Women Have A Safe Alternative to Mammograms to Maintain Annual Screenings

For immediate release from the American College of Clinical Thermology.

 Women of all ages received good news with the recent revision of the government recommendations for screening mammography.  The US Department of Health and Human Services released their findings and recommendations that screening mammography should now be started at age 50 and performed bi-annually. Up until now, screening was recommended on an annual basis at age 40; this new recommendation has created renewed controversy as doctors have concerns about reducing the number of mammograms that would be clinically justified and indicated..  It takes years for most cancers to develop to the stage that they can be detected with mammogram or ultrasound (dense enough for location and biopsy) so Breast Thermography or Digital Infrared Thermal Imaging (DITI) is ideally placed as an alternative screening tool to identify changes over time in the ‘early’ development stages, before there is more advanced pathology that can be detected with other tests. If changes for the better are to be made, then the recent recommendations of the Preventative Services Task Force will establish the foundation of a more affective screening program which should integrate other types of safe testing.  Of the various testing options Breast Thermography or Digital Infrared Thermal Imaging (DITI) offers the most promise for screening the younger age group women.  

To understand the arguments and issues involved with the new recommendations, we need to understand the difference between ‘screening mammography’ and ‘diagnostic mammography’:

‘Screening’ mammography has been performed annually on healthy women from the ages of 40 to 70 and is aimed at identifying suspicious findings, which justify further investigation. ‘Diagnostic’ mammography is performed on patients who have one or more risk factors, clinical symptoms, or most commonly a palpable lump. There is little argument about mammography’s role as the ‘gold standard’ for

evaluating suspicious symptoms but the question was, can we still justify subjecting women without symptoms to ‘screening’ mammography ?  The answer was NO.

The federal department of health and human services  task force says that “the modest benefit of screening mammograms must be weighed against the harms… which are nearly cut in half when mammograms are performed every other year  but the benefits remain the same”. It needs to be pointed out that the recommendations of the task force are not intended for women at increased risk for breast cancer who should continue to be referred for diagnostic mammography by their doctors when appropriate, and on a case by case basis. It is interesting to note that The United States is currently the only country that routinely screens women below age 50 and extends its screening practice by taking two or more mammograms per breast annually in women over age 50. This contrasts with the more restrained European practice of a single view every two to three years. The evidence concludes that while there is a justifiable role for mammography to play in a breast cancer screening program that role is very different from the one currently in place.

For over 20 years Breast Thermography is being used increasingly  by women throughout the US, and it has been rapidly gaining acceptance by doctors as an additional tool in the early diagnosis of breast disease. FDA registered since 1984, Thermography is an adjunctive diagnosic test being offered by hundreds of clinics in all states. A list of certified thermography clinics can be found at the The American College of Clinical Thermology website at :   http://www.thermologyonline.org/Breast/breast_thermography_clinics.htm. Thermography is 100% safe, has no radiation, does not touch the breast, and only takes a couple of minutes. A positive or suspicious thermal study will indicate medical necessity for a mammogram, ultrasound or other tests. The thermal findings will increase the sensitivity and specificity of most other tests by targeting an area of the breast showing dysfunction and providing decision making information in women that would not have otherwise been tested.

Early detection is aimed at prevention and if early changes are detected then we have an opportunity to intervene and change the outcome. The earlier an abnormality is detected the better the treatment options will be, resulting in a better outcome. There are no contraindications for DITI, it is totally non-invasive, no radiation of any type, and no contact with the body so it can ‘do no harm’. DITI is positioned as the ideal screening test for women of all ages but particularly for the 30 to 50 age group. The best possible plan is to use every appropriate test adjunctively to get the highest detection rates without generating additional or unnecessary invasive testing. It would be unfortunate for a patient to forgo a necessary mammogram that was justified, and any decision should be made between the patient and her doctors based on individual history, symptoms and test results.

The principle of informed consent in medicine is ignored if women are not informed of the evidence relating to any risks of a test and if women more readily consent to annual mammograms because they have been given ‘misinformation’ this is as bad as obtaining consent by deliberately blocking valid information. Women are entitled to know the full range of responsible opinion about the benefits, the risks, and the many uncertainties of mammography.

The government task force are to be applauded for presenting the evidence for women and their doctors to be able to make better informed decisions about breast screening.

As reported, the scientific and medical evidence indicates that:

No ‘screening’ mammography is justified for women under the age of 50.

A baseline screening mammogram may be justified at age 50 and bi-annually thereafter.

Accountability and responsibility should be considered in regard to all radiation exposure and the accumulative biological effects.

Reducing ionizing radiation exposure from all other sources whenever possible should be practiced.

Up-to-Date and accurate information must be given to patients for informed consent.

Other non invasive tests should be promoted as part of a breast screening program.

Thermography, Ultrasound and MRI should be further explored, adapted and integrated.

The Record

Alternative to mammograms

In view of the recent U.S. Preventive Services Task Force recommendations concerning new guidelines for having mammograms, some vital information for women needs to be presented. The new guidelines are for the general population, not those at high risk of breast cancer because of family history or gene mutations.

