Breast Screening

“In whatever part of the body excess of heat or cold is felt, the disease is there to be discovered”
Hippocrates around 400 BC.

Adams, F.: The Genuine Works of Hippocrates. Baltimore: Williams and Wilkins, 1939

Fortunately, medical discoveries have moved on from covering the patient with mud and seeing what area dries first!

Are We Screening or Are We Detecting?

Breast cancer is now the most common cancer in the UK.
In the UK in 2006 more than 45,500 women were diagnosed with breast cancer, around 125 women a day.
Breast cancer is the leading cause of death for women aged 34 – 54.
Each year around 300 men in the UK are diagnosed with breast cancer.
Breast cancer incidence rates have increased by more than 50% over the last 25 years.
In the last 10 years, female breast cancer incidence rates in the UK have increased by 6%.
The highest rates of breast cancer occur in Northern and Western Europe and North America and the lowest rates are in Northern, Eastern and Middle African countries and Asia.
Worldwide, more than 1,000,000 women are diagnosed with breast cancer every year.

These statistics are scary and the question needs to be asked again - should we continue to concentrate on procedures that can only detect an existing lump, or should we be focusing on screening methods that can warn of a pending problem far in advance of a lump developing?

Why Wait?
Book your appointment now, call 952 883 151 or contact us

What is Thermal Imaging?

Thermal Imaging is a diagnostic screening procedure that images the breasts to help in the early detection of abnormalities. It is:

Pain Free
100% Safe
No Contact
No Radiation
Non Invasive

There are no contra-indications for Thermal Imaging making it safe for pregnant women and those with implants.

Thermal Imaging is a screening test for all age groups and is designed to establish a baseline (the patient’s normal thermal “fingerprint”) for ongoing comparative analysis to detect any physiological change that justifies additional testing. Such testing could be physician exam, mammogram, ultrasound, MRI, blood work, hormone testing or a number of other interventions.

The thermal images produced by a screening are forwarded via a secure intranet to fully qualified and licensed medical doctors who are certified thermologists and experienced in reading thermograms. The reading doctor takes into consideration all history, symptoms and the results of other tests. From these thermal images, sophisticated computer programmes allow the doctor to isolate temperature differentials, perform vascular analyses, dynamic thermal subtraction studies and more.

What happens during an appointment?
Dawn from Lifetimes Magazine has written about her experience at the clinic.

How Does Thermal Imaging and Breast Screening Work?

The cells of your body produce heat through their normal function. Abnormalities change this heat pattern - think of a hot painful knee or a swollen ankle.

Diseased cells, for example cancer, usually produce much more heat in their earliest stages of development (before a cancerous tumour forms). In the case of cancer, the cells will:

stimulate new blood vessels to help them grow
re-open unused blood vessels
maintain those blood vessels already in use

A cancer tumour needs more blood flow than normal healthy cells to support its rapid growth and eventually, the cancer cells build a vast network of blood vessels in the area it will ultimately grow. This new blood vessel formation is called Malignant Angiogenesis.

Guidi AJ, Schnitt SJ: Angiogenesis in pre-invasive lesions of the breast. The Breast J (2): 364-369, 1996.

With more blood flow, there is more heat. Thermal Imaging examines these “hot spots” which can be the earliest warning signs of potential cancerous activity. This activity has been shown to begin years before a tumour or a lump forms and before any warning signs can be given by other screening methods such as mammograms or ultrasound.

Digital Infrared Thermal Imaging (DITI) uses an extremely precise, high-resolution, digital infrared thermal camera to take pictures of your body’s heat pattern. These pictures are able to detect temperature differences and changes of as little as 0.1 degree Centigrade and are then displayed as a digital image. Breast Screening using modern DITI is one of the latest medical technologies used in the fight against breast cancer.

Is Breast Screening Using DITI Approved?

In 1982 and again in 2005, the FDA approved breast thermography as an adjunctive breast screening procedure.

