The Status and Future of Diagnostic Infrared Imaging for Breast Cancer

Guest Editorial

The Status and Future of Diagnostic Infrared Imaging for Breast Cancer

Ancient physicians lacked the scientific rationale for medical practices that we take for granted in the modern era.  Without any concept of the causative mechanisms, the earliest surviving medical texts describe a practical wisdom that associated body heat with the life process, excess body heat with certain diseases and precipitusly cooling after death. (1)  So too was it in 1956, with the advent of the first analog infrared imagers, a physician first observed unusual "hot spots" overlying known breast cancers. (2)  Early investigators speculated that the basis for the hot skin patterns overlying breast cancer was local inflammation or attributed to the inefficiencies of cancer's divergent metabolism. (3,4)  Amazingly invasive clinical experiments of the era revealed some features of the heat flow in the breast but did not reveal the fundimental basis for the hot patterns associated with breast cancer. (5,6)  A simple calculation of the energy requirements to maintain the increased temperatures commonly encountered with breast cancer effectively eliminates locally generated metabolic heat as a possible mechanism for the hot patterns related to breast cancer. (7)

 Early thermographers started with a broad knowledge of breast cancer pathology and developed an applied emperical method from their experience with infrared imaging of many patients as part of a comprehensive diagnostic work-up and biopsy.  Under the best of circumstances, the most expert of these early emperical thermographers achieved a diagnostic accuracy of 72%. (8)  While almost all breast cancers
produce patterns of elevated skin temperatures, the specificity of their empirical
methodology was invariably poor as it was confounded by noncancerous conditions
that also present "hot spots." It was the poor specificity demonstrated by the
empirical application of thermography in the National Cancer Institute's Breast
Cancer Detection Demonstration Project that was cited as the reason breast
thermography was not recommended for wide clinical application.9 As
a result, Medicine relegated thermography and promoted X-ray mammography as the
singular screening modality for breast cancer.  Fundamental limitations have
constrained X-ray mammography from satisfactorily fulfilling the important role
as a primary screening modality for breast cancer. Recently revised clinical
guidelines that do not recommend screening X-ray mammography for women under 50 years and biennial screening of women aged 50 to 74 appear paradoxical to the
persistently high incidence and serious risk of death from breast cancer outside
the context of the limitations of X-ray mammography.10 The diagnostic sensitivity of 
 X-ray mammography is significantly diminished for premenopausal women, pregnant or lactating women, women with fibrocystic/dense breasts, women with unusually large or small breasts, women with prior biopsies, women with mammoplasty or reductions, menopausal women taking HRT, and women with fast-growing carcinomas. Screening X-ray mammography demonstrates 20% false-negative rate (40% for women under 50), an 83% false-positive rate, and a 10% to 15% interval diagnosis of breast cancer in less than one year.11  2500 women require annual screening X-ray mammograms for 10 years to prevent the death of 1 woman, while 1000 of those women would have at least one false-positive finding, and 500 women would undergo unnecessary biopsy.12  Worse, breast cancer would be overdiagnosed in 5 to 15 women, who will needlessly receive treatment with surgery, radiation, or chemotherapy singularly or in combination.12X-ray mammography is now controversial as a primary screening tool for breast cancer and has not demonstrated the ability to detect the different varieties of breast cancer for the at-risk population at a stage early enough to save lives.13,14 However, most practitioners don't get this information. Certainly, it is not part of the annual public exhortation of "breast cancer awareness" month.

Diagnostic infrared imaging has a well-established scientific basis as a biomarker for breast cancer. Two abnormal mechanisms, dysfunctional neoangiogenic blood vessels and the strong dilatory effect of nitric oxide, are responsible for the "hot spots"
associated with breast cancer as the dysregulated hyperemia of core body-temperature blood flows to a relatively superficial area.15-18 New generations of high-resolution digital instruments combined with methodology intended to differentially indicate breast cancer and the standardized reporting format of the Marseille System (TH-1-TH-5) have enabled an objective and quantitative analytic system for diagnostic infrared imaging for breast cancer with high sensitivity and specificity. These developments are a sharp departure from the empirical origins of judgment-based thermography that is characterized by the termthermology, a young but proper medical science. Applying these abilities into a clinical diagnostic tool has yielded a sensitivity of 96% and a specificity of 91% in a large-scale clinical study, a
substantial improvement over that of the earlier era.19 Currently, there are well over 800 peer-reviewed clinical studies on diagnostic infrared imaging for breast cancer in the Index Medicus literature with a database in excess of 300,000 women participating in these studies, often in large cohorts and some followed up to 12 years.

With these developments, breast thermology should be progressing into medicine's mainstream. However, diagnostic infrared imaging is an unregulated activity without effective practice guidelines. The lack of national standards has permitted a new
generation of pretentious thermographers to disregard the relevant developments
of the past 50 years and practice a obsolete form of judgment-based empirical thermography without the comprehensive multidisciplinary experience that enabled the early successes.20,21

