location is in Falmouth, ME.