Digital Infrared Thermal Imaging has been recognized as a viable diagnostic tool since:

1987 by the AMA Council on Scientific affairs and the ACA Council on Diagnostic Imaging
1988 by the Congress of Neuro-Surgeons
1990 by the American Academy of Physical Medicine and Rehabilitation
Full European Certification

What Trials Have Been Done On Breast Screening Using Digital Infrared Thermal Imaging?

Over 800 peer-reviewed studies and well over 300,000 women have been included as study participants. The number of participants in many studies are very large (10,000, 37,000, 60,000, 85,000, etc.) and some of these studies have followed patients for up to 12 years.

These clinical trials have demonstrated that breast thermography detects the first potential signs of a cancer up to 10 years before any other procedure.

M. Gautherie, Ph.D.; Thermobiological Assessment of Benign and Malignant Breast Diseases. Am. J. Obstet. Gynecol., 1983; V 147, No. 8: 861-869.
P. Gamigami, M.D.; Atlas of Mammography: New Early Signs in Breast Cancer. Blackwell Science, 1996.
J. Keyserlingk, M.D.; Time to Reassess the Value of Infrared Breast Imaging? Oncology News Int., 1997; V 6, No. 9.
P.Ahlgren, M.D., E. Yu, M.D., J. Keyserlingk, M.D.; Is it Time to Reassess the Value of Infrared Breast Imaging? Primary Care & Cancer (NCI), 1998; V 18, No. 2.
N. Belliveau, M.D., J. Keyserlingk, M.D. et al ; Infrared Imaging of the Breast: Initial Reappraisal Using High-Resolution Digital Technology in 100 Successive Cases of Stage I and II Breast Cancer. Breast Journal, 1998; V 4, No. 4

Importantly, DITI significantly augments the long-term survival rates of its recipients. When used as part of a multimodal approach i.e. thermography plus clinical examination and mammography, studies show that up to 95% of early stage cancers can be detected.

M. Gautherie, Ph.D.; Thermobiological Assessment of Benign and Malignant Breast Diseases. Am. J. Obstet. Gynecol., 1983; V 147, No. 8: 861-869.
P. Gamigami, M.D.; Atlas of Mammography: New Early Signs in Breast Cancer. Blackwell Science, 1996.

What Are the Benefits of Using Thermal Imaging for Breast Screening?

The earlier an abnormality is detected the better the treatment options will be, resulting in a better outcome. Early detection is aimed at prevention and if changes are detected early enough, you have an opportunity to intervene and hopefully change the outcome.

It takes around 8 years for most cancers to develop to the stage that they are large enough to be detected with mammograms or ultrasound (dense enough for both location and biopsy). Thermal Imaging therefore is ideally placed as a screening tool to identify changes over time in the early development stages of a cancer i.e. before there is more advanced pathology that can be detected with other tests such as mammograms.

With the pre-mammogram age group (under 50), the benefits of screening to detect any findings or changes that justify additional testing or closer monitoring are easier to define.

In general, women under the age of 50 usually have breasts which are simply too dense to be effectively screened by a mammogram or ultrasound. In this case and on average, only 10 – 40% of abnormalities are detected.

Mammograms	Ultrasound	Thermal Imaging
40% of cancers missed in women under age 50 i.e. average 60% sensitivity	17% of cancers missed in all age groups i.e. average 83% sensitivity.	10% of cancers missed in all age groups i.e. average 90% sensitivity
20% of cancers missed in women over 50 i.e. average of 80% sensitivity

With any positive DITI findings in this younger age group, any mammogram or ultrasound investigations can be specifically targeted via the Thermal Imaging findings thereby increasing their chances of finding the abnormality and ultimately improving the outcome.

By performing thermography years before conventional mammography, a selected “at risk” patient population can be monitored more carefully and more safely.

It is in this role that thermography provides its most practical benefit to the general public and to the medical profession. It is a safe adjunct to the appropriate usage of mammography and not a competitor and in fact, increases the effective usage of mammographic imaging procedures.

Early Detection of Breast Abnormalities

Breast cancers grow significantly faster and are usually much more aggressive in younger women and are the leading cause of death for women aged 34 – 54.