Currently, a variety of companies provide a broad range of infrared devices and reporting services, making diagnostic claims for breast cancer detection. Recently published studies based upon this underclass technology have demonstrated the vastly inferior diagnostic sensitivity to the clinical studies of 40 years ago and belie the real abilities of modern thermology.22 More appalling are the incredible
claims of "whole body" diagnostic studies for "visceral health," "digestive disorders: irritable bowel syndrome, diverticulitis and Crohn's disease," "immune dysfunction," "nutritional disease (alcoholism, diabetes)," "chronic fatigue," and "gingivitis" that are unsubstantiated by any proper studies published in peer-reviewed journals. Thermal imaging of the skin is certainly nonspecific and insensitive for pathologies in the core of the body with no demonstrated diagnostic ability to indicate inflammatory or hypermetabolic processes in the body's core.23 Diagnostic thermal imaging is not a
legitimate tool for every medical condition, and claims for these novel applications are speculative and without diagnostic parameters at best and probably misleading. These preposterous claims can be seen as evidence of defective scholarship, doubtful veracity, and/or overriding financial interests.  These unsubstantiated diagnostic claims have evoked the FDA to issue formal warning letters to some of the equipment providers.24-26 Some companies involved with the sale of infrared imaging systems and the judgment-based thermography reporting services have created clinical thermography "professional" organizations rather than participate in established peer
professional organizations. These petty organizations are simple inventions
centered on proprietary interests with the purpose of justifying an obsolete methodology and covering their otherwise lack of relevant professional credential with daisy-chained and vapid "board certifications." Considering the bold and unsubstantiated claims made by self-proclaimed thermographers sporting meaningless "certifications," is it any wonder that many sincere medical professionals don't know what to make of diagnostic infrared evaluation for breast cancer detection? All this considered, I call for responsible physicians and scientists involved in breast thermology to join with me in the formation of an interest group in order to
advise professional organizations and regulatory agencies in matters of policy
and practice.

REFERENCES

1.  Breasted JH. The Edwin Smith Papyrus. New York Historical Society; 1922.

2.  Lawson R. Implications of surface temperatures in the diagnosis of breast cancer. Canad Med Assn J. 1956;75:309-310.

3.  Lawson RN. Thermography - a new tool in the investigation of breast cancer. Can Serv Med J. 1957;13:517-518.

4.  Head JF, Elliott RL. Thermography. Its relation to pathologic characteristics, vascularity, proliferation rate, and survival of patients with invasive ductal carcinoma of the breast.Cancer.  1997;79:186-188.

 5.  Lawson, op. cit.

 6.  Lawson RN, Chughtai MS. Breast cancer and body temperatures. Can Med Assoc J.1963;88: 68-70.

 7.  Anbar M. Hyperthermia of the cancerous breast: analysis of mechanism. Cancer Lett. 1994.

 8.  Isard HI, Ostrum RJ, Shilo R. Thermography in breast carcinoma. Surg Gyne Obst. 1969;128:1294.

 9.  Baker LH. Breast Cancer Detection Demonstration Project: five year summary report.CA Cancer J Clin. 1982;32:192-225.

 10. Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement. Ann Internal Med. 2009(151);10:716-726.

 11.  Lidbrink E, Elfving J, Frisell J, Jonsson J. Neglected aspects of false-positive findings of mammography in breast cancer screening: analysis of the false-positive cases from the Stockholm Trial. BMJ. 1996;312:273.

 12.  Kalagar M, Zelen M, Langmark , et al. Effect of screening mammography on breast cancer mortality in Norway. N Engl J Med. 2010;363:1203-1210.

 13.  Miller AB, To T, Baines CJ, Wall C. The Canadian National Breast Screening Study-1: breast cancer mortality after 11 to 16 years of follow-up: a randomized screening trial of mammography in women age 40 to 49 years. Ann Int Med. 2002;137(5, part 1):305-312.

 14.  Olsen O, Gotzsche PC. Cochrane review on screening for breast cancer with mammography. Lancet. 2001(358);9290:1340-1342.

 15.  Loibl, S. Buck A, Strank C, et al. The role of early expression of inducible nitric oxide synthase in human breast cancer. Eur J Cancer. 2005(41);2:265-271.

 16. Thornsen LL, Miles DW, Happerfield L, Bobrow LG, Knowles RG, Moncada S.
Nitric oxide synthese activity in human breast cancer. Br J Cancer. 1995 July;72(1):41-44.

 17.  Reveneau G, Arnould L, Jolimoy G, et al. Nitric oxide synthase in human breast cancer is associated with tumor grade, proliferation rate, and expression of progesterone receptors. Lab Invest. 1999(79);10:1215-1225.

 18.  Martin JHJ, Begum S, Alalami O, Harrison A, Scott KWM. Endothelial nitric oxide synthase: correlation with histologic grade, lymph node status and estrogen receptor expression in human breast cancer. Tumor Biol. 2000;21:90-97.

 19. Hoekstra P. The autonomic challenge and analytic breast thermology. Thermol Int. 2004(14);3:106.

 20.  Cockburn W. Announcement of official change in thermal reporting [online
document]. Meditherm Clinic. July 26, 2005.

 21.  Leando P. Cold stressing breasts and why don't we do it anymore and the thermal rating system [blog entry]. American College of Clinical Thermology. available
at aact-blog.com.

 22.  Kontos M, Wilson R, Fentiman I. Digital infrared thermal imaging of breast lesions: sensitivity and specificity of detection of primary breast cancers. Clin Radiol. 2011 June;66(6):536-539.

 23. Loviagin EV, Mus VF, Litvinov PD, Iakovleva LA. Possibilities of contact chromatic thermography in the diagnosis of lung cancer. Med Radiol (Mosk). 1991;36:11-14.

 24. US Food and Drug Administration. Warning letter to Central Coast thermography [online document].http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2011/ucm245253.htm.

25. US Food and Drug Administration. Warning letter to Dr. Joseph Mercola. http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2011/ucm250701.htm.

 26.  US Food and Drug Administration. Warning letter to Dr. Peter Leandro.
[online document] http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/ucm249863.htm.

