Breast Thermography Questions & Answers

Is Digital Infrared Imaging (breast thermography) safe?

The procedure uses no radiation or intravenous injection; therefore, DII poses absolutely no health risk to the patient.

Since there is no contact with the body, the procedure is also completely painless.

Is Digital Infrared Imaging costly?

No, DII of the breast is very reasonable considering the sophistication of the technology involved. However, costs do vary depending upon the location of the imaging lab and if special studies need to be performed. Our center's fee for a DII breast scan is $150.00 which includes consultation, imaging, a written report, and selected copies of the images.

Is Digital Infrared Imaging an approved procedure?

Yes, DII is approved by the FDA for use as an adjunctive breast cancer screening procedure.

Does Digital Infrared Imaging replace mammograms?

    Absolutely not! However, do mammograms replace DII? The answer to this is also a resounding no; the two tests complement each other. The consensus among health care experts is that no one procedure or method of imaging is solely adequate for breast cancer screening. The false negative and positive rates for mammography are too high for the procedure to be used alone. DII can pick up many of the cancers missed by mammography. A positive infrared image is also the single most important marker of high risk for developing breast cancer. It is DII's unique ability to monitor the abnormal temperature (physiological) changes produced by diseased breast tissue that allows for extremely early detection. Since it has been determined that 1 in 8 women will get breast cancer, we must use every means possible to detect these tumors when there is the greatest chance for survival.

Who is qualified to take and interpret Digital Infrared Images?

Only well-trained and experienced personnel in the health care field (MD, DC, DO, PhD, etc.) should be interpreting thermographic images for a clinical impression. The doctor should also be board certified as a clinical thermographer, diplomate, or fellow (with extended training in infrared breast imaging interpretation) from a reputable and recognized organization. Any individual wishing to perform DII in their office - with the images sent for outside interpretation - should be certified as a clinical infrared imaging technician by a recognized organization.

What other centers perform Digital Infrared Imaging?

Because of the special training, technical expertise, and unique clinical environmental needs necessary to perform DII, many centers do not have this technology as of yet. Currently, independent digital infrared imaging centers and highly specialized independent breast clinics are the most common place to find this technology.

How can I find a Qualified Digital Infrared Imaging lab in my area?

As with any diagnostic imaging, whether it is thermography, mammography, ultrasound, MRI, etc., technicians taking the images and doctors interpreting the scans must be adequately trained in order to provide a safe and quality assured service.

It is very simple choosing a qualified thermography lab. The first thing you can do is go to our association web site at http://www.iact-org.org and select the qualified lab link. Here you will find a list of world wide qualified labs. The problem begins when there is no lab listed near you. If you find one on your own, there are 2 simple questions you can ask to find out if the lab is qualified to perform breast thermography.

1.) Ask where the technician received his or her training and request copies of their credentials. The only active recognized educational organizations are the International Academy of Clinical Thermology and the International Thermographic Society.

2.) Does the lab read their own studies or are they sent out for interpretation? Find out who reads the studies and get copies of their credentials. Only board certified clinical thermographers who are licensed diagnosticians (MD, DO, DC, and in some countries PhDs) should be interpreting the scans.

If anyone cannot answer these questions, refuses to cooperate, or gives an answer that implies private or equipment manufacturing company training, I would not have scans performed from this lab. Proper training from a reputable agency ensures that correct imaging protocols and interpretations are made. If the technician and interpreter are properly trained, you will receive quality infrared breast imaging.

Why haven't I heard of Digital Infrared Imaging before?

 Due to a poorly constructed and performed (with regards to DII (Breast Thermography)) research study back in the 1970's, DII was placed in a "further study needed" and "no improvement over mammography" category. Along with this study, health care politics and insurance cost-containment issues caused interest in this technology to be put on hold. However, with the combination of a multitude of large-scale studies performed in the 80's and 90's, and recent advances in technology, DII has become one of the most important frontline procedures in early breast cancer detection.

I mentioned Digital Infrared Imaging to my doctor and was told that the procedure is outdated and useless, is this true?

Unfortunately, many physicians either do not know about this technology or are knowledgeable about a single poorly performed (with regards to DII) research study; the BCDDP (Breast Cancer Detection Demonstration Project). The BCDDP was a large study done in the 1970's which collected data from many centers around the United States. Three methods of breast cancer detection were studied: physical examination, mammography, and infrared imaging (breast thermography).

    With regards to infrared imaging, the BCDDP was seriously flawed in four critical areas.

    1.) Completely untrained technicians were used to perform the scans.

    2.) The study used radiologists who had no experience or knowledge in reading infrared images.

    3.) No standardized reading protocol had yet been established for infrared imaging.

    4.) Proper laboratory environmental controls were completely ignored. In fact, many of the research sites were mobile trailers with extreme variations in internal temperatures.

    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 DII.

Breast Thermography Facts and Figures

Positive Points:

The procedure is non-invasive, no radiation or intravenous injection is used; thus, examinations can be performed as often as indicated.

    Since there is no body contact during the examination, there is no discomfort.

Infrared imaging (thermography) is the earliest method of breast cancer detection known. This is due to its ability to monitor the physiology (function), and thus the health, of the breast over time.

    Infrared imaging can detect the pre-cancerous state of the breast up to 10 years before a cancerous tumor is found by any other method.

    A positive infrared image represents the highest known risk factor for the future development of breast cancer, 10 times more significant than any family history of the disease.

    Compared to mammography, 7 out of 10 times infrared imaging is the first alarm that something is happening.

    Infrared imaging has an overall 90% sensitivity rate.


Negative Points:

    Infrared imaging has an overall 10% false positive rate. However, due to infrared imaging's ability to detect the earliest signs of breast cancer, further studies are needed to follow patients over a prolonged period of time.

    The examinations produce an overall 10% false negative rate. Using this as a prognostic indicator has shown that most of these tumors are non-aggressive.

    Since infrared imaging is not an anatomical imaging procedure, it cannot determine the exact location of a tumor.

Sources:

         1997-2000 Index Medicus - ACS, NEJM, JNCI,  J Breast
         1980-1986 Index Medicus - Cancer, AJOG, Thermology
         1996 Text - Atlas of Mammography: New Early Signs in Breast Cancer
         1982 Text - Biomedical Thermology

Mammography Facts and Figures

Positive points:

    Mammography can detect cancer earlier than physical examination.

    In mainly slow-growing cancers, mammography can detect tumors in the pre-invasive stage.

Mammography is an anatomical imaging procedure; consequently, it has the ability to locate the area of the tumor.


Negative points:

    Mammography cannot detect an exponentially fast-growing cancer in the pre-invasive stage.

    Mammography has an overall 25% false positive rate (false indication that a cancerous tumor is present) which leads to unnecessary biopsies.

    85% of mammography initiated biopsies are negative.

    Mammography has an overall 20% false negative rate (missed cancerous tumor) in women under age 60 - and up to 40% in women under age 50 due to breast density.

    Large, dense, fibrocystic, or enhanced breasts cause reading difficulties.

    The examination can cause discomfort due to compression of the breasts.

    In most women the medial upper triangle, peripheral areas next to the chest wall, and the inframammary sulcus of the breast cannot be visualized with mammography.

Sources:

      1997-2000 Index Medicus - ACS, NEJM, JNCI, Lancet, BMJ, J Breast