It has always been known that mammograms carry a significant risk of causing and spreading breast cancer, although this has largely been ignored by mainstream medicine. They can cause breast cancer through repeated irradiation of the breasts and spread cancer by the fracturing of the fibrous capsule surrounding the tumor through compression of the breasts.

A 1999 meta-analysis, “Is Screening for Breast Cancer with Mammography Justifiable?,” was published in The Lancet, the United Kingdom’s premier medical journal, in 2000. It said, “Screening for breast cancer with mammography is unjustified.” This study showed that “for every 1,000 females having mammograms over a 12-year period, the life of one was saved, while the total number of deaths increased by six.” The United States continued to screen with mammography until the new recommendations appeared in the Nov. 17 issue of the Annals of Internal Medicine.

Many women are asking themselves, “What should I do now?” The answer is simple: thermography, or digital infrared thermal imaging. This is a true “screening” test that is absolutely 100 percent safe, since it does not require contact with the breasts or use ionizing radiation. It has been approved by the FDA for breast cancer screening since 1982.

Thermography employs an infrared camera that measures the physiology of the breast, not the structures within the breast, as does mammography. The physiology is function rather than structure, more specifically inflammation. Inflammation at any tissue depth will be recorded by the sympathetic fibers in the neurological supply of nerves to that area. This neural information will then be processed through the central nervous system, which will then cause a sympathetic (automatic) response in the area of the skin corresponding to the affected site. Thermographically, the area of hyperthermia seen at the surface of the skin is due to a decrease of sympathetic motor tone (reduced sympathetic function) allowing increased blood flow through the postganglionic gates serving that area. And, all this happens before the presence of a tumor.

In addition, thermography can pick up breast disease eight to 10 years earlier than mammography can pick up a tumor. This happens long before tumor formation, whereas a tumor of a rather large size must be present for mammography to be effective. The bottom line is thermography is preventive, and mammography is no more than “early detection” of an already present tumor.

If any further studies are required for diagnosis, breast ultrasound and breast MRI are the tests of choice, since they are completely safe and do not employ radiation.

Women 21 or older should screen for cancer by doing breast self-examination, clinical breast examination annually and at each doctor’s visit, and thermography.

Alan L. Woods. 

Wyckoff, Nov. 17

The writer, a physician, is director of natural health education for the Institute of Natural Health and Wellness in Wyckoff.

Readers Comments:

Welcome attack on ‘holy grail’

Speaking from the vantage point of a senior citizen, I am thrilled that the U.S. Preventive Task Services Force has issued new guidelines for mammogram screenings.

In the past, whenever I tried to have a conversation with my doctors about the risks of mammography, my questions were answered with anger and belligerence as if I were violating a sacred holy grail.

Now, women can feel free to ask such questions as: Will repeated radiation exposures to the breast pose a cancer risk for premenapausal women under 50?

What about so-called indolent cancers that will never spread and tiny cancers that might go away by themselves? Is it possible that I could be subjected to unnecessary surgery, radiation and chemotherapy and really be healthy?

The benefit of breast thermography is that it offers the opportunity of earlier detection of breast disease than has been possible through breast self examination, doctor examination or mammography alone.

Thermography can detect the subtle physiologic changes that accompany breast pathology, whether it is cancer, fibrocystic disease, an infection or a vascular disease. Your doctor can then plan accordingly and lay out a careful program to further
diagnose and /or MONITOR you during and after any treatment.

Normal

Good thermal symmetry with no suspicious vascular patterns or significant thermal findings.

Fibrocystic Changes

The very significant vascular activity in the left breast justified clinical correlation and close monitoring which returned an opinion of fibrocystic changes taking place.

These changes can be monitored thermographically at regular intervals until a stable baseline is established and is reliable enough for annual comparison.

Early Stage Malignant Tumor

This is the specific area of a small DCIS. We can see the vascular feed and the discreet area of hypothermia that is displacing the surrounding hyperthermia.

Thermography is a painless, non invasive, state of the art clinical test without any exposure to radiation and is used as part of an early detection program which gives women of all ages the opportunity to increase their chances of detecting
breast disease at an early stage. It is particularly useful for women under 50 where mammography is less effective.

Thermography’s role in breast cancer and other breast disorders is to help in early detection and monitoring of abnormal physiology and the establishment of risk factors for the development or existence of cancer. When used with other procedures the best possible evaluation of breast health is made.

This test is designed to improve chances for detecting fast-growing, active tumors in the intervals between mammographic screenings or when mammography is not indicated by screening guidelines for women under 50 years of age.

All patients thermograms (breast images) are kept on record and form a baseline for all future routine evaluations.

This patient’s thermograms have remained stable for two years. These patterns are like a thermal fingerprint which will only change if pathology develops.

Baseline	3 Month Follow-up
First Annual	Second Annual

With the new ultra-sensitive, high resolution digital infrared cameras available today a technology that has been developing over the past 20 years is now becoming more accessible.