Overview: Beyond Mammography, Len Saputo. MD

The most devastating loss of life from breast cancer occurs between the ages of 30 to 50. Fortunately,
women today have more options available to them to help in the detection of breast cancer than in
past decades. Unfortunately, education and awareness of these options and their effectiveness in
detecting breast cancer at different stages in life are woefully deficient.
The first, part of this in-depth article explores the latest findings on the effectiveness and
shortcomings of various detection methods used by the mainstream medical community, including
mammography, clinical breast exams, and to a lesser extent, magnetic resonance imaging (MRIs) and
PET scans.
The second part of this article goes beyond mammography, exploring a highly advanced but much
maligned detection tool for breast cancer--breast thermography. Breast thermography, which involves
using a heat-sensing scanner to detect variations in the temperature of breast tissue, has been
around since the 1960s. However, early infrared scanners were not very sensitive and were
insufficiently tested before being put into clinical practice, resulting in misdiagnosed cases.
Modern-day breast thermography boasts vastly improved technology and more extensive scientific
clinical research. In fact, the article references data from major peer-reviewed journals and research
on more than 300,000 women who have been tested using the technology. Combined with the
successes in detecting breast cancer with greater accuracy than other methods, the technology is
slowly gaining ground among more progressive practitioners.
"Beyond Mammography" concludes that breast thermography needs to be embraced more widely by
the medical community and awareness increased among women. Not only has it demonstrated a
higher degree of success in identifying women with breast cancer under the age of 55 in comparison
to other technologies, but it is also an effective adjunct to clinical breast exams and mammography
for women over 55. Finally, it provides a non-invasive and safe detection method, and if introduced at
age 25, provides a benchmark that future scans can be compared with for even greater detection
accuracy.

Introduction
 
The most devastating loss of life from breast cancer impacts women between the ages of 30 and 50.
For women between the ages of 40 and 44, breast cancer is the leading cause of death, according to
the American Cancer Society. Yet the November 10, 2003 issue of the AMA journal, American Medical
News, reports little evidence documenting that mammography saves lives from breast cancer for
premenopausal women, which are many of the women who fall into these age ranges. (1)
Good evidence supports mammography as a valuable breast cancer screening tool for women in their
late 50s and 60s, but reveals room for substantial improvement. For women over the age of 70,
accumulated data documents limited value in doing mammograms since they do not significantly
extend life. (2, 9, 10)
Obviously, as a detection tool, mammography has a valued place in clinical practice; however, other
technologies are proving to be more effective in breast cancer detection and should become part of
mainstream clinical practice in order to save more lives.

The Prevalence, Fear and Risk Factors of Breast Cancer
 
According to the American Cancer Society (ACS), breast cancer is the leading cause of death in
women between the ages of 40 and 44. Although breast cancer has only 10% the morbidity and
mortality of coronary heart disease, it is generally more feared. (3)
ACS statistics further document that every year in the United States there are approximately 200,000
new cases of breast cancer and more than 40,000 deaths. Not included in this number are more than
47,000 new cases of carcinoma in situ breast cancer, which is better known as DCIS (ductal
carcinoma in situ) or LCIS (lobular carcinoma in situ) and is a very early form of breast cancer.
DCIS and LCIS are very mild cancerous lesions that only become malignant in about 2% of cases. For
this reason many physicians do not consider DCIS and LCIS true cancers.
The risk of breast cancer at age 25 is less than one in 19,000 whereas by age 35 it is one in 217. (4)
Yet, the statistic people are most familiar with is that one in eight women will eventually develop
breast cancer. It is important to appreciate that this number is a cumulative risk that only applies to
women who have reached the age of 90.
The hereditary breast cancer genes, referred to as BRCA 1 and 2 genes, are known to be associated
with both breast and ovarian cancers, but only account for 5 to 10% of all breast cancer. Newer, less
well-known factors are estimated to account for another 10% of all breast cancers. In at least 70% of
cases, however, the cause of breast cancer is yet unknown. (5)

Generally Accepted Risk Factors
 
The risk for breast cancer is increased if you:
* Had your first period before age 12
* Went through menopause after age 50
* Had your first child after age 30 or never were pregnant
* Were on hormone replacement therapy or birth control pills
* Consume one or more alcoholic drinks per day
* Have a family history of breast cancer
* Are found to have inherited the breast cancer genes
* Are postmenopausal and gained weight (not so for premenopausal women)
* Have elevated levels of insulin as seen with syndrome X or type 2 diabetes, which are conditions
associated with central obesity and increased levels of insulin-like growth factor-1 (6)
* Are sedentary
Popular myths regarding what causes breast cancer include antiperspirants, wearing a wire bra, and
having had an abortion.

Mainstream Breast Cancer Screening Technologies
 
The gold standard study that assesses breast cancer detection technologies stems from the "Breast
Cancer Detection Demonstration Project: Five year summary report." (7) This study reviewed 283,000
women between the ages of 35 and 74 who had undergone mammography and clinical breast
examinations. Over a five-year period 4,400 women were found to have developed breast cancer. So,
the purpose of the study was to see how well clinical breast exams and mammography worked in
identifying women with breast cancer.
The BCDDP study documented that overall, clinical breast exams discovered only 60% of women who
actually had breast cancer. When these women had tumors that were less than 1 centimeter, only
47% were identified. However, detection rates were 66% for tumors between one and two
centimeters in size, and were 79% of tumors bigger than 2 centimeters. Clearly, clinical breast exams
are important, but overall they miss nearly 40% of cancers.

Mammography and Women Under 50
 
Mammography has been the state-of-the-art screening test for several decades. However,
considerable controversy remains regarding its value, particularly in women under the age of 50. (1,
8-10) Results from the widely accepted BCDDP study documented that the overall ability of
mammograms to detect cancer was only 70%. This means that 30% of mammograms found to be
negative for potentially cancerous lesions are actually positive.
 
False Positive Rate High
 
The false positive rate of mammograms--those patients without cancer but with a positive finding on
testing--turned out to be another problem. Only one biopsy in six was found to be positive for cancer
when done on the basis of a positive mammogram or breast examination. The combined false positive
rate was determined to be as high as 89%. Identifying and performing biopsies on these clinically
insignificant lesions represents overdiagnosis and overtreatment. Further, the physical and
psychological stress associated with mammogram findings is not a small concern nor are the
additional costs.
 
Too Many Mammograms Performed?
 
