More on Breast Thermography

When my doctor suggested a breast thermogram he also mentioned that I should check with my insurance company to see if they covered it.  My insurance informed me that this screening test is considered experimental and unproven. I was surprised by this because from what I understand breast thermography has been approved by the FDA since 1983. So what's up?

Well, unfortunately it seems that thermography has become a victim of ethics and politics. According to Dr. William Cockburn, some less than ethical providers aren't adhering to testing protocol, or aren't qualified to interpret the thermograms.  These should always be read by doctors trained in thermography, just as doctors trained in radiology read mammograms. Politically, thermography is seen as competition with mammography. The American College of Clinical Thermography states that thermography  is a supplement to mammography, not a competitor. "In fact, thermography has the ability to identify patients at the highest risk and actually increase the effective usage of mammography."

I found several studies that underscore the effectiveness of thermography in detecting breast cancer. Research reported in the International Cancer Journal suggests that it shows considerable predictive value.  It's important to note that thermography and mammography do not diagnosis breast cancer.  This can only be done by pathology, but both screening tools do aid in detection.  Where thermography shines is in its ability to find abnormalities before they can be seen with mammography. This is especially important for young women who typically have denser breast tissue, which makes detection of irregularities more challenging with mammography. 

Another benefit of thermograms is their cost. Screening mammograms aren't routinely offered to women under the age of 40. Electing to monitor breast health with an annual screening thermogram is a more cost effective option than paying for a mammogram. With the recent advances in digital technology, current research in breast cancer screening is showing that "for breast cancer care, it has become possible to use thermography as a powerful adjunct and biomarker tool, together with mammography for diagnosis purposes." I think a thermogram is worth it.  What do you think?

By the way, if you're interested in finding a qualified thermography clinic in the US, this link lists them by state: http://www.thermologyonline.org/Breast/breast_thermography_clinics.htm
 



Sources:
http://www.breastthermography.org/paradigmshift.html
http://www.thermologyonline.org/Breast/breast_thermography_what.htm
http://www.biomedcentral.com/content/pdf/1471-2407-4-17.pdf
http://informahealthcare.com/doi/abs/10.1080/03091900600562040

Breast thermography?

Isn't technology incredible? Especially when it works. My most recent remarkable medical technology moment occurred the other day when I had a digital infrared thermal imaging (DITI) test. DITI, or thermography, is a no contact, non-invasive screening tool. When I took the test all I had to do was stand in front of the scanner. There is no risk of radiation, no needles and no nuclear dyes.  Ladies, imagine no cold, glass plates clamping down on your sensitive body parts! A screening test with NO side effects.  Like I said, remarkable.


No side effects sounded great, but I wondered how does thermography work? From what I understand, we all radiate infra-red heat (think night vision goggles). Each of us has our own unique heat signature and usually these are fairly symmetrical. Symmetry is important in heat signatures, but more on that later.

Anyway, the thermography technician explained to me that as I stand in front of the scanner it converts the infrared heat radiating from my body into electrical impulses. As the image from Meditherm shows, these impulses are then computer mapped using different colors. A photo is taken of these colored heat patterns. This is called a thermogram. Each color on the thermogram indicates more or less heat coming off the body.

Of course, being the wondering type of person I am,  I questioned why I needed a thermogram when I've already had digital mammograms, a contrast MRI and a sonogram of my breasts. My doctor explained that a thermogram is about looking at physiology, which is the study of the function of the body's systems.  Whereas, a mammogram, MRI and sonogram are all about anatomy, which is the study of the body's physical structures. He went on to say that because of this they can be complementary tests. 

So what is significant about temperature imbalances in the body showing up on a thermogram?  Well, remember I mentioned that symmetry or balance of heat signatures in the body is important. My doctor explained that he compares the heat signatures from one breast with the other.  If an imbalance between them is noted he considers it a "thermal signal." A thermal signal may be the result of "increased vascularity". What's that? Well, it may indicate disease and in some cases cancer. According to the American Cancer Society (ACS), when cancer cells begin to grow they start out by using nearby blood vessels. But the tumor soon outgrows this blood supply and it begins angiogenesis - the growth of new blood vessels.  As a result, increased vascularity, or blood flow, occurs in the area of the tumor. This additional blood supply increases metabolic heat which shows up as a thermal signal on the thermogram.
 
Interestingly, "without new blood vessels, a tumor can't grow larger than about the size of a pin head (about 1 to 2 cubic millimeters)(ACS)." Cancerquest states that "a mammogram can detect tumors at very early stages, when they are around the size of a pencil eraser." So what about the period of growth between pin head and pencil eraser stage? This is where breast thermography is particularly useful. It has the potential to detect problems earlier than mammography and this allows for earlier intervention and treatment.

So you may be wondering, like I was, why thermography isn't offered as a standard screening tool for breast cancer? Why isn't it used in conjunction with mammography? Why doesn't my insurance company cover this test? I'll get into this in my next post.  



Sources:
http://degreedirectory.org/articles/What_is_Anatomy_and_Physiology.htmlhttp://www.meditherm.com/thermography.htm
http://www.acsevents.org/docroot/ETO/content/ETO_1_4X_Why_Do_Tumors_Need_Their_Own_Blood_Supply.asp
http://www.cancerquest.org/index.cfm?page=3223#Q19
http://www.radiologyinfo.org/en/info.cfm?pg=bodymr