Thermography as a physiologic test, demonstrates heat patterns that are strongly indicative of breast abnormality, the test can detect subtle changes in breast temperature that indicate a variety of breast diseases and abnormalities and once abnormal heat patterns are detected in the breast, follow-up procedures including mammography are necessary to rule out or properly diagnose cancer and a host of other breast diseases such as fibrocystic syndrome, Pagets disease, etc.

Canadian researchers recently found that infrared imaging of breast cancers could detect minute temperature variations related to blood flow and demonstrate abnormal patterns
associated with the progression of tumors. These images or thermograms of the breast were positive for 83% of breast cancers compared to 61% for clinical breast examination alone and 84% for mammography.

By performing thermography years before conventional mammography, a selected patient population at risk can be monitored more carefully, and then by accurately utilize mammography or ultrasound as soon as is possible to detect the actual lesion – (once it has grown large enough and dense enough to be seen on mammographic film), can increase the patients treatment options and ultimately improve the outcome.

It is in this role that thermography provides its most practical benefit to the general public and to the medical profession. It is certainly an adjunct to the appropriate usage of mammography and not a competitor. In fact, thermography has the ability to identify patients at the highest risk and actually increase the effective usage of mammographic imaging procedures.

Until such time as a cure has been found for this terrible disease, progress must be made in the fields of early detection and risk evaluation coupled with sound clinical decision making.

Thermography, with its non-radiation, non-contact and low-cost basis has been clearly demonstrated to be a valuable and safe early risk marker of breast pathology, and an excellent case management tool for the ongoing monitoring and  treatment of breast disease when used under carefully controlled clinical protocols.

With the pre mammogram age group (under 50) the benefits of screening to detect any findings or changes that justify additional testing or closer monitoring are simple. With any positive DITI findings in this younger age group, any mammogram and ultrasound sensitivity and specificity will be increased with the objective DITI findings targeting a dysfunction and location and providing decision making information in women that would not have otherwise been tested.

It takes years for most cancers to develop to the stage that they can be detected with mammogram or ultrasound (dense enough for location and biopsy) so DITI is ideally placed as a screening tool to identify changes over time in the ‘early’ development stages, before there is more advanced pathology that can be detected with other tests.

The major benefit in this group is in detecting early changes that precede malignant pathology that will become diagnosable at some stage.

Early detection is aimed at prevention and if early changes are detected then we have an opportunity to intervene and change the outcome.

The earlier an abnormality is detected the better the treatment options will be, resulting in a better outcome.

Prevention may include treatment of inflammation, fibrocystic disease, lymph congestion, estrogen dominance and more specific conditions like angiogenesis.

DITI does not provide any of the same findings or information that mammogram or ultrasound provides, it is a different type of test. DITI shows information relating to vascular activity, inflammation, lymphatic activity, hormonal dysfunction and other ‘functional’ abnormalities. 

There are no contraindications for DITI, it is totally non-invasive, no radiation of any type, no contact with the body so it can ‘do no harm’.

Mammogram and ultrasound shows ’structure’, tissue densities can be evaluated, lumps can be measured, calcifications located and opinions given regarding pathology before biopsy ….. none of which DITI can provide.

There is no comparison or competition between mammogram and DITI. They are two different tests providing different results !    

The results are reported by medical doctors who are certified thermologists and experienced in reading thermograms, the reading doctor takes into consideration all history and symptoms and the results of other tests.

In patients of mammographic age (generally over 50), post menopause or when the density of breast tissue has reduced sufficiently to make mammography more affective, DITI not only provides the benefit of early detection of functional change but can also increase the detection rates of other tests by contributing additional information about functional (physiological) abnormality and also the location of suspicious (positive) thermal findings that may be outside the range of other tests due to location, size of breast, implant, or other limiting factors .

DITI as a screening test in all age groups is designed to establish a baseline (the patients normal thermal fingerprint) for ongoing comparative analysis (normally annual) to detect any physiological change that justifies additional testing (which could be physician exam, mammogram, ultrasound, MRI, blood work, hormone testing or a number of other interventions).

The changes that DITI can detect include, inflammatory pathology (inflammatory carcinoma / inflammatory breast disease) Infection, Lymph dysfunction (lymph congestion, lymph node pathology) Vascular changes (development of new and abnormal blood vessels known as ‘angiogenesis’) and also any suspicious activity outside the range or scope of other tests (outside the boarder of the breast, in the sternum or axilla) so again, there is no comparison or competition between different tests.

DITI cannot detect specific pathology like a biopsy, it cannot detect tumors or micro-calcifications. DITI cannot ‘see’ structure.

DITI does have the potential to create anxiety for a patient (as does mammogram) with equivocal results or results that cannot be confirmed or positively diagnosed but both tests can minimize unnecessary anxiety with better informed consent, education and realistic expectation for the test.

The best possible plan is to use every appropriate test adjunctively to get the highest detection rates without generating additional or unnecessary invasive testing.