Recent data from the University of Washington and Harvard University reveals that over a period of a
single decade, one out of every two women will have a false positive result as the result of
mammography, and of those, nearly 20% will undergo an unnecessary breast biopsy. (9) Contrary to
what many health-related agencies advise, recent findings seem to demonstrate that too many rather
than too few mammograms are performed every year in the United States. Further, estimates show
that for every $100 spent on the cost of mammograms, $33 goes to the unproductive and
unnecessary expense of false positive results.
 
Mammograms for Women Over the Age of 70
 
A recent article from Duke University Medical Center reports that women over 70 are over-screened
for both breast and cervical cancers. (10) The authors estimated the cost in the year 2000 for women
over the age of 70 for the unnecessary mammograms they received was approximately $460 million.
The article went on to point out that clinical guidelines for women over the age of 70 are ambiguous
and based on almost no clinical research.
 
Mammography and Younger Women
 
For younger women, mammography is more likely to miss breast cancers that are rapidly growing,
especially in women with dense breast tissue who are at a significantly increased risk for developing
breast cancer. (15) At least 10% of breast cancers cannot be identified by mammography, even when
they are palpable. (8)

Other Mainstream Technologies
 
Advances in technology now allow digitally enhanced mammograms to be taken alone or after
injecting intravenous contrast, but they have not been proven to be significantly more sensitive than
regular mammograms, and they have the added risk of the invasiveness of an injection that can cause
other problems. Further, they come with a substantial increase in cost and still expose the patient to
radiation. (11)
Similarly, MRIs with and without contrast are a step forward, but they involve similar risks and are
even more costly. While their sensitivity is near 90%, their accuracy (specificity) in identifying cancer
as opposed to some other benign finding is no better than mammograms. (12)
PET scans are useful in identifying metastatic lesions but have an overall sensitivity similar to
mammography. Further, for breast tumors less than one centimeter, only 25% of breast cancers are
identifiable using this technology. (13) The most useful application of PET scans are in discriminating
between viable tumor, fibrotic scar, and necrosis. Radiologists do not recommend PET scanning as a
screening tool in asymptomatic women for breast cancer. (14)
For women under the age of 40, no accurate or cost effective technology exists in mainstream medical
practice that identifies lesions likely to be breast cancer with reasonable sensitivity and specificity.
Given that breast cancer is the leading cause of death in women between the ages of 40 and 44, it is
obvious that a pressing need exists for another test to identify these cancers when they are just
starting to develop and still small enough to be cured.
Most breast cancers do not become palpable until they are greater than one centimeter in size--by
that time 25% have already metastasized. Because most lethal breast cancers take approximately 15
years from their beginning to the time of death, women need reliable testing that starts when the
cancer is initially forming--in their mid-twenties.
Even though there is reliable technology existing today that is available, there is limited awareness
and insufficient education that has resulted in its being greatly underused in clinical practice.

The History of Breast Thermography
 
Breast thermography has been available in clinical practice since the 1960s. Initially, physicians were
very excited when they learned that breast cancers emit more infrared heat than normal healthy
tissues, and that they could be detected using infrared scanners. However, this technology was
brought into practice prematurely--before clinical trials were completed, and before sufficient
information about other health conditions that also emitted large amounts of infrared light were
understood.
Unfortunately, this resulted in many women having breast surgeries that did not have breast cancer.
Eventually, the high rate of unneeded surgeries led to the rejection of infrared breast imaging in the
United States, with the entire technology being sidelined by mainstream medical practice for several
decades.
Since the 1970s, however, clinical research has continued, especially in Canada and France where this
technology is considered more mainstream. More than 800 research papers have been published on
the subject of breast thermography, and a research databank on more than 300,000 women who
have been tested with infrared breast imaging now exists.
In addition, major advances in infrared imaging technology have been achieved that improve the
sensitivity to 0.05 degrees centigrade, which makes identifying breast cancer much easier and more
reliable. The combination of improved technology and scientific clinical research is sparking the return
of breast thermography into clinical practice today.
 
How Breast Thermograms Work
 
Breast thermography measures differences in infrared heat emission from normal breast tissue,
benign breast abnormalities--such as fibrocystic disease, cysts, infections and benign tumors--and
from breast cancers. It does this with a high degree of sensitivity and accuracy. Breast thermography
is a non-invasive measurement of the physiology of breast tissue. This technology is not meant to
replace mammography or other diagnostic tests presently used in clinical practice that measure
anatomical abnormalities in breast tissue. While breast cancer can only be diagnosed by tissue biopsy,
breast thermography safely eliminates the need for most unnecessary biopsies as well as their
associated high cost and emotional suffering, and it does so years sooner than any other test in
modern medicine.
Modern infrared scanners have a thermal sensitivity of 0.05 degrees Centigrade. Because tumor tissue
does not have an intact sympathetic nervous system, it cannot regulate heat loss. When the breast is
cooled with small fans in a room kept at 68 degrees Fahrenheit, blood vessels of normal tissue
respond by constricting to conserve heat while tumor tissue remains hot. Thus, tumors emit more
heat than their surrounding tissues and are usually easily detected by heat-sensing infrared scanners.
Over time, cancerous tissues stay hot or become even hotter--they do not cool down. In sharp
contrast, however, other possible conditions such as fibrocystic breasts, infections, and other benign
disorders cool down as they resolve.
Breast thermograms have highly specific thermal patterns in each individual woman. They provide a
unique "thermal signature" that remains constant over years unless there is a change in an underlying
condition. Thus, over time, it is possible to differentiate between cancers and benign conditions. Based
on this ability to more accurately detect cancers over time, it becomes important to have a benchmark
early on in a woman's life. For this reason, women should have breast thermography performed
beginning at age 25.
Thermograms are graded with a system much like pap smears with grades 1-5. Th1 and Th2 are
normal, Th3 is moderately abnormal, and Th4 and Th5 are severely abnormal and require careful
follow-up because many of them are caused by cancer. Of significance, one recent study documented
that women with Th1 and Th2 scores can be reassured with a 99% level of confidence that they do
not have breast cancer. (16)
 
