Frequently Asked Questions
Here are some questions we answer very often about Thermography...
Is Breast Thermography Safe?
Yes, it is FDA approved in the United States and has been used in Canada and in Europe for over fifty years. Thermography is a non-invasive test. This means that nothing is sent into your body. It simply is creating an image of your breasts by measuring your heat. There is no contact of any kind, nor is there any pain due to compression or radiation. In fact, there is absolutely no contact of any kind with your breast.
Can Thermography diagnose Breast Cancer?
No. Thermography, like mammography is a assessment tool. Thermography identifies abnormal physiological changes in your breasts that may be malignant. Mammography, is an x-ray, as such it identifies certain structures in the breast that can potentially be malignant. 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 an abnormal "lets watch this area" mammography, and 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.
Does Thermography replace Mammography?
No, we recommend that Thermography be used together with Mammography and other structural examinations for the most comprehensive screening and the earliest possible detection.
Is Thermography covered by health insurance plans?
No. As of yet, none of public health insurance plans cover the cost of Thermography. However there are more and more private insurance companies that may cover the cost of this examination.
Have any studies been done regarding the accuracy of Thermography?
Yes, hundreds of studies have been written up in medical journals.
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Do I need a referral from my doctor?
No, a referral is not necessary.
How long does a Thermography Breast Assessment take?
The imaging procedure, including the time to acclimate to the room will take 20 to 30 minutes.
How often will I need a follow up?
This depends on the results of your initial examination. With no unusual changes noted and depending on your age, we will recommend re-imaging annually or every 2 years. If your test results show changes, depending on the level of risk, you will be asked to have a re-examination sooner.
I have breast implants - is Thermography safe?
Yes. Breast implants do not interfere with Thermography. Breast Thermography is painless and safe, using no radiation or compression. It can be used effectively and safely for all women including pregnant or nursing women, women with dense breast tissue, and women with breast implants.
Why do we plunge our hands into cold water during a Thermography Breast Screening? What is "The Cold Challenge"?
During your Thermography Breast Assessment, you will be asked to plunge your hands into 10ºC water for 60 seconds. Your Thermography Technician will then repeat the process of imaging, providing before (baseline) and after (functional) images. Under normal, healthy conditions, your blood vessels will constrict, which a normal physiological response. However, high-risk areas will not respond to this challenge at the same rate as the healthy surrounding tissue. The cold challenge test provides us with additional information that aids in our comprehensive analysis of your images. Thermography is a test of physiology that measures physiological response (dynamic testing vs. static testing), thus a cold challenge test provides us with additional physiological assessment. Breast Thermography clinics that do not perform a cold challenge test are making a grave mistake and doing a disservice to their clients by not following international standards and, in effect, performing only half the test.
Please note, if you have Raynaud’s or any other condition that would prevent you from taking the cold challenge test during your thermography session, please inform your Thermography Technician, who will provide you with an alternative protocol that will not affect your condition.
Why is Thermography not embraced by mainstream medicine?
As a stand-alone test, Thermography has been criticized for its high rate of false negative and false positive results. Historically, infrared cameras lacked the sensitivity to detect subtle temperature changes necessary to identify and monitor disease. Since the 1990’s, major advancements in infrared technology, coupled with sophisticated computerized software programs, have resulted in a significant increase in the accuracy of thermal images. For example, a 4-year clinical trial by Parisky and colleagues demonstrated 97% sensitivity in the detection of Breast Cancer with the use of dynamic, computerized, thermal imaging. In another recent trial, modern digital thermography was also able to detect 97% of biopsy-confirmed breast malignancies.
The high incidence of ‘false’ positive results documented with thermography can often be a reflection of breast abnormalities that are not yet palpable through breast examination or detectable through Mammograms. Early research assessing approximately 58,000 women has shown that a significant percentage (>30%) of abnormal Thermograms, in the absence of any other breast abnormalities, eventually manifest at a later stage as cancer.
Because Thermography cannot provide information on the exact anatomic detail of the breast or define a specific area that needs to be biopsied, it needs to be combined with an anatomical test, such as Mammography. As a functional test, Thermography cannot identify the specific cause of physiological changes to breast tissue. For this reason, it serves as a risk marker and complementary modality, rather than a stand-alone assessment tool.
Thermography is not a competitor to, or a replacement for, Mammography. Rather it is an adjunctive tool that can identify areas of abnormal thermal symmetry, which are often associated with underlying pathology. When functional abnormalities are detected early, there is an opportunity for early intervention. Cure rates for Breast Cancer are thought to be as high as 95% when detected in the earliest stages. When combined with other anatomical procedures, Thermography may contribute to the best possible evaluation of breast health.
What are the benefits of Thermography?
One of the key benefits of Thermography is its effectiveness in women with dense breasts, making it suitable for:
Approximately 18% of Breast Cancers are diagnosed in women during their forties. Women who develop Breast Cancer at a younger age tend to have more rapidly growing cancers that are more likely to metastasize (spread throughout the body).
Women taking hormone therapy
Results from the Women’s Health Initiative trial revealed a significant increase in invasive breast cancer in women taking synthetic hormone replacement therapy.
Serial Thermograms can also help monitor the effects of hormone treatment for fibrocystic breasts.
Women with fibrocystic changes
Fibrous breasts are very dense and can mask early cancers, particularly if no micro calcifications are present. Research has shown that approximately 40% of women with fibrocystic disease and an abnormal thermogram develop breast cancer within five years. Conversely, women with fibrocystic disease and a normal thermogram have a less than 3% likelihood of developing breast cancer.
Thermography can also provide early warnings of breast abnormalities and highlight potentially suspicious cases, particularly when mammographic and clinical exams are equivocal or non-specific.
Thermography as an independent risk marker
An estimated 60-70% of women diagnosed with breast cancer have none of the obvious risk factors. For this reason, breast cancer has been considered an equal opportunity killer. According to a number of researchers, a persistent abnormal thermogram is thought to be “the single greatest indicator of Breast Cancer risk” and is considered 10 times more important than a positive family history for the disease.
Because physiological changes over time are known to precede morphological changes, an abnormal thermogram can often be the first warning sign of an increased risk for Breast Cancer.
The value of thermography as a complementary tool
An increase in the detection rate of breast cancer has been demonstrated in a number of peer- reviewed studies with the combined use of clinical breast examination, mammography, and thermography. In one study using high-resolution thermography, an abnormal Thermogram, coupled with a positive Mammogram and Clinical Breast Exam, was associated with a 98% sensitivity rate for breast cancer detection.
Results from a recent 2010 trial showed an 89% sensitivity rate for the detection of breast cancer in women under 50 when thermal imaging and mammography were combined.
The increase in sensitivity relates to the fact that mammography and thermography do not always identify the same lesion. For example, Gamagami’s research revealed that thermography is able to detect changes in breast temperature and vascularity in 86% of non-palpable breast cancers. This research also concluded that thermal imaging was able to detect 15% of cancers not visible through mammographic assessment. Based on the extensive research by Gautherie and Gros, approximately 10% of Breast Cancers can be detected at an earlier stage with the combined use of thermal imaging.