It would be unfortunate for a patient to forgo a necessary mammogram that was justified, and any decision should be made with consultation between the patient and her doctors based on individual history, symptoms and test results. 

Peter Leando PhD. DSc. DAc..

Fellow, Royal Society of Medicine.

Fellow, American College of Clinical Thermology.

2030 West First St., Suite E

Fort Myers. FL. 33901

Office: 1-239-337-3631

Fax: 1-239-337-3632

Once upon a time, thermography was a secret weapon. Its
heat-sensing ability helped the military flush out adversaries
hiding by night and led missiles to their targets. People
trapped in burning buildings, lost at sea or in snowdrifts,
could be rescued because their body temperature showed up
as thermal images. So far, so dramatic, but when the
technology was released into the public domain, 1960s
physicians leapt on thermography’s potential as an equally
potent life-saver in the medical sphere: cancerous tissues
emit more infra-red heat than healthy tissue, so here, it
seemed, was a surefire way of detecting tumours.

Zeal, unfortunately, ran ahead of clinical trials, which at the
time were carried out using ex-military and industrial
equipment. Thermography fell out of favour for many years
but good ideas find their own right time: in the past decade
thermography scanning has been re-introduced and refined
in tune with greater understanding of physiology and
advances in computer technology. It is now routinely used in
many areas of mainstream medicine (including
rheumatology, neurology, pain clinics and vascular-related
dysfunction). But so far it’s been most enthusiastically
embraced by the holistic health world, where its value as an
extra diagnostic tool for breast disease is seen as groundbreaking:

“It seems to spot active pre-cancerous breast signs
some six to eight years before any palpable lump appears.”

Thermography’s key asset is that it seems to spot active
pre-cancerous breast signs some six to eight years before
any palpable lump appears. This may well be in time for
wise patients to alter their lifestyle and so modify their
health, reversing the earliest changes. Speedy (the whole
procedure is over in 15 minutes), safe (there’s no exposure
to radiation) thermography is also non-invasive (so there’s
no unpleasant compression and the patient sits in a small
cosy room several feet from the scanner). So could
thermography be the new secret weapon in the battle
against breast cancer? Could it help women avoid
unnecessary mammograms and reduce exposure to harmful
radiation? Could it lead the way beyond screening
mammography which, on its own, only detects breast
disease that is already well developed enough to be seen
with x-ray? We already know that thermography works for
young women where mammography is contra-indicated
because their breast tissue is too dense to “read”. Given the
sharp rise in breast cases among younger women, this
simple screening system would be hot news indeed.

The picture – for young women especially – looks good, and
women would naturally wish thermography to take over
from mammography because it is so simple, painless and
radiation free. But Dr Peter Leando, founder and Managing
Director of Meditherm, the US firm producing high specificity
medical thermal scanners cautions against seeing
thermography as a stand-alone diagnostic miracle:
“Thermography is very much an extra, not an alternative
breast screening tool” he explains, “and I stress that we are
not in competition with mammography or taking on the
same job. Thermography works best in clinical evaluation as
an adjunct to mammography and ultrasound: a study at the
Ville Marie Institute in Canada found thermography to have
an 83 per cent detection rate as opposed to mammography’s
84 per cent. When combined, however the two services
reached 95 per cent accuracy.”

“The real purpose is to establish a base line – a thermal fingerprint.”

A thermal scan can provide additional information about the
body, but it does a different job from mammogram or
ultrasound which test structure and anatomy. Thermography
is a test, instead, of function and physiology and its
overriding purpose in specialist breast screening, says Peter
“is to monitor breast physiology and track changes over
time. A first study is not really designed to identify any
suspicious findings (though of course any patient would
immediately be referred to her physician for further clinical
investigation if worrying signs did emerge). The real purpose
is to establish a base line – a thermal fingerprint, if you like,
of the breast physiology that is normal for that particular
patient. Everyone has a vascular structure and anatomy
that’s particular to them, so what we are trying to establish
in every case is whether this thermal fingerprint is stable, so
we re-scan after the first three months to monitor for
changes that might give concern. Thereafter women are
followed up annually.”

All thermologists – the medical doctors trained to “read”
thermal scans just as radiologists read the x-ray pictures
radiographers have taken – are highly trained to look for
patterns particular to various breast conditions. These may
present as asymmetry – where the colour pattern differs in
one breast from the other – though repeat monitoring could
also evaluate this as normal for that particular woman.
“Comparing right side to left, and different areas of the
breast,” says Peter “we are looking for temperature
differentials and particularly patterns that may be
suspicious. But even if they do change over time, these
differences could also relate to fibrocystic changes, and
thermal ‘hotspots’ could simply reflect nerve irritation.”

Thermography, Peter points out, is not the appropriate firstline
service for any woman with known breast cancer:
“Mammography is more accurate for later stage cancer or
for anyone with a palpable lump, although the thermal
image can help pinpoint where the cancer is most active,
and therefore act as a useful guide for more targeted
mammography. Thermography only enables us to look at
the activity of that lump and see if it’s very vascular,
indicating angiogenesis or an active blood supply “feeding”
the tumour.