Clinical Research Supporting Breast Thermography
 
At least five important studies published between 1980 and 2003 document that breast thermal
imaging is a major advancement in identifying breast cancers not only with greater sensitivity and
specificity, but also years earlier than with any other scientifically tested medical technology.
These scientific studies include:
* Cancer, 1980, Volume 56, 45-51. (17) Fifty-eight thousand patients with breast complaints were
examined between 1965 and 1977. Twelve hundred and forty-five patients with abnormal Th3
mammotherms had normal breasts by mammography, ultrasound, physical exam, and biopsy. Thirtyeight
percent of women with normal breasts and 44% of those with mastopathy developed biopsy
proven breast cancer within five years. Ninety percent of patients with Th4 or 5 had diagnosis of
cancer made on their first visit.
* Biomedical Thermology, 1982, 279-301, Alan Liss, Inc, New York. Michel Gautherie, MD, followed
10,834 women over 2 to 10 years by clinical examination, mammography and thermography. (15)
The study followed 387 people with normal breast examinations and mammograms but Th3
thermographic scores for an average of less than three years. In those without symptoms, 33%
developed cancer. In those with cystic mastitis, cancer developed in 41%. These were predominately
women between 30 to 45 years of age where breast cancer is the leading cause of death.
* Thermology, 1986, Volume 1, 170-73. (18) The effectiveness of mammography, clinical palpation,
and thermography were compared in the detection of breast cancer. Thermography had the best
reliability, but the best results were found when all three were used together.
* The Breast Journal, Volume 4, 1998, 245-51. (19) Keyserlingk et al documented 85% sensitivity in
diagnosing breast cancer using clinical examination and mammography together. This increased to
98% when breast thermography was added.
* American Journal of Radiology, January 2003, 263-69. (16)
The journal reported that thermography has 99% sensitivity in identifying breast cancer with single
examinations and limited views. Thus, a negative thermogram (Th1 or Th2) in this setting is powerful
evidence that cancer is not present.
Important Highlights from Breast Thermography Studies
* Advances in infrared technology combined with data on 300,000 women with mammotherms
document that breast thermography is highly sensitive and accurate. Today, this means that more
than 95% of breast cancers can be identified, and that this is done with 90% accuracy. In women
under the age of 50, where there is the most devastating loss of life from breast cancer,
mammography, MRIs and PET scans cannot come close to matching the combined sensitivity and
specificity (accuracy) of breast thermography.
* Breast thermography involves no radiation exposure or breast compression, is easy to do, is done in
a private setting, and is affordable.
* The FDA approved breast thermography for breast cancer risk assessment in 1982.
* It is important to begin breast cancer screening long before age 40. It should begin at age 25 in
order to identify young women who are already developing breast cancer since it takes approximately
15 years for a breast cancer to form and lead to death. Further, young women with dense breast
tissue are the most difficult to evaluate using breast palpation, mammography, and ultrasound
examinations, yet their significantly higher risk of developing breast cancer can be accurately detected
with breast thermography.
* Mainstream procedures are not approved for breast cancer screening in women under age 40--it is
widely known and accepted that they miss too many cancers and lead to too many false positive
findings that result in far too many needless breast biopsies.

Conclusion
 
There is an abundance of scientific evidence supporting that breast thermography is the most
sensitive and accurate way to identify women with breast cancer, especially in women under the age
of 55, where it causes the most devastating loss of life. For women over 55, breast thermography is
an important adjunct to clinical breast examination and mammography, as this combination has been
documented to increase identification of breast cancers to 98%.
Because of its low cost and high degree of sensitivity and accuracy, all women who want to be
screened for breast cancer should begin having breast thermograms beginning at age 25. Clearly,
there are situations that warrant the use of other modalities such as mammography, ultrasound, MRI,
PET scanning, nipple aspirations, or biopsy, and these valuable tools should continue to be used in
clinical practice along with breast thermography.
Many new technologies are on the horizon that may become mainstream in the near future. With the
advent of highly sophisticated genetic technology, new proteins are constantly being discovered that
offer promise as markers of early breast cancer. (20) Recently published reports also suggest that
MRI technology may be blended with spectrophotometric measurements that could diagnose breast
cancer without even doing a biopsy. (21)
The practice of medicine, just like everything in life, is in constant evolution--there is no guarantee
that what is in the mainstream today will be here tomorrow. Yet, the advancement of all fields of
endeavor often moves slowly and cautiously, sometimes at the expense of human life. We must
remain open and alert as new, exciting, and safe strategies emerge, especially in situations where
there is such a pressing need for new approaches.

References
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Liquid-Crystal Thermal Imaging. Biomedical Thermology, pages 279-301. 1982 Alan R. Liss, Incl, 150
Fifth Avenue, New York, NY 10011.
16. Parisky, Y R, et al. Efficacy of Computerized Infrared Imaging Analysis to Evaluate
Mammographically Suspicious Lesions. American Journal of Roentgenology, January 2003, 263-69.
17. Gautherie, M, and Gros, C M. Breast Thermography and Cancer Risk Prediction. Cancer, 1980,
volume 56, 45-51.
18. Nyirjesy, M D, et al. Clinical Evaluation, Mammography and Thermography in the Diagnosis of
Breast Carcinoma. Thermology, 1986, volume 1, 170-73.
19. Keyserlingk, M D, et al. Infrared Imaging of the Breast: Initial Reappraisal Using High-Resolution
Digital Technology in 100 successive cases of Stage I and II Breast Cancer. The Breast Journal,
volume 4, 1998, 245-51.
20. Zangar, R. Breast Cancer Research and Treatment. July 3, 2003.
21. Bolan, P. In vivo quantification of choline compounds in the breast with 1H MR spectroscopy.
Magnetic Resonance in Medicine. Volume 50, Issue 6, Date: December 2003, Pages: 1134-1143.
by Len Saputo, MD
Correspondence:
Len Saputo, MD
Health Medicine Institute
3799 Mt. Diablo Blvd.
Lafayette, California 94549 USA
925-926-3799
www.healthmedicineinstitute.com
COPYRIGHT 2004 The Townsend Letter Group
COPYRIGHT 2004 Gale Group

 

 

The Institute of Medicine is finally acknowledging the toxic effects of mammogram radiation as a significant factor in the development of breast cancer  - just one mammogram can expose you to the radiation equivalent of 1,000 chest x-rays.

