There are a lot of misconceptions regarding thermograms in breast cancer screening. Many patients often wonder which method of screening is right for them (mammogram, breast MRI, breast ultrasound) and thermograms are often brought up as a less invasive alternative. While thermograms are valuable medical resources, it is important to note what they can and cannot do for breast cancer screenings.
What is a thermogram?
Thermography uses a type of infrared technology that detects and records temperature changes on the surface of the skin. It CAN help screen for breast cancer by using a thermal infrared camera that takes a picture of the areas of different temperature in the breasts. The camera displays these patterns as a sort of heat map. When a cancerous growth develops, there may be excessive formation of blood vessels and inflammation in the breast tissue. These show up on the infrared image as areas with a higher skin temperature.
As the less invasive option, thermography is also less accurate. At present, the detection rate for thermography is only 42% to 80% of cancers, against 82% to 93% with mammography. Its false positive rate is 25%, more than double that of mammography. No evidence exists that it can reliably detect breast cancer as sensitively as mammography.
The main appeal of thermography is that it is a less invasive and less costly way to detect breast cancer than mammography. As it is a newer procedure, it does not have nearly the same degree of research or accreditation in detection as mammography. In 2019, the FDA issued the following warning:
“There is no valid scientific data to demonstrate that thermography devices, when used on their own or with another diagnostic test, are an effective screening tool for any medical condition including the early detection of breast cancer or other diseases and health conditions.”
Scientists suggest that although people may use thermography to complement other methods of screening and diagnosis, they should also use mammography to confirm the results. Women should speak to their doctor about breast cancer screening from around the age of 40 years, and they should follow their doctor’s recommendations about screening.
Mammography equipment is high-maintenance and costly. Sensitivity is reduced when scanning dense breasts or in young women. False positives occur in about 10% of cases, causing unnecessary testing, increased costs, and significant emotional and physical distress.
False-negatives (missing a tumor) occur in about 20% of screening mammograms, especially in very dense breasts and in younger women. Since mammograms are x-rays, they can also cause radiation exposure, which is most dangerous among women under 40 years. Most physicians and oncologists agree that for those above 40, the risk of missing breast cancer detection is higher than the small risk of mammography, which is proved to have saved up to a third of lives by early detection.
Breast ultrasound is generally not used as a screening tool for breast cancer detection because it does not always detect some early signs of cancer such as microcalcifications, which are tiny calcium deposits. A breast ultrasound may be used in women for whom radiation is riskier, such as pregnant women, women younger than 30 years, and women with silicone breast implants. Generally, there is no special care following a breast ultrasound. However, your physician may give you additional or alternate instructions after the procedure, depending on your particular situation.
A breast MRI usually is performed there is a biopsy that’s positive for cancer and your doctor needs more information about the extent of the disease. For people considered to be high-risk, a breast MRI may be used with mammograms as a screening tool for detecting breast cancer. Women who have a very strong family history of breast cancer or carry a hereditary breast cancer gene mutation are considered to be high-risk. Breast MRI is intended to be used along with a mammogram or other breast-imaging test — not as a replacement for a mammogram. Although it’s a sensitive test, a breast MRI can still miss some breast cancers that a mammogram will detect.
The Fast Breast MRI is a low cost, self-pay supplemental study for women with dense breast tissue who want a screening that is more sensitive to breast cancer than mammography. The Fast Breast MRI may detect cancers not visible on a mammogram, however, doctors note that it is not intended to replace mammography. Slow-growing cancers or pre-invasive cancers like those that form in your milk ducts may not easily appear on a fast breast MRI — they may only be seen on a mammogram. Routine screening mammograms are still recommended.
As always, consult your doctor to decide your preferred screening method.
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