After reading about some of the negatives of mammography and doing a tremendous amount of research on breast thermography I opted out of getting a mammogram last year (after doing them for 14 years) and had a thermogram with a certified thermographer.
Just recently however, Dr. William Amalu, a chiropractor with 19 years experience in thermal imaging and I had a conversation over the phone after he read an article where I cited him.
Dr. Amalu explained that to prescribe on screening over another is dangerous to the patient. A mammogram detects 80% of all breast cancers, thermogram 90%.
With 1 in 8 women predicted to develop invasive breast cancer over the course of their lifetime and with 10-20% cases missed, the question we have to ask ourselves Dr. Amalu says is:
What number of breast cancer deaths is acceptable?
Given the margin of error with our CURRENT screening guidelines – too many. What number of deaths should be acceptable? NONE.
“Certain types of cancers, Dr. Amalu writes on his website, “will not be detected (approximately 20%) by mammography for various reasons, but some of these cancers will be discovered by DII (digital infrared imaging – thermography).”
Mammogram is NOT the answer but neither is thermography – by itself.
The ideal, best practices approach to breast cancer screening should be a three prong approach. In a perfect world this means doctors prescribe the following exams for women:
- Physical – Doctor’s exam. Detect observable and structural abnormalities by manual examination.
- Functional – Thermogram. Looks at functional, physiological changes. Highly sensitive, detecting 90% of all breast cancers vs mammogram at 80%. Thermography offers the earliest detection, detecting vascular changes, inflammation, and functional abnormalities in the breast caused by the highly dangerous “estrogen dominance,” one of the leading causes behind breast cancer.
- Structural – Magnetic Resonance Imaging (MRI). Structural imaging examines the anatomic basis of changes caused by disease. Yet, most women don’t have access to this perfect breast screening protocol because the current screening guidelines don’t support this three-pronged approach, unless a woman is high risk, or shows signs of a high risk abnormality in her first line screening.*If and MRI isn’t possible, (most doctors will NOT write a prescription for and MRI even with risk factors), Dr. Nelly Yefet, an IACT (International Academy of Clinical Thermology) Board Certified Medical Thermographer, CTT, specializing in women’s breast health (who did my thermogram), says try to get an ultrasound in lieu of a mammo.
Best Breast Cancer Screening Approach, For Now
Most doctors are not yet prescribing this three prong approach, or at the very least, the next best protocol, a thermogram as adjunct (in addition to) a mammogram for a woman’s first line breast cancer screening.
“The consensus among health care experts is that no one procedure or method of imaging is solely adequate for breast cancer screening, writes Dr. Amalu. “The false negative and positive rates for currently used examination tests (including Digital Infrared Imaging) are too high for the procedures to be used alone. However, DII may pick up many of the cancers missed by other test.”
Current Breast Cancer Screening Guidelines
In 2009, the U.S. Preventive Services Task Force revised the long held American Cancer Society’s (ACS) breast cancer screening guidelines, bringing them in line with the European Guidelines which screen women age 50-69 every two years. ACS however, states that “yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health.”
After analyzing Norway’s large national database the committee found that breast cancer will sometimes regress and is not always life-threatening. *In response, the task force suggested re-evaluating the use of routine mammography for breast cancer screening.
The dialogue surrounding the new guidelines focused on re-assessing the value of breast self exams, physician breast examinations, and the age and frequency of mammograms.
In the wake of the debate a renewed interest in alternative approaches to breast cancer screening and prevention surfaced, including the use of thermography. Thermography offers advantages over mammography in number of areas, including earlier detection, avoiding r but by itself will not detect 100% of all breast cancers.
Approved by the FDA in 1982 as an adjunct (done in conjunction with) to mammography and other breast cancer screening tools, proponents of thermography cite large, longitudinal studies to support its use as a highly sensitive, breast cancer detection tool. Advocates say research indicates thermography offers an advantage in early detection over mammography and physician evaluation because it can detect small tumors sooner.
