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The use of Digital Infrared Imaging is based on the principle that metabolic activity and vascular circulation in both pre-cancerous tissue and the area surrounding a developing breast cancer is almost always higher than in normal breast tissue. In an ever-increasing need for nutrients, cancerous tumors increase circulation to their cells by holding open existing blood vessels, opening dormant vessels, and creating new ones ( neoangiogenesis). This process frequently results in an increase in regional surface temperatures of the breast. DII uses ultra-sensitive medical infrared cameras and sophisticated computers to detect, analyze, and produce high-resolution images of these temperature variations. Because of DII’s extreme sensitivity, these temperature variations may be among the earliest signs of breast cancer and/or a pre-cancerous state of the breast (3,6,7,8,9).
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Current methods used to detect suspicious signs of breast cancer depend primarily on the combination of both physical examination and mammography. While this approach has become the mainstay of early breast cancer detection, more is needed. Since the absolute prevention of breast cancer has not become a reality as of yet, efforts must be directed at detecting breast cancer at its earliest stage. As such, the addition of Digital Infrared Imaging (Breast Thermography) to the frontline of early breast cancer detection brings a great deal of good news for women.
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WHAT MAKES DIGITAL INFRARED IMAGING SO UNIQUE
While mammography, ultrasound, MRI, and other structural imaging tools rely primarily on finding the physical tumor, DII is based on detecting the heat produced by increased blood vessel circulation and metabolic changes associated with a tumor’s genesis and growth. By detecting minute variations in normal blood vessel activity, infrared imaging may find thermal signs suggesting a pre-cancerous state of the breast or the presence an early tumor that is not yet large enough to be detected by physical examination, mammography, or other types of structural imaging (3,6,7,8,9).
Certain types of cancers will not be detected (approximately 20%) by mammography for various reasons(10), but some of these cancers will be discovered by DII (3,6,7,8,9).
Difficulties in reading mammograms can occur in women who are on hormone replacement, nursing or have fibrocystic, large, dense, or enhanced breasts (6,8). These types of breast differences do not cause difficulties in reading digital infrared scans.
DII AS A RISK MARKER FOR BREAST CANCER
Studies show that an abnormal infrared image is the single most important marker of high risk for developing breast cancer, 10 times more significant than a family history of the disease (5). Consequently, in patients with a persistent abnormal thermogram, the examination results become a marker of higher future cancer risk (4,5). Depending upon certain factors, re-examinations are performed at appropriate intervals to monitor the breasts. This gives a woman time to take a pro-active approach by working with her doctor to improve her breast health. By maintaining close monitoring of her breast health with infrared imaging, self breast exams, clinical examinations, mammography, and other tests, a woman has a much better chance of detecting cancer at its earliest stage and preventing invasive tumor growth.
Angiogenesis, or new blood vessel formation, is necessary to sustain the growth of a tumor. Digital Infrared Imaging may be the first signal that such a possibility is developing (3). |
Just as unique as a fingerprint, each patient has a particular infrared map of their breasts. Any modification of this infrared map on serial imaging (images taken over months to years) may constitute an early sign of an abnormality. However, if a pathology is suspected, this information is used to recommend further examinations and tests.
TECHNOLOGY, INTERPRETATION AND COMPARATIVE IMAGING
As is the case with mammography and all other imaging modalities, access to sophisticated technology and the expertise to interpret the findings are of prime importance. To help distinguish a normal process from an abnormal one requires proper training, clinical experience, strict adherance to protocols, and meticulous image acquisition. While not all tumors are visible on a mammogram, not all tumors are associated with a high level of blood vessel activity; thus, escaping infrared detection. Less aggressive lesions can be associated with less evident images. Therefore, in these select cases, DII may be an indicator suggesting a much better overall prognosis.