Age	Average Tumour Doubling Time
Under 50	Every 80 Days
50 - 70	Every 157 Days
Over 70	Every 188 Days
Source: Cancer 71:3547-3551, 1993

For example, in those women under 50 years of age, an average cancer cell growth rate might look something like - after:

90 days - 2 cells
1 year - 16 cells
2 years - 256 cells
3 years - 4,896 cells
4 years - 65,536 cells
5 years - 1,048,576 cells
6 years - 16,777,216 cells
7 years - 268,435,456 cells
8 years - 4,294,967,296 cells
10 years - considered lethal

It is only after 8 years and having doubled around 32 times that mammograms or ultrasound usually detects a problem and at this stage, it might be the size of a small grape.

Thermal Imaging can detect growth patterns usually in the 2nd year and can be as early as after only 90 days.

Should we continue to concentrate our efforts on procedures that can only detect an existing cancer, or should we be focusing on true screening methods that can warn of a pending problem far in advance?

Can Thermal Imaging Diagnose Breast Cancer?

The simple answer is NO.

Neither mammogram nor ultrasound can diagnose cancer. Only a biopsy can diagnose cancer.

Currently, no single screening procedure can detect 100% of all breast cancers but when DITI, mammograms, ultrasound and clinical exams are used together, studies have shown that the best possible evaluation of breast health can be made.

M. Gautherie, Ph.D.; Thermobiological Assessment of Benign and Malignant Breast Diseases. Am. J. Obstet. Gynecol., 1983; V 147, No. 8: 861-869.
P. Gamigami, M.D.; Atlas of Mammography: New Early Signs in Breast Cancer. Blackwell Science, 1996.

How Often Should I be Screened

This is largely dependant on age, family history and findings but on average and for the healthy woman:

Age 20 – Baseline (15-20 percent of breast cancer occurs between the ages of 20-44.)
20-30 yrs – Every 3 years
30 years and older - Yearly

What Else Can Thermal Imaging Detect?

The changes that DITI can detect include; inflammatory pathology (inflammatory carcinoma / inflammatory breast disease), fibrocystic breast disease, infection, lymph dysfunction (lymph congestion, lymph node pathology), vascular changes (development of new and abnormal blood vessels “angiogenesis”) and also any suspicious activity outside the range or scope of other tests (outside the border of the breast, in the sternum or axilla as in mammograms).

Remember that DITI cannot “see” structure such as micro-calcifications.

DITI, as well as mammograms does have the potential to create anxiety for a patient with equivocal results or results that cannot be confirmed or positively diagnosed. However, both tests can minimize unnecessary anxiety with better informed consent, education and realistic expectation for the test.

The best possible plan is to use every appropriate test adjunctively to get the highest detection rates without generating additional or unnecessary invasive testing. It would be unfortunate for a patient to forgo a necessary mammogram that was justified, and any decision should be made with consultation between the patient and her doctors based on individual history, symptoms and test results.

Can I use Breast Thermography as an alternative to Mammography?

Although this may sound appealing at first, there is no evidence supporting the use of thermography as an alternative to mammography at this time. Like mammograms, Breast Thermography is extremely sensitive but will still miss a certain percentage of cancers. No one procedure (mammography included) is 100% accurate.

Both tests “look” for different things.

Furthermore, the highest detection rates (95%) were seen when thermography was combined with physical examination and mammography.

Thermography is complimentary to mammography and an adjunctive tool in the war on breast cancer. We must learn to accept the information these tools bring to us, and use the information to the best management of you, the patient.

If and as soon a suspicious (positive) breast thermal examination is performed, the appropriate follow-up diagnostic and clinical testing can be ordered. This would include mammography and other imaging tests, clinical laboratory procedures, nutritional and lifestyle evaluation and training in breast self examination.

Thermal scanning is purely a test of physiology. It does not provide the information a mammogram does in terms of size and density of a lump. However, when thermography does produce positive findings, it justifies more invasive tests. Thermal Imaging also gives mammography something to look for, especially in the younger and more dense breast and so further aids detection by providing a “thermal map” and a location.