Opponents however, cite high error rates and say thermography can’t pick up deeply imbedded breast tumors, although proponents insist these concerns are based on widespread misinformation as well as a misunderstanding by clinicians of the now highly sophisticated assessment capabilities of thermography.
Breast Thermography Offers Distinct Advantages Over Mammography
Breast thermography uses special infrared-sensitive cameras to digitally record images of the variations in surface temperature of the human breast, recording images of the heat patterns. The recorded images are called thermograms. Its use in cancer screening is based on the concept that cancer gives off more heat than normal tissue.
This technology detects functional changes in the breast tissue before tumors form or before they’re large enough to be detected by other secondary prevention techniques like a clinical breast exam or mammography, say advocates.
“Difficulties in reading mammograms can occur in women who are on hormone replacement, nursing or have fibrocystic, large, dense, or enhanced breasts. These types of breast differences do not cause difficulties in reading digital infrared scans.” Dr. Amalu, Breastthermography.com
Blood vessels, cysts, other benign sources, and metabolic processes such as growing breast tumors all radiate heat from within the breast. A portion of the radiated heat reaches the surface of the breast where it composes a stable thermal pattern.
A breast thermography examination records these thermal patterns and interprets them according to a strict and complex analytical procedure. When analyzed properly by trained individuals, the images disclose various pathological and abnormal processes.
Where a mammogram looks at anatomical changes in the breast and detects masses or lumps in the tissue, a thermogram picks up vascular changes in the breast by detecting blood flow patterns, inflammation and asymmetries. Thermography is used extensively in other countries including Japan, France and Sweden.
Early Thermography Technology Flawed – Now Highly Accurate
Dr. Amalu reviewed the history of thermography studies in breast cancer detection in 1995 and concluded in his report that The Breast Cancer Detection and Demonstration Project (BCDDP) formed in the seventies should not have dismissed thermography as a viable breast cancer screening tool.
Many of the studies included in the committee’s review, he writes, suffered from serious methodological errors, unrealistic expectations and flaws, that at the time were the result of infrared technology still in its infancy. Since then, new generations of thermography technology have emerged and the accuracy and sensitivity for breast cancer detection has greatly improved.
“Thermography has the unique ability to “map” the individual thermal fingerprint of a woman’s breasts. Any change in this map over the course of months and years can signal an early indication of possible tumors or other abnormalities. In fact, studies have shown that an abnormal infrared image is the single most important indicator of high risk for developing breast cancer.” Dr. Amalu.
In his review Amalu summarizes findings to support thermography’s use for breast cancer screening:
- Breast thermography has undergone extensive research since the late 1950’s.
- Over 800 peer-reviewed studies on breast thermography exist in the index-medicus literature.
- In this database, well over 300,000 women have been included as study participants.
- The numbers of participants in many studies are very large — 10K, 37K, 60K, 85K …
- Some of these studies have followed patients up to 12 years.
- Strict standardized interpretation protocols have been established for over 20 years.
- Breast thermography has an average sensitivity and specificity of 90%.
- An abnormal thermogram is 10 times more significant as a future risk indicator for breast cancer than a first order family history of the disease.
- A persistent abnormal thermogram caries with it a 22x higher risk of future breast cancer.
- An abnormal infrared image is the single most important marker of high risk for developing breast cancer.
- Research has shown that breast thermography significantly augments the long-term survival rates of its recipients.
- When used as part of a multimodal approach (clinical examination + mammography + thermography) 95% of early stage cancers will be detected.
Dr. Mercola and Others Against Mammography
Dr. Joseph Mercola, a leading natural health advocate strongly opposes mammograms.“Unfortunately mammograms use ionizing radiation at a relatively high dose, which in and of itself can contribute to the development of breast cancer.