When digitally produced, and interpreted by qualified doctors, abnormalities or changes in infrared images provide invaluable information. This is particularly true in patients with dense breasts, non-specific physical or mammographic findings, or women with a previous history of breast surgery or radiation. The use of serial infrared imaging can draw additional attention to areas that require further evaluation or closer scrutiny during initial or subsequent exams. This further evaluation may include additional imaging such as mammography, ultrasound, or MRI. Used as a complimentary imaging technique, recent data suggests that DII may also help monitor the effects of some of the newer proposed anti-angiogenesis therapies (currently recognized as a promising treatment strategy) (6,8).
Since we have not been able to prevent breast cancer as of yet, there is a consensus among experts that more lives will be saved with earlier detection. Since both physical and mammographic examination cannot detect all cancers, particularly smaller tumors in younger patients and those with dense breast tissue, there is currently much interest in finding new ways to improve our abilities in early detection. While some new promising techniques have emerged such as MRI, doppler ultrasound, and scintimammography, most are designed to be used in selected cases where physical and mammographic examinations have already picked up an abnormality. These tests also do not address the limitations of combined physical examination and mammography in frontline detection. Consequently, we are left with too many patients who have undergone these two screening tests and are still left with undetected breast cancer. Therefore, experts have concluded that no one procedure or method of imaging is solely adequate for breast cancer screening (1,2,6).
EARLY DETECTION MEANS LIFE
Breast cancer is the most common cancer in women, and the risk increases with age (1). Risk is also higher in women whose close relatives have had the disease. Women without children, and those who have had their first child after age 30, also seem to be at higher risk. However, every woman is at risk of developing breast cancer. Current research indicates that 1 in every 8 women in the US will get breast cancer in their lifetime (1).
Studies show an increase in survival rate when breast thermography and mammography are used together(3). |
DII’s ability to detect thermal signs that may suggest a pre-cancerous state of the breast, or signs of cancer at an extremely early stage, lies in its unique capability of monitoring the temperature variations produced by the earliest changes in tissue physiology (function) (3,6,7,8,9). However, DII does not have the ability to pinpoint the location of a tumor nor can it detect 100% of all cancers. Consequently, Digital Infrared Imaging’s role is in addition (an adjunct) to mammography and physical examination, not in lieu of. DII does not replace mammography and mammography does not replace DII, the tests complement each other. Since it has been determined that 1 in 8 women will get breast cancer, we must use every means possible to detect cancers when there is the greatest chance for survival. Proper use of breast self-exams, physician exams, DII, and mammography together provide the earliest detection system available to date (3,7,8,9). If treated in the earliest stages, cure rates greater than 95% are possible (3,6).
REFERENCES
1. American Cancer Society – Breast Cancer Guidelines and Statistics, 2009-2010
2. I. Nyirjesy, M.D. et al; Clinical Evaluation, Mammography and Thermography in the Diagnosis of Breast Carcinoma. Thermology, 1986; 1: 170-173.
3. M. Gautherie, Ph.D.; Thermobiological Assessment of Benign and Malignant Breast Diseases. Am. J. Obstet. Gynecol., 1983; V 147, No. 8: 861-869.
4. C. Gros, M.D., M. Gautherie, Ph.D.; Breast Thermography and Cancer Risk Prediction. Cancer, 1980; V 45, No. 1: 51-56.
5. P. Haehnel, M.D., M. Gautherie, Ph.D. et al; Long-Term Assessment of Breast Cancer Risk by Thermal Imaging. In: Biomedical Thermology, 1980; 279-301.
6. P. Gamigami, M.D.; Atlas of Mammography: New Early Signs in Breast Cancer. Blackwell Science, 1996.
7. J. Keyserlingk, M.D.; Time to Reassess the Value of Infrared Breast Imaging? Oncology News Int., 1997; V 6, No. 9.
8. P.Ahlgren, M.D., E. Yu, M.D., J. Keyserlingk, M.D.; Is it Time to Reassess the Value of Infrared Breast Imaging? Primary Care & Cancer (NCI), 1998; V 18, No. 2.
9. N. Belliveau, M.D., J. 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. Breast Journal, 1998; V 4, No. 4
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