DEAR DR. GOTT: I would like to know if breast thermograms are as reliable as mammograms in detecting cancer.
DEAR READER: Thermography utilizes an infrared camera to produce images that reveal a pattern of heat and blood flow on or near the surfaces of the body. The process is painless, non-invasive and relatively inexpensive. Although the FDA gave safety approval in 2004, in June 2011 it issued a safety communication notifying consumers that thermography is not a replacement for screening mammography and that on its own is not an effective screening tool. Proponents feel the procedure can detect precancerous inflammatory changes and cancerous tumors up to 10 years earlier than routine mammography. Despite the accolades of some and the fact that the process has been used for almost 50 years, it has never been accepted as clinically useful by many medical professionals, cancer organizations or insurance companies. Further, there has never been a major randomized, controlled study of the procedure’s efficacy, in large part because there are no universal standards. Despite this, renewed interest in the procedure is beginning to flourish with naturopaths, chiropractors and some general practitioners.
There are more than a half dozen thermology societies that perform digital infrared thermal imagery, infrared mammography, digital infrared imaging, and more. Call it what you will but the issue remains that there is no universal standards for quality. And, questions remain as to what type of equipment should be used. At present, cameras range from low-end industrial cameras designed to determine if a building is well-insulated, to more expensive equipment used on spy satellites. Now let’s consider that interpretation of these images requires unique techniques and skills. When a radiologist reviews a mammographic breast film, there are identifiable pattern recognitions, whereas thermography has only one component. Thermography may be beneficial for women with dense breasts, fibrocystic changes and those on estrogen because mammogram testing has a harder time differentiating between cancerous and non-cancerous changes.
According to the U. S. Food and Drug Administration, they are unaware of any valid scientific data to substantiate that these devices, when used on their own, are an effective screening tool for detecting early breast cancer or other breast diseases. Their well-documented view is that thermography is not a replacement for screening mammography and that breast examinations that should be continued on a schedule as outlined by a woman‘s primary care physician or gynecologist. Rather than choosing sides and procedures, even enthusiasts now feel the infrared procedure is an excellent adjunct to mammography, rather than competition.
In my opinion, before thermography can play a positive role in breast cancer detection, many questions must be answered and larger test studies must be performed by reputable sources. Research continues but I‘m taking the position that the jury, for the present time, is unable to endorse or pan the infrared procedure.