Thermography, Mammography or Ultrasound? Part 2
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Here are some points to consider regarding MAMMOGRAPHY:
• Structural test: can pinpoint the location of suspicious area
• Compresses the breast
• X-ray radiation produces an image; the area of concern must have greater density to stand out against regular tissue
• Can detect tumors in mainly slow-growing stage or pre-invasive stage
• Cannot detect fast-growing tumors in the pre-invasive stage
• The use of hormones decreases sensitivity
• Large, dense and fibrocystic breasts are difficult to read
• The upper portions of the breast (including the tail of the breast and the axillary region) cannot be visualized
• Can detect tumors 1-2 years earlier than physical examination
• Average specificity 75% (25% false-positive)
• 9 out of 10 biopsies initiated by mammography are negative
• Average sensitivity 80% with 20% of cancers missed in women over age 50
• In women under age 50, sensitivity is 60% (or, 40% of cancers missed)
Next week, I will go over the pros and cons of ultrasound.
Dr. Alex Mostovoy
Thermography, Mammography or Ultrasound? Part 1
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One of the most frequent questions I am asked as a clinical thermographer is: “What exactly is the difference between mammography, ultrasound and thermography?” There seems to be some confusion on this subject. Many people think that one test replaces the others, but nothing could be further from the truth.
Both mammography and ultrasound are structural (anatomical) tests, while thermography is a functional (physiological) test. None of these tests are truly diagnostic technologies. Thermography images the breast and surrounding area and provides us with risk assessment, while mammography and ultrasound detect structural abnormalities. If a breast abnormality is found that could possibly be malignant, a biopsy is performed. A biopsy removes a tissue sample for examination under a microscope.
Many women, after their initial assessment with thermography, may be asked to follow up either with an ultrasound or mammogram or both to rule out the existing pathology. Frequently some will be relieved that their mammogram or ultrasound test results show no abnormal findings, however this does not necessarily mean that nothing is going on with their breasts. Several other factors may be contributing to a high risk (abnormal) thermogram, such as: hormonal imbalance, early angiogenesis (proliferation of blood vessels), lymphatic swellings and poor function, and other contributing factors. All of these are important contributors to breast disease and malignancy; they are not detected by mammography or ultrasound, as these factors do not appear as structural changes.
Over the new few weeks, I will clearly set out the pros and cons of each type of test.
Dr. Alex Mostovoy
Is Breast Thermography Safe?
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Yes. Thermography is FDA-approved in the United States and has been used there and in Europe for over 20 years. Thermography is a non-invasive test. This means that nothing is sent into your body. It is simply creating an image of your breasts by measuring your heat. There is no contact of any kind, nor is there any pain or radiation.
Breat thermography can be used effectively and safely for all women including pregnant or nursing women, women with dense breast tissue, and women with breast implants.
It’s important to note that thermography does not diagnose breast cancer; like mammography, it is a screening tool. Thermography identifies abnormal physiological changes in your breasts that may be cancerous. Mammography, a type of x-ray, identifies certain structures in the breast that can potentially be cancer. With both mammography and thermography, definitive diagnosis is done by other procedures such as a biopsy or lumpectomy. Many of our patients come in after their doctors have decided “Let’s watch this area” due to an abnormal mammography. We correlate the area to be watched with a thermographic image of the same area. If the thermography shows an issue in the same area, the patient will have more information with which to make an informed decision.
We recommend that thermography be used together with mammography for the most comprehensive screening and the earliest possible detection.
Dr. Alex Mostovoy
What Is Breast Thermography?
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Thermography measures the infrared radiation (heat) that is constantly radiating (emitting) away from the surface of the human skin. Skin is an organ, and it breathes, exchanges gases with the environment, cools us as well and keeps us warm by letting heat out or keeping it in by controlling the amount of circulation, or blood flow, in the skin. This automatic regulation is done without conscious thought and is controlled by the autonomic nervous system via the sympathetics. The whole process is called thermoregulation.
The thermography procedure is based on the principle that chemical and blood vessel activity in both pre-cancerous tissue and the area surrounding a developing breast cancer is almost always higher than in the normal breast. Since pre-cancerous and cancerous masses are highly metabolic tissues, they need an abundant supply of nutrients to maintain their growth. In order to do this they increase circulation to their cells by sending out chemicals to keep existing blood vessels open, recruit dormant vessels, and create new ones (neo-angiogenesis). This process results in an increase in regional surface temperatures of the breast.
Abnormal thermographic scans of the breast clearly demonstrate abnormal areas of heat. This gives the clinician an alert that something might be wrong with physiology of the breast. It could be an infection, inflammatory disease, trauma or cancer.
Thermography uses no painful breast compression, no radiation and is non-invasive. It is an ideal tool for mass screening not only for women over 40, but younger women as well. Breast pathologies have been found in women as young as 18 utilizing thermal imaging equipment. It would be a grave error to deny the efficacy of thermal imaging of the breast as an adjunctive diagnostic procedure in the overall management of the patient.
The procedure is both comfortable and safe, using no radiation or compression. By carefully examining changes in the temperature and blood vessels of the breasts, signs of possible cancer or pre-cancerous cell growth may be detected up to 10 years prior to being discovered using any other procedure. This provides for the earliest possible detection of cancer. Because of breast thermography’s extreme sensitivity, these temperature variations and vascular changes may be among the earliest signs of breast cancer and/or a pre-cancerous state of the breast.
Dr. Alex Mostovoy
How Effective Is Thermography in Detecting Breast Cancer?
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Breast thermography has been researched for over 30 years, and over 800 peer-reviewed breast thermography studies exist in the index-medicus. In this database well over 250,000 women have been included as study participants. Some of these studies have followed patients up to 12 years. Breast thermography has an average sensitivity and specificity of 90%.
Studies show that:
· An abnormal infrared image is the single-most important marker of high risk for developing breast cancer.
· A persistent abnormal thermogram carries with it a 22 times higher risk of future breast cancer.
· When thermography is added to a woman’s regular breast health checkup, a 61% increase in survival rate has been realized.
· When used as part of a multimodal approach (clinical examination + mammography + thermography), 95% of early-stage cancers will be detected.
Breast thermography is not a stand-alone tool in the screening and diagnosis of breast cancer. It is adjunctive. We can’t ignore the tremendous role of thermography as an early risk indicator or as a monitor of treatment. When a thermogram is positive, a closer look at the patient’s diet, exposure to environmental pollution, toxins and lifestyle is in order. Clinical blood work in addition to ultrasound and mammography is essential. When mammography and blood work are negative or equivocal, thermographic monitoring on a quarterly to semi-annual basis should be performed in those patients with suspicious thermograms.
Changes in tumor angiogenesis can be evaluated and other procedures can be ordered to aid in the earliest possible diagnosis. Thermography is non-ionizing and safe. There is no reason to simply “wait and see” any longer. We must become proactive rather than passive with our health. It is no longer acceptable to “wait and see” just because a mammogram is negative or equivocal. With a more universal approach, thermal imaging can become a valuable early detection tool that is indispensable in patient’s health care.
Since it has been determined that 1 in 8 women will get breast cancer, we must use every means possible to detect cancers when there is the greatest chance for survival. Proper use of breast self-exams, physician exams, thermography, and mammography together provide the earliest detection system available to date. If treated in the earliest stages, cure rates greater than 95% are possible.
Dr. Alex Mostovoy
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