Mammograms also carry an unacceptably high rate of false positives—up to 6 % —which can lead to repeat screenings that expose you to even more radiation, as well as unnecessary medical procedures, including biopsies, surgery, and chemotherapy.

 

A new study in the British Medical Journal highlights losses in quality of life related to the high rates of false positives and unnecessary treatment associated with breast cancer screening. Mammograms have been scientifically proven not to save women’s lives, and do not improve breast cancer survival rates over annual physical examination alone.

Your immune system is your greatest weapon against breast cancer; research now shows that 30%t of breast tumours go away on their own, because a healthy immune system is so adept at eradicating cancer.

 

According to the National Breast Cancer Foundation, 200,000 new cases of breast cancer will be diagnosed each year in the US, making it three times more common than other gynaecological cancers. Breast cancer will claim the lives of 40,000 people this year. In fact, the only type of cancer that claims the lives of more women is lung cancer. Even more disturbing is the speed at which breast cancer rates have risen over the past 5 decades. In 1960, one in 20 women was diagnosed—but today, it is one in seven.

 

 

The following are some important facts about this type of cancer:

 

 Breast cancer is the leading cause of death for women age 40 to 55. (1)

 

15 % of all breast cancers occur in women under age 45; in this age group, breast cancers are more aggressive and have lower recovery rates.

 

80 % of breast lumps are NON-cancerous.

 

70 % of breast cancers are found through breast self-exams.

 

About 80 % of women diagnosed with breast cancer have no family history of breast cancer.

 

The toxic effects of mammogram radiation are finally being acknowledged as a significant factor in the development of breast cancer. Several recent studies have clearly shown that breast cancer screenings may be causing women more harm than good. A new study published in the British Medical Journal (December 2011) confirmed that breast cancer screening may cause women harm, especially during the early years after they start screening.

 

 

This harm is largely due to surgeries, such as lumpectomies and mastectomies, and other (often unnecessary) interventions.(2) The study highlights losses in quality of life from false positive results and unnecessary treatment. Fortunately, we're beginning to see the initial stirrings of change, as this latest report from the Institute of Medicine (IOM) shows, which calls into question the role environmental exposure may be playing in the development of breast cancer.

 

 The IOM committee is absolutely correct in calling for more research into the risks of various environmental exposures over the course of a woman's lifetime.(3)

 

Isn't it ironic that the mammogram—the principle diagnostic test given to women to help detect and prevent breast cancer—is responsible for increasing women's risk for developing it?

Mammogram Radiation is Much More Damaging than a Chest X-Ray. Mammograms use ionizing radiation at a relatively high dose, which can contribute to the mutations that can lead to breast cancer. You can get as much radiation from one mammogram as you would from 1,000 chest X-rays. Mammography also compresses your breasts tightly, which can lead to a dangerous spread of cancerous cells, should they exist. Dr. Samuel Epstein, one of the world's top cancer experts, has stated: "The premenopausal breast is highly sensitive to radiation, each 1 rad exposure increasing breast cancer risk by about 1 percent, with a cumulative 10 percent increased risk for each breast over a decade's screening.

" Breast Cancer Screening May Lead to Unnecessary Treatments and Surgeries that Can Actually SHORTEN Your Lifespan.

 

Another concern is that mammograms carry an unacceptably high rate of false positives—up to 6 %. False positives can lead to expensive repeat screenings, exposing you to even more radiation, and can sometimes result in unnecessary invasive procedures such as biopsies, surgery, radiation, and chemotherapy. In fact, if you undergo breast screenings, you have a 35% increased risk of having surgery.(4)

 

If a mammogram detects an abnormal spot in your breast, the next step is typically a biopsy. This involves taking a small amount of tissue from your breast, which is then looked at by a pathologist under a microscope to determine if cancer is present. These biopsies are notoriously inaccurate, often leading to misdiagnosis and unnecessary treatments, not to mention undue emotional stress. Just thinking you may have breast cancer, when you really do not, focuses your mind on fear and disease, and the stress is actually enough to trigger an illness. It is well established that stress has damaging effects on your health. So, a false positive diagnosis can be damaging to your health from multiple angles.

 

In a 2009 Cochrane Database Systematic Review of breast cancer screening and mammography, the authors wrote:(5) "Screening led to 30% over diagnosis and overtreatment, or an absolute risk increase of 0.5 %. This means that for every 2000 women screened for 10 years, one will have her life prolonged, and 10 healthy women who would not have been diagnosed if they had not been screened, will be treated unnecessarily."

