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by Michael Bennett, Pharm.D.
Breast Cancer Screening
Using High-Resolution Digital Thermography
We have just completed October, declared by Komenites and the drug company AstraZeneca as the official Breast Cancer Awareness Month. To many women the whole year is of concern, however. The issue of breast screening with mammography has always been a controversial topic. New studies appear frequently that seem to add confusion to a busy woman’s choice for an accurate, non-toxic and unbiased method for breast cancer screening. Recently published, the Canadian National Breast Screening Study1 found that annual mammograms are no more effective in preventing breast cancer deaths among women age 50 to 59 than a through, detailed 10-minute breast exam given by a professional. The women were also taught breast self-examination (BSE). It has also recently been shown that if a good exam were coupled with high-quality digital thermography, the chance for finding cancers would be even greater.2
Historical Perspective—The Past
Thermography, also called thermology, is a very old method for detecting heat patterns in breast tissue. Ray Lawson, M.D. first used thermography clinically in 1956.3 Many papers were published after this but will not be discussed here. Perhaps the height of excitement came in the 1980s when more patient experiences and slightly better equipment added to the conviction of even radiologists (who generally prefer mammography) that thermography was a useful and non-toxic tool in the detection of breast cancer. Michel Gautherie, Ph.D. and Charles Gros, M.D., a radiologist, summarized their 12-year/58,000 patient clinical experience4 stating, “Thermography makes a significant contribution to the evaluation of patients suspected of having breast cancer. The obviously abnormal thermogram carries with it a high risk of cancer.” Another radiologist, Harold Isard, who was chairman emeritus,of the radiology department of the Albert Einstein Medical Center in Philadelphia, was also very impressed with thermography and wrote papers in support of this technology.5,6
Unfortunately there were many others who didn’t share the same enthusiasm. For example, the 1982 first edition7 textbook Mammography, Thermography, and Ultrasound in Breast Cancer Detection was name-changed to Breast Cancer Detection: Mammography and Other Methods in Breast Imaging in the 1987 second edition. The foreword section of the first edition stated, “Thermography in the hands of some experts is a valuable diagnostic tool.” However, the second edition foreword did an about face and stated, “Thermography was proved not to be effective in breast cancer detection in the Breast Cancer Detection Demonstration Projects (BCDDP), and was discontinued after the second year of the five-year program.” Many have criticized this 1970s project and perhaps the best history and criticism appears in Keyserlingk’s report,8 where he calls BCDDP “ill-conceived and poorly controlled.” The political and economic forces (i.e., radiology groups) seemed to drive thermology into the dark with just a few small groups believing in the technology. After all, this method is a “do-no-harm” technology and offers women a safe method to help in the “early detection” of breast cancer.
The Technology Revolution—Now and in the future
The improvement in computers and electronics has changed the face of modern medical thermography. In the old days (1980s) they used contact thermography and low-resolution, film-based systems. Computerized systems were also available but the resolution was poor and therefore results were very subjective. Just in the past few years, several articles in medical electronic journals have been published on the medical use of thermography. No longer do we need to interpret the old film shots or Polaroids of the ’80s. We now have systems and detector materials with very high resolution and temperature sensitivity. A computer algorithm processes the raw thermal data and paints a clearer picture. Sequential thermograms during a cold stress allow further refinement of the suspected areas and tests sympathetic function.
Basic Requirements and Qualifications
In September 1999 Alternative Medicine did a story on breast thermography. It was a big hit with women and they wanted to know where to get theirs. Unfortunately for them, the article listed many places that had some equipment but the people at these places were not set up nor specifically trained for breast thermography and offered no guarantee that one would get high-quality images or accurate interpretation. Someone must read, process and interpret the raw images in context with a specific situation. Obviously only trained health professionals should interpret the thermograms and give specific recommendations. There are, of course, the basics that need to be followed by the facility for a high-quality set of images to be obtained. The room must be kept around 70 degrees F, carpeted and with no drafts. There is a minimum cooling time of around five minutes for the subject to be completely exposed from the waist up. A cold stress challenge is an option and can be done with fans or cold water however, there are no studies comparing the two so using fans is more convenient for the subject and most preferred at this time. A recent study by experienced Japanese medical thermographers9 used electric fans for the cold stress and increased the diagnostic accuracy from 54 percent to 82 percent. Breast thermography using high-resolution digital imaging is here to stay and is considered by some experts to be the screening method of first choice.
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