I Have a Suspicious Mammogram or Felt a Lump on My Breast. Should I Still Have a Thermogram?

Absolutely

The information provided from the thermogram can clarify the other findings ultimately helping your doctor make better decisions as the best way to manage the situation.

I Have Had Cancer, Should I Have Thermography?

Again, yes.

Thermography is 100% safe with no radiation. Performed before and after surgery, thermography can help evaluate the success of the operation. It is important to protect the healthy breast as after you develop breast cancer, you are at a higher risk to develop it again.

My Doctor Says that DITI is no Good

Sadly many doctors either do not know about thermal imaging or are aware of a single poorly performed research study; the BCDDP (Breast Cancer Detection Demonstration Project).

The BCDDP was a large study done in the 1970’s and three methods of breast cancer detection were studied: physical examination, mammography and thermography. With regards to thermography, the BCDDP study was seriously flawed in six critical areas.

Completely untrained technicians were used to perform the scans.
The study used radiologists who had no experience or knowledge in reading infrared images.
No standardized reading protocol had yet been established for infrared imaging.
Proper conditions were ignored. Many of the research sites were mobile trailers with extreme variations in internal temperatures.
Low resolution industrial grade infrared imagers were used.
The initial premise of the study was flawed: “A negative thermogram would preclude the need for a mammogram.” A functional imaging test (thermography) cannot replace a structural imaging procedure (mammography). These two imaging tools complement each other. Thermography is to be viewed as an addition to mammography, not as a replacement.

Of considerable concern was the reading of the images. It wasn’t until the early 1980’s that established and standardized reading protocols were introduced. Considering these facts, the BCDDP could not have properly evaluated infrared imaging.

With the advent of known laboratory environmental controls, established reading protocols, and state-of-the-art infrared technology, a poorly performed 20-year-old study cannot be used to determine the appropriateness of Thermal Imaging.

I Have Heard About False Positives, Are They Problems?

Thermography detects the “fever” of breast pathology, whether it is cancer, fibrocystic disease, an infection or a vascular disease. If detected sufficiently early, you can plan accordingly. Your doctor can lay out a careful clinical program to further diagnose and or MONITOR you until other standard testing becomes positive, thus allowing for the earliest possible treatment.

Of course you can take matters into your own hands and by amending your diet, stopping smoking, having electro lymphatic drainage, doing regular exercise etc, etc!

Every abnormality that breast thermography finds is not necessarily cancer and this is the problem. One has to bear in mind however that every cancer STARTS as an abnormality.

It is frightening to the uneducated clinicians and patients and poses quite a dilemma for those with a "wait and see" attitude. This is not thermography's failure. Maybe this is where the scientific and research community has failed thermal imaging. Thermography's only error is that it is too right ~ too early.

It is the job of scientists, physicians and concerned patients, to identify the appropriate protocols once a thermogram is positive.

CONCLUSION

From a study of 58,000 women, it was concluded that “an abnormal thermogram is the single most important marker of high risk for the future development of breast cancer”!

Gros, C., Gautherie, M.: Breast Thermography and Cancer Risk Prediction. Cancer 45:51-56, 1980

Thermography has a significant place as one of the major front-line methods of breast cancer detection.

It is unfortunate therefore that many physicians still hesitate to consider thermography as a useful tool in clinical practice in spite of the considerable research database, continued improvements in both thermographic technology and image analysis.

This attitude may be due to the fact that the physical and biological bases of thermography are not familiar to most doctors with the other methods of cancer investigations referring directly to topics of medical teaching. For example, radiography and ultrasonography refers directly to anatomy. Thermography on the other hand is based on thermodynamics and thermokinetics which are unfamiliar to most physicians, even although man is experiencing heat production and exchange in every situation he undergoes or creates.

Considering the contribution that thermography has demonstrated thus far in the field of early cancer detection, all possibilities should be considered for promoting further technical, biological and clinical research in this procedure.

Why wait?

Thermal Imaging is now here in Spain.

Contact us at The Bodyworks Health Clinic and arrange your safe, pain free, non invasive screening now by calling us on (0034) 952 883 151.