 

Unfortunately, the disturbing scientific findings do not end there. This means that by having these breast cancer screenings, you may be shortening your life, rather than extending it. In reference to the 2011 BMJ findings about the damage being done by breast cancer screening, Sayer Ji of Green Med Info wrote:(6) "What is perhaps most disturbing about these findings is that, while they clearly call into question the safety and effectiveness of breast screenings, the studies upon which they are based use an outdated radiation risk model, which minimizes by a factor of 4 to 5 the carcinogenicity ... What this indicates, therefore, is that breast screenings are not just 'causing more harm than good,' but are planting seeds of radiation-induced cancer within the breasts of millions of women." Mammograms are NOT Really Saving Lives, Research Says In September 2010, the New England Journal of Medicine, one of the most prestigious medical journals, published the first study in years7 to examine the effectiveness of mammograms. Their findings are a far cry from what most public health officials would have you believe. The bottom line is that mammograms seem to have reduced cancer death rates by only 0.4 deaths per 1,000 women—an amount so small it might as well be zero. Put another way, 2,500 women would have to be screened over 10 years for a single breast cancer death to be avoided. So, not only are mammograms unsafe, but they are NOT saving women's lives, as was commonly thought. Past research has also shown that adding an annual mammogram to a careful physical examination of the breasts does not improve breast cancer survival rates over physical examination alone.

 

If mammograms won't save you, then what will?

 

Cancer's Greatest Enemy: Your Immune System.

Recent discoveries suggest that your immune system is designed to eliminate cancer. However, when you implement caustic medical interventions (such as radiation and chemotherapy) that damage your immune system so that it cannot respond appropriately, you are destroying your body's best chances for healing. Unfortunately, mammograms tend to increase the likelihood that women will undertake medical procedures that interfere with this natural healing ability. There is now a great deal of scientific evidence supporting the theory that your own immune system is your best cancer weapon: Individuals with liver or ovarian cancer survive longer if their killer T cells have invaded their tumours. A 2005 study showed that colon cancers that most strongly attract T cells are the least likely to recur after treatment.(8)   Another study found that 60 percent of precancerous cervical cells (found on PAP tests) revert to normal within a year and 90% revert within three years.(9)   Some kidney cancers are known to regress, even when highly advanced. The presence of white blood cells in and around a tumour is often an indication that the cancer will go into remission—or even vanish altogether—as this New York Times article explains.(10)  

A breast cancer is no exception. 30% of Breast Tumours Go Away on their Own. According to breast surgeon Susan Love of UCLA, at least 30 percent of tumours found on mammograms would go away if you did absolutely nothing.(11) These tumours appear to be destined to stop growing on their own, shrink, and even go away completely. This begs the question—how many cancer cures that are attributed to modern interventions like chemotherapy and radiation, are actually just a function of the individual's immune system ridding itself of the tumour on its own? How many people get over cancer in spite of the treatments that wreak havoc on the body, rather than because of them? It is impossible to definitively answer this question. But it is safe to say that the strength of your immune system is a major factor in determining whether or not you will beat cancer, once you have it. Nearly everyone has cancerous and pre-cancerous cells in their body by middle age, but not everyone develops cancer. The difference lies in the robustness of each person's immune system. Dr. Barnett Kramer of NIH12 says it's becoming increasingly clear that cancers require more than just mutations to progress. They need the cooperation of surrounding cells, certain immune responses, and hormones to fuel them. Kramer describes cancer as a dynamic process, whereas it used to be regarded as "an arrow that moved in one direction" (e.g., from bad to worse). What does this mean for you?

 

The better you take care of your immune system, the better it will take care of you. One way to strengthen your immune system is to minimize your exposure to mammograms and other sources of ionizing radiation. But you can also build up your immune system DAILY by making good diet and lifestyle choices. One of the best ways to do this is by optimizing your vitamin D level. Vitamin D: Cancer Fighter Extraordinaire Vitamin D, a steroid hormone that influences virtually every cell in your body, is one of nature's most potent cancer fighters. Receptors that respond to vitamin D have been found in almost every type of human cell, from your bones to your brain. Your liver, kidney and other tissues can convert the vitamin D in your bloodstream into calcitriol, which is the hormonal or activated version of vitamin D. Your organs then use it to repair damage and eradicate cancer cells. Vitamin D is actually able to enter cancer cells and trigger apoptosis, or cancer cell death. When Jo Ellen Welsh, a researcher with the State University of New York at Albany, injected a potent form of vitamin D into human breast cancer cells, half of them shrivelled up and died within days. The vitamin D worked as well at killing cancer cells as the toxic breast cancer drug Tamoxifen, without any of the detrimental side effects and at a tiny fraction of the cost. I strongly recommend making sure your vitamin D level is 70 to 100ng/ml if you've received a breast cancer diagnosis. You can achieve this through direct, safe exposure to ultraviolet light, or if this is not possible, by taking an oral vitamin D3 supplement. Vitamin D works synergistically with every cancer treatment I am aware of, without adverse effects. Please watch my free one-hour lecture on vitamin D for more information. For a comprehensive guide to breast cancer prevention and treatment, refer to this previous article. Some of the other research-based breast cancer fighters include the following: Eating plenty of fresh, whole, organic vegetables, especially fermented vegetables Avoiding all processed foods, and minimizing sugar, grains and starchy foods Vitamin A plays a role in preventing breast cancer; your best sources are organic egg yolks, raw milk and butter, and beef and chicken liver (from organically raised, grass pastured animals) Curcumin (the active agent in turmeric) is one of the most potent tumour-inhibiting foods; black cohosh, artemisinin, green tea, kelp, cruciferous vegetables and evening primrose oil also show promise in helping to prevent breast cancer Getting plenty of exercise daily.

 

If You Are Diagnosed With Early Stage Breast Cancer.

 

In the event that you are diagnosed with early stage breast cancer, always get a second opinion—and possibly a third and fourth. I cannot stress this enough, as false positive rates are just too high and the diagnostic criteria is too subjective. Before you make any decision about treatment, and definitely before you decide to have surgery or chemotherapy, make sure your biopsy results have been reviewed by a breast specialist who is knowledgeable and experienced in that field. The majority of breast cancer is preventable. But if you are hit with that diagnosis, don't lose hope! There is a great deal you can do to harness your body's own powerful healing abilities.