“Thermal scanning can’t give the information a mammogram provides in terms of size, density and order of the lump.”

Thermal scanning can’t give the information a mammogram
provides in terms of size, density and order of the lump. It
doesn’t provide what pathology can; it’s purely a test of
physiology. It can’t assess whether a lump is attached to the
surrounding tissue, if it’s rough or smooth, filled with fluid or
a denser, more solid mass. So much is involved in a
diagnosis of cancer. But when thermography does produce
positive findings, it justifies the more invasive tests and it
does give mammography something to look for and so aids
detection.

Thermography really comes into its own as preventative
screening before a woman ever has a scare or is called for
routine NHS mammography at 50. Although the thermal
scan colour images produced look very straightforward,
most women wanting the bottom line about breast health
would not immediately grasp what they are seeing: “What
the thermal image reflects” Peter explains, “is skin blood
flow. We don’t see any organs, any depth into the body or
any conducted heat from deeper structures or underlying
inflammation. Any thermal patterns we do see reflect the
body’s surface temperature as a neural response to
whatever is going on beneath, which could be inflammation,
lymph congestion or angiogenesis. Thermography works
because the skin, as an organ, is totally under the control of
sympathetic nerve function and thermography provides a
snapshot of the body’s response on the skin surface to any
disease or injury.” For young women who are wisely healthconscious
or, at the other end of the spectrum, concerned
about the effects of lifestyle habits like smoking or drinking,
thermography clearly fills a gap in the standard diagnostic
screening process.

As it’s non-invasive, patients can self-refer, yet come away
with a report that then becomes part of their medical record.
If thermography shows cause for concern, then it’s helpful
for a young woman to have something tangible to show her
doctor, who might otherwise dismiss her as one of the
worried well. Peter Leando says his thermography service
regularly picks up patients where a slight change registers
during the three months between initial scan and follow up.
“Sometimes mammography is negative nonetheless, and it
can take up to another year before what we first identify
becomes dense enough for mammography to identify. It
also takes quite a long time before biopsy can verify the
finding because you have to have some physical calcification
or cell growth to get a needle into.”

“Most women in this waiting state would rather not sit back and do
nothing. ‘

Most women in this waiting state would rather not sit back
and do nothing. And those wishing to do all they can to help
themselves, find their way to holistic health practitioners like
Dr Shamim Daya in Harley Street. Shamim (who explains
that she left general practice because “there was too much
emphasis on symptomatic treatment and not enough on the
root cause of the disease process”) will see the situation as a
wake-up call for any such patient in her care:

“I ask a lot of questions about women’s lifestyle and
generally find that they urgently need to clean up their act -
to cut out toxic drinks, drink more water, improve their diet,
introduce an exercise programme. The aim is to minimise
the toxic load that is primarily affecting the liver and
creating lymph congestion. For slightly older women in the
perimenopause, hormone imbalances increase stress on the
body. It’s common to find that these women have a
mouthful of mercury fillings, which also increases the toxic
load. If the lymph congestion is pronounced, I would
prescribe some herbal/homeopathic ‘drainage’ remedies as
well as suggesting that she drank more water and took
exercise. I’d ask ‘Have you done a bowel cleanse with herbal
capsules recently?’ This multi-factorial approach is intended
to get toxic waste out of your system as quickly as possible -
that’s what the breasts are trying to tell me.”

Shamim regularly sees women in their twenties who are
already at risk from smoking and drinking habits that put a
strain on key organs including the liver. Her message to
them cuts straight to the chase: “Please don’t wait till your
thirties, when you have a family and a drastic diagnosis like
breast cancer is the last thing you need.” She is quietly
confident that indications of early breast damage can be
reversed, “although in my experience thermography doesn’t
pick up a problem that will go away on its own. That’s why
we monitor. The importance of follow-up scanning is to
check for the progress of disease or its reversal, provided
my recommendations are followed. If things aren’t
improving as we would hope, then it may be necessary to
take a more aggressive approach to reduce the toxic load,
adding in specialist infrared saunas, correcting any
underlying hormonal imbalances using bio-identical (natural)
hormones and carefully supervised removal of mercury
fillings together with liver-supporting remedies.

“We can only advise and leave the responsibility to them.”

“Obviously we can’t force women to change – we can only
advise and leave the responsibility to them. Thermography
is a great tool for giving women choices and for many it’s a
great motivator for change. My resident thermographer
suggested screening to her own daughter, who seemed
impervious to warnings about booze and fags. Motivated by
her aunt’s recent breast cancer diagnosis, this young woman
came along – and was shocked enough by what she saw on
screen to change her lifestyle almost overnight.”