Mammograms expose your body to radiation that can be 1,000 times greater than that from a chest x-ray, which we know poses a cancer risk. Mammography also compresses your breasts tightly, which could lead to a dangerous spread of cancerous cells, should they exist,“ he writes in his online article, “Stop! Read This BEFORE You Get that Mammogram” (Mercola.com, June 27,2009).
The Ideal Breast Cancer Prevention Screening Approach: Multi-Modality
In a 2009 review of thermography for breast cancer detection, researcher DA Kennedy and others recommended using thermography in combination with other modalities to increase screening accuracy.
“No single tool provides excellent predictability; however, a combination that incorporates thermography may boost both sensitivity and specificity. In light of technological advances and maturation of the thermographic industry, additional research is required to confirm the potential of this technology to provide an effective non-invasive, low risk adjunctive tool for the early detection of breast cancer,” write the authors.
The American Cancer Society does not endorse thermography to replace mammography, “No study has ever shown that it is an effective screening tool for finding breast cancer early. It should not be used as a substitute for mammograms.”
“There is a great deal of literature concerning the thermal imaging field in medicine. In fact, it is one of the most studied imaging technologies in the past 20 years. Politics, lack of regulation and misuse of the technology have gone a long way in keeping thermography from the mainstream.” Dr. William Cockburn, Breastthermography.org
Patients interested in pursuing thermography for breast screening need to be aware of unscrupulous practices warns Dr. Cockburn, a pioneer and long time educator in Medical Thermal Imaging.
Patients interested in pursuing thermography should consult with a licensed practitioner who is certified in thermal imaging through a recognized agency (AAT, AMIT, AAMII, AMIA, IACT, ITS). In addition, the rating system the technologist uses to assess the breast readings vary; some producing a higher than average false positive rate.
Footnote: My experience with a thermogram, cold but tolerable.
After my thermography I received via email incredibly detailed images and a written risk assessment report. My results were normal, low risk with some mild “mottling” (areas of vascular changes attributed to years of (synthetic) hormone replacement therapy due to a pituitary disorder diagnosed decades back). I remain on hormone replacement but bioidentical vs. synthetic.
I plan a one year follow-up with the same practitioner, but NOW, after talking to Dr. Amalu, I will also get a mammogram, UNLESS I can convince my doctor to prescribe an MRI instead (not likely with an “all clear” on my thermo.
This is a Catch 22. If you’re not high risk (how do I know, I’m adopted?), you can’t get an MRI. While I have had breast ultrasounds (they were negative) after an abnormal mammo, I’ve never had an MRI and frankly, these are cost prohibitive in many cases.
So what was my thermogram like?
Similar to the immodesty inherent in the mammogram that flat irons your breasts under “plexiglass” while the tech moves them like putty this way and that, during my thermography standing semi in the buff for about 10 minutes (with a woman practitioner) was mildly awkward.
And admittedly, putting my hand in ice water for a full minute (to lower my body temperature for the reading) was more than a bit unpleasant (a six), but it was fast, it was handled very professionally and I’m glad I did it.
Ultimately my credo is that everyone has to make their own informed health decision, but the key is, make it informed.Until today I was hell bent on ditching the mammo and only going with the thermogram, now? I’ll do both until one day I can opt out of the radiation the mammo gives off and go with the MRI.
Gautherie M, Gros CM.. “Breast thermography and cancer risk prediction.” Pol Arch Med Wewn March 2010.
Jay, Edward, Thermogram Assessment Services, “Winning the Battle Against Breast Cancer.”
Kennedy DA, Lee T, Seely D. “A comparative review of thermography as a breast cancer screening technique.” Integrative Cancer Therapies,2009 Mar;8(1):9-16.
Plotnikoff G, Carolyn T. ”Emerging controversies in breast imaging: is there a place for thermography?” Minnesota Medicine 2009 Dec;92(12):37-9, 56.
Copyright Laura Owens. Contact the author to obtain permission for republication.