 

References: ________________________________________ 1  About Breast Cancer, The Breast Cancer Site. 2 Possible Net Harms of Breast Cancer Screening: Updated Modelling of Forrest Report, British Medical Journal, December 8, 2011: 343; d7627, James Raftery and Maria Chorozoglou. 3 Breast Cancer and the Environment: A Life Course Approach, Institute of Medicine of the National Academies, December 7, 2011. 4 Confirmed: Breast Screenings Cause More Harm Than Good, GreenMedInfo.com, January 5, 2012: Sayer Ji. 5 X-ray Mammography: For Every Woman Whose Life is Prolonged 10 Women's Lives will be Shortened, i.e. "Treated Unnecessarily", Cochrane Database of Systematic Reviews, October 7, 2009: 2009(4); CD001877, Peter C. Gotzsche and Margrethe Nielsen. 6 Confirmed: Breast Screenings Cause More Harm Than Good, GreenMedInfo.com, January 5, 2012: Sayer Ji. 7 Effect of Screening Mammography on Breast-Cancer Mortality in Norway, New England Journal of Medicine, September 23, 2010: 363(13); 1203-10, Mette Kalager, MD, et al. 8 Effect of Screening Mammography on Breast-Cancer Mortality in Norway, New England Journal of Medicine, September 23, 2010: 363(13); 1203-10, Mette Kalager, MD, et al. 9 Regression of Low-grade Squamous Intra-epithelial Lesions in Young Women, The Lancet, November 6, 2004: 364(9446); 1678-1683, Anna-Barbara Moscicki, M.D., et al. 10 Cancers Can Vanish Without Treatment, but How?, The New York Times, October 26, 2009: Gina Kolata. 11 Could This Be The End of Cancer?, Newsweek, December 12, 2011: Sharon Begley. 12 Cancers Can Vanish Without Treatment, but How?, The New York Times, October 27, 2009: Gina Kolata. Sources: CNN Health December 7, 2011 Chicago Tribune Health November 21, 2011 Institute of Medicine of the National Academies December 7, 2011 National Cancer Institute Recommendations The Daily beast December 12, 2011 New York Times October 26, 2009 Lancet November 6, 2004 The Breast Cancer Site New England Journal of Medicine December 22, 2005 New England Journal of Medicine September 23, 2010 Green Med Info January 5, 2012 Green Med Info December 8, 2011 British Medical Journal December 8, 2011 Green Med Info October 7, 2009

Further reading:


American Journal of Roentgenology:

Efficacy of Computerized Infrared Imaging Analysis to Evaluate Mammographically Suspicious Lesions 
http://www.ajronline.org/content/180/1/263.full.pdf+html


An overview of  Infrared Thermal Imaging in Medicine with referenced studies.


Dr. William Cockburn, DC FIACT, FABFE Articles on Thermography:

http://www.breastthermography.org/secondlook.html 



In English | En español
Questions About Cancer? 1-800-4-CANCER
 

Breast Cancer Screening (PDQ®)

  • Updated: 07/27/2011

Table 1. Harms of Screening Mammography

Harm Study Design Internal Validity Consistency Magnitude of Effects External Validity 
Treatment of insignificant cancers (overdiagnosis, true positives) can result in breast deformity, lymphedema, thromboembolic events, new cancers, or chemotherapy-induced toxicities.Descriptive population-based, autopsy series and series of mammary reduction specimensGoodGoodApproximately 33% of breast cancers detected by screening mammograms represent overdiagnosis.[6]Good
Additional testing (false-positives)Descriptive population-basedGoodGoodEstimated to occur in 50% of women screened annually for 10 years, 25% of whom will have biopsies.[7]Good
False sense of security, delay in cancer diagnosis (false-negatives)Descriptive population-basedGoodGood6% to 46% of women with invasive cancer will have negative mammograms, especially if young, with dense breasts,[8,9] or with mucinous, lobular, or fast-growing cancers.[10]Good
Radiation-induced mutations can cause breast cancer, especially if exposed before age 30 years. Latency is more than 10 years, and the increased risk persists lifelong.Descriptive population-basedGoodGoodBetween 9.9 and 32 breast cancers per 10,000 women exposed to a cumulative dose of 1 Sv. Risk is higher for younger women.[11,12]Good

References

  1. Zahl PH, Strand BH, Maehlen J: Incidence of breast cancer in Norway and Sweden during introduction of nationwide screening: prospective cohort study. BMJ 328 (7445): 921-4, 2004.  [PUBMED Abstract]

  2. Elmore JG, Barton MB, Moceri VM, et al.: Ten-year risk of false positive screening mammograms and clinical breast examinations. N Engl J Med 338 (16): 1089-96, 1998.  [PUBMED Abstract]

  3. Rosenberg RD, Hunt WC, Williamson MR, et al.: Effects of age, breast density, ethnicity, and estrogen replacement therapy on screening mammographic sensitivity and cancer stage at diagnosis: review of 183,134 screening mammograms in Albuquerque, New Mexico. Radiology 209 (2): 511-8, 1998. [PUBMED Abstract]

  4. Kerlikowske K, Grady D, Barclay J, et al.: Likelihood ratios for modern screening mammography. Risk of breast cancer based on age and mammographic interpretation. JAMA 276 (1): 39-43, 1996.  [PUBMED Abstract]

  5. Porter PL, El-Bastawissi AY, Mandelson MT, et al.: Breast tumor characteristics as predictors of mammographic detection: comparison of interval- and screen-detected cancers. J Natl Cancer Inst 91 (23): 2020-8, 1999.  [PUBMED Abstract]

  6. Ronckers CM, Erdmann CA, Land CE: Radiation and breast cancer: a review of current evidence. Breast Cancer Res 7 (1): 21-32, 2005.  [PUBMED Abstract]

  7. Goss PE, Sierra S: Current perspectives on radiation-induced breast cancer. J Clin Oncol 16 (1): 338-47, 1998.  [PUBMED Abstract]