Thus far the NHS shows no sign of embracing thermography
So, sadly, almost all thermographic breast screening is paid
for privately: “But it’s no more expensive than a takeaway
coffee a day” says Dr Daya “We charge £185 for the first
scan, including a three month follow up. An annual scan is
£150 thereafter.” Sherrill Sellman, (one of icon’s Icons and
author of Hormone Heresy) has described the thermal
scanner as “the most neglected piece of apparatus for
female wellbeing”. Cost wise, it is relatively modest – around
£20,000 would buy a local Health Authority the whole kit -
camera, scanner computer, all the relevant software plus
training for two technicians. You could say that
thermography also has the royal seal of approval, having
been used to scan the four elegant legs of the late Queen
Mother’s racehorses at Lambourn, Berks! Thermal imaging is
very good for pain assessment and for picking up nerve
damage and muscle atrophy.

However promising, the future of thermography in twolegged
health will take its time to unfold. “Medical
developments are always very, very slow” says Peter. “But
breast screening will hopefully progress to include more
physiological assessment and a combined approach using
the different techniques for optimum results and early
detection.” Of the 600 Meditherm scanners worldwide, about
half are used predominantly in breast screening – 200 of
them in the US. In the first year of thermal scanning, one in
30 women presents with positive findings across the age
range from 25-75. That’s one more woman who can seek
early help and thank thermography for providing an extra
weapon in the war against cancer.

Examples
One

This 57 year old patient had her first scan last year. The
result was worrying so we asked for an urgent report.
Further investigation found that she was in need of natural
hormone support; she had a mouthful of mercury fillings,
metal toxicity in her liver and a sluggish lymph system
round the breasts. There was no lump to feel; ultrasound
and mammograms were negative.Yet something was
brewing that in five years or more could have become a
lump. Here we had a star patient, who was very
responsive and embarked pro-actively on a six month
restorative health programme. A year on you can see a
classic recovery. She feels great – and relieved.

Two

This young woman in her twenties has relatively
healthy looking breasts.

Three

This young woman in her twenties shows lymph congestion
in both breasts which seemed more marked in her three
month follow up scans, prompting her to quit smoking and
drinking.

The images illustrating this feature were taken with a
Meditherm, Med2000 scanner.

Contact
Dr Peter Leando’s website address is:
www.meditherm.com.

Dr Shamim Daya BM DRCOG works
from the Wholistic Medical Centre, 57 Harley St, London,
W1G 8QS; Tel: 07000 388 388
Website:www.wholisticmedical.co.uk.

One day there may be a single method for the early detection of breast cancer. Until then, using a combination of methods will increase your chances of detecting cancer in an early stage.

These methods include :

• Annual breast thermography screening for women of all ages.
• Mammography, when considered appropriate for women who are aged 50 or older.
• A regular breast examination by a health professional.
• Monthly breast self-examination.
• Personal awareness for changes in the breasts.
• Readiness to discuss quickly any such changes with a doctor.

These guidelines should be considered along with your background and medical history.

All women can benefit from breast thermography screening. However, it is especially appropriate for younger women (30 – 50) whose denser breast tissue makes it more difficult for mammography to be effective. Also for women of all ages who, for many reasons, are unable to undergo routine mammography. This test can provide a ‘clinical marker’ to the doctor or mammographer that a specific area of the breast needs particularly close examination.

It takes years for a tumor to grow thus the earliest possible indication of abnormality is needed to allow for the earliest possible treatment and intervention. Thermography’s role in monitoring breast health is to help in early detection and monitoring of abnormal physiology.

Breast cancers tend to grow significantly faster in younger women under 50

Source: Cancer 71:3547-3551, 1993

The faster a malignant tumor grows, the more Infrared radiation it generates. For younger women in particular, results from thermography screening can lead to earlier detection and, ultimately, longer life.

Doctors do not yet know how to prevent breast cancer. However you can increase your chances of detecting breast cancer in its earliest stages by understanding the need for, and participating in an early detection program.

Only about 20 percent of biopsied breast lumps are cancerous. And, if cancer is found early, there are choices for treatment. With prompt treatment, the outlook is good. In fact, most women treated for early breast cancer will be free from breast cancer for the rest of their lives.

Inflammatory Breast Cancer

The results of this routine study led to the diagnosis of inflammatory carcinoma in the right breast. There were no clinical indications at this stage. (Thermography can show significant indicators several months before any of the clinical signs of inflammatory breast disease, skin discoloration, swelling and pain). Inflammatory breast disease cannot be detected by mammography and is most commonly seen in younger women, the prognosis is always poor. Early detection provides the best hope of survival.

Ductal Carcinoma in Situ

 This 37 year old patient presented for routine thermographic breast screening, she was not in a high risk category and had no family history. No breast exams had been performed previously. The vascular asymmetry in the upper left breast and the local hypothermia at 11 O’clock was particularly suspicious and subsequent clinical investigation indicated a palpable mass at the position indicated. A biopsy was performed and a DCIS of 2 cm was diagnosed. Unfortunately this patient only survived for 12 months after diagnosis.

Male Breast Cancer

One per cent of breast cancers are found in men. The survival rate is much lower than in women as most breast cancers in men are only detected in advanced stages.

