Breast Thermography: A 20-Year Retrospective Review of Infra-Red Breast Thermal Imaging in New Zealand.
'Thermography has a particular role in those with dense breast tissue, where mammography is less specific, and especially in younger women.'
By Michael E. Godfrey.
MBBS, FACAM, FACNEM. Director, Bay of Plenty Environmental Health Clinic, Trustee PSGR.
Breast thermal imaging or thermography started over 100 years ago as a non-touch and non-invasive method of potential early detection of breast cancer. The earliest images were primitive compared to later technological developments as seen below.
The concept is based on the known logical fact that a developing cancer would need to develop a blood supply and breast tissue being superficial rather than in a body cavity, would show localized heat and/or new blood vessels.
Breast thermography started in New Zealand 20 years ago with the purchase of a $40,000 American system using a Military-developed Infra-red camera and proprietary software. This was replaced in 2009 by Mammovision a more sophisticated semi-automated German system developed by Professor Berz at Frankfurt University with a German Government grant of €750,000.
To date, over 9000 women (and a few men) have chosen to include thermography as a apart of breast health monitoring, some using it on its own, and others alternating with mammography every 2 years. All have been variously motivated to use thermography as it unequally reveals the state of breast health.
Logically, a breast has to become unhealthy prior to a breast tumour developing and this is where thermal imaging is superior to mammography.
However, unlike thermal imaging, structural investigations such as ultrasound, mammography and MRI can locate and outline a mass.
Radiologists acknowledge that mammography has limitations with the possibility of false positives and/or missed cancers especially in women with dense breasts. This was recently extensively discussed where the authors concluded:
This study suggests that the risk of developing breast cancer after a false-positive mammography result differs by individual characteristics and follow-up. These findings can be used to develop individualized risk-based breast cancer screening after a false-positive result. [1]
Modern computerized thermography has the potential to help radiologists differentiate between the so-called indolent or harmless breast tumours and those that are active and potentially life-threatening, something that the mammogram is less able to do. [2]
REFERENCES
1. Mao X, He W, Humphreys K, Eriksson M, Holowko N, Yang H, Tapia J, Hall P, Czene K. Breast Cancer Incidence After a False-Positive Mammography Result. JAMA Oncol. 2023 Nov 2:e234519. doi: 10.1001/jamaoncol.2023.4519. Epub ahead of print. PMID: 37917078; PMCID: PMC10623302.
2. Godfrey, M. and Godfrey, P. (2023) Breast Thermography: A 20-Year Retrospective Review of Infra-Red Breast Thermal Imaging in New Zealand and Its Potential Role in Breast Health Management. Advances in Breast Cancer Research , 12, 129-141. doi: 10.4236/abcr.2023.124010