This tumor was palpable at the time of imaging, there is a well established vascular feed which has even caused increased blood flow at the left brachial plexus and there is also drainage toward the sternum that extends to below the left breast.

Cold stress testing of the breast was performed on the assumption that thermography would identify angiogenesis and that angiogenesis could be correlated with the development and existence of breast cancer. This can be possible if a number of factors are present but there are too many variables that we now know make this an unreliable procedure. We don’t know at what stage angiogenisis begins but we do know that it does not continue throughout all stages of breast disease. No studies have been done to find out how long it takes for new (angiogenic) blood vessels to establish sympathetic fibers which then let the vessel behave like a normal vessel (contract when cold stressed) but even if we did have a better understanding of this physiology it would still not be a reliable test as many patients would undoubtedly fall outside of the window of detectable angiogenesis.

Considerations, the logic and philosophy of performing a cold stress test:
1. If there are no suspicious thermal patterns to test, (negative thermogram) the test is not justified.
2. If there are suspicious patterns (positive thermogram) then the patterns remain suspicious irrespective of the results of cold stress testing……. A cold stress test does not and should not affect the thermographic opinion and resulting report.

3. A cold stress test might offer results relating to a particular suspicious pattern but if there is no way of correlating this information to a clinically valid or plausible rational to act on this information then the test is not justified in the first place.
4. If a cold stress test is performed and the results are reported, this changes the status of the test and the report, both of which make claim to diagnostics and will carry the associated increase of liability and issues of scope of practice and medical licensure (practicing medicine without a license).
5. The disservice to patients who suffer unnecessary mammography, biopsy, and other tests as a result of positive thermography generated by the attempt to produce diagnostic results from a single study is unacceptable.
7. Reporting vascular change over extended periods of time by comparative analysis of thermal testing may be enhanced by the inclusion of a cold stress test if ordered specifically by a licensed physician who can integrate the results into decision making or a differential diagnosis. Historically, it was the way breast thermography was used with protocols that included cold stress testing (and the diagnostic claims that were made) which generated the criticism that thermographers still suffer from today. The accusations of unreliability and the clinical trial results showing false positives and false negatives were all generated by the protocols that included cold stress testing. Cold stress is a test of sympathetic function which has good utility in many areas of medicine and is the definitive diagnostic test for CRPS / RSD. These tests were used before it was tried in breast screening.

In the mid eighties many people, including myself got excited by the potential offered by breast thermography performed with cold stressing. I was lucky enough to be working in France where the concept originated and I did a lot of cold stress thermography with a liquid nitrogen cooled NEC Sani and a Hues Aircraft Probeye, both of which were excellent cameras at the time. My own observations regarding the low rates of correlation between the results of cold stress tests and case histories and the growing evidence of false positives and false negatives led me to abandon cold stressing of breasts in the early nineties. I learned a more logical and more efficient approach which still relied on the detection of changes in the breast over time but was far more objective and reliable.

We have advanced significantly in our understanding of physiology and how thermography can be effectively used. No technology stands still, we expect science to advance, medical knowledge to improve and evolve and we have to be prepared to learn from experience….. both our own and others. I have no doubt that there will be ongoing advances in thermographic imaging and they may even include new forms of stress testing but the best way to move forward is to learn from experience and then look ahead rather than back.

First published August 2003 ACCT Thermology Times.

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Thermal Image Analysis    
                                                                 Dr. William Cockburn, DC, FIACT, FABFE
                                                                                Fellow in Thermal Imaging

Announcement of Official Change in Thermal Reporting
Effective Date:  July 26, 2005

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There has been much controversy within the thermal imaging community, and much comment by outside observers concerning two factors related to the interpretation of thermal imaging of the human breast.   In this regard, I have spent quite some time investigating alternative language and reporting methodology and I have determined to make changes to my interpretation reports as follows:

1)  The Thermal Rating System is being dropped.

The thermal rating system has proven to be a hindrance to proper communication and understanding of actual findings with referring physicians and indeed, with patients.  The rating system has not been updated nor revised since its initial inception and utilization in the mid 1980’s.   There are two significant problems which routinely occur with the utilization of the reporting system; however there has not been a proposed change that makes good clinical sense until now.  The two key problems with the thermal reporting or thermal rating system are:

    A)  Unresolved anxiety for both patient and physician when TH3 – TH5 class thermograms are not confirmed by so-called conventional methodologies such as Mammography, Ultrasound or MRI.  We all know that a positive thermogram is often many years ahead of anatomical testing as confirmed by the scientific research, but this does not help us when we “label” a breast as suspicious and no other method can confirm or deny the thermal findings.   This creates the medical impression of a false positive and the resulting loss of confidence by the referring clinician.

    B)  Inaccuracy of the Rating System itself.   This rating system was designed decades ago to provide for a more accurate and quantifiable system of reporting risk, however it has inherent errors which I feel cause tremendous confusion for the primary care physician and indeed the patient.  Many patients with cancer have only one rating factor, for example a marginal 1.1C delta at the nipple, and are as such, rated TH-3 Equivocal.   Other patients may have three or more low level rating factors with a completely healthy breast and as such are rated TH5 Suspicious.  Often these patients present in my practice for many years with absolutely no change in thermal patterning,  In other words – no increase in vascular or heat signature.  Very often these patients have anatomical testing which is clearly within the normal parameters (not equivocal).

In the world of diagnostic imaging, the premise of any system, be it mammography, ultrasound or thermography is simply to identify risk factors which may not be determined in any other way.   As such, a heads up is given to the primary care doctor that there may be pathology requiring further investigation.   That is all.  

The attempt of earlier thermographers to create a rating system which is more objective and meaningful has actually created confusion within and outside of the thermal imaging community, and as such, this system should be abandoned.

This does not mean however, that reporting should simply be a series of circles or squares drawn over areas of clinical concern.   Some rating factors, especially those in the “primary factors” category, still require description as a methodology to alert the primary care physician to areas of higher concern.  To label these patients as equivocal, abnormal, suspicious or for that matter, normal is an inappropriate reporting methodology and as such, is no longer to be utilized.

2.   The use of the Thermal Cold Stress Challenge for Breast Evaluations is being dropped.

This protocol has never been scientifically proven to be reliable and may indeed; affect the clinical management of a patient in the wrong way, for the wrong reason.

There are several solid reasons for this decision and these factors are related to my 20 years of clinical practice in the realm of thermal imaging.  I wish to share these factors with you as a practicum.

    A)  There is no reliable literature nor blinded study to validate the use of the procedure for breast thermal imaging studies, contradictory to many studies on Reflex Sympathetic Dystrophy (RSD) and Chronic Regional Pain Syndrome (CRPS) (CMPS)  Many thermographers have inappropriately applied the cold stress challenge designed for neurological conditions to the female breast. 

    B)   The use of the stress challenge does not, and should not be used as an indicator of “aggressiveness” or “staging” of breast cancer.   Some interp clinicians actually utilize a (+) or (-) in their reporting methodology to indicate whether for example, a Suspicious breast (TH5) is more (+) or less (-) suspicious depending on whether or not the area cooled.  This is not a verifiable protocol and it is to be discouraged.  (TH5+ or TH5-)  An abnormal breast factor is ratable as a factor and requires clinical correlation, period.

    C)  The degree of cooling, or lack thereof, has also not been scientifically established as an indicator and I feel this has been an anecdotal use of the procedure. As such the stress challenge can be very misleading to both physician and patient.  Depending on dietary influences, hormonal levels of the particular day, and the amount of stress within the patient from a variety of sources, the stress challenge may be more or less effective.   Some days, a patient will cool 0.2C in a given area, and six months later 1.0 and on the next visit, 1.5.  Some patients will not cool on a particular visit even 0.1C and on a subsequent visit they may cool 1.2C.   Of course there are many instances of patient’s temperature increasing on the stress challenge and then on subsequent visits the area cools or stays the same.   These variances have cast great doubt on the reliability of the stress challenge.

    D)  Some anatomical factors which are benign can severely compromise the ability of the sympathetics to provoke vasoconstriction.   This would include blood vessels which have been compromised by surgery, incisional biopsy, lumpectomy, local trauma and even thoracic spine instabilities.  These factors can provide for permanently dilated vessels or capillary networks which fail to respond to sympathetic stimuli.

    E)  The patient’s own apprehension of the procedure may produce sympathetic fight or flight responses prior to the stress challenge, often seen when patients can view the monitor during exam for example.  This provokes a cooling response and “sets” the sympathetic tone prior to the actual cold challenge thus producing potential failure reporting when the fight or flight response actually took place minutes or moments before.  Other examples of this are fear of the exam, an event proximate to the exam that has upset the patient (phone call) (rude comment) (slip and fall) etc.  Many of these variables simply can not be accounted for.

    F)  Finally, and most simply, the fight or flight sympathetic response has never changed the thermal rating nor denies the need for further testing and correlation.   Some clinicians will make a decision on whether or not to order additional testing based on the Success or Failure of the stress challenge procedure.   The very fact that we can not with thermography, determine the amount or aggressiveness of angiogenesis validates this fact.   The question must be asked-  At what point of existing cancer development does angio-neo-genesis override sympathetic input?  It is a great concept in theory, but it is not practical in day to day practice.

These factors (the thermal rating system) and (the cold stress challenge) contribute greatly to an overall confusion of the basic purpose of breast thermography and are based largely in Dogma.  The purpose of breast thermal imaging is to view with a complimentary technology, the human breast and to determine if there are areas of clinical interest that require further clarification that can not be seen by other methods. 

Thermography is a screening procedure.  To continue to follow dogma and unproven methods will further restrain and constrain the advancement of this noble science.

William Cockburn, DC, FIACT, FABFE
Fellow International Academy of Clinical Thermology
Fellow American Board of Forensic Examiners