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Question for Dr. McAndrew
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judyfams posted:
Can thermography be incorporated as a tool to be used between mammography to help diagnose very early growing masses? Can thermography or similar technology be used in some manner to aid in the detection of early or pre cancer cellular growth?
Judy
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Philomena McAndrew, MD responded:
Dear Judy

Thermography, which is also called thermal imaging or infrared imaging, was approved by the U.S. Food and Drug Administration in 1982 as a supplement to mammography in helping to detect breast cancer. This exam has not gained acceptance in the medical community as a necessary or useful in breast cancer detection since numerous studies have not shown the value as a screening, diagnostic or effective tool in addition to screening mammography to detect breast cancer.

Thermography is appealing to some women because it is a pain-free exam, but research over the last 20 years has shown that thermography is not reliable for detecting breast cancer. In 1977, a committee of the National Cancer Institute recommended that thermography be discontinued as a routine screening modality in the Breast Cancer Detection Demonstration Project where it was being evaluated along with mammography and ultrasonography. This does not mean that an improved thermography technology may not be useful in the future to aid in the diagnosis of breast cancer and currently there is research using computerized thermal imaging (CTI) which uses the principle of traditional thermography with the addition of digital image reconstruction. This technology has not been approved by the FDA and is currently being studied.

The theory behind thermography is that any local abnormality in the breast may cause an alteration in the temperature in that region. This may give false positives as well as false negatives and prior studies of thermography have shown a false positive rate of 25%. It is hoped that the addition of computerized reading using digital images of the thermogram may lead to a reduction in the false positive rate in the future. Also, microcalcifications, which are tiny calcium deposits that may indicate the presence of cancer are not seen on thermography. Up to 50% of breast cancers detected by mammography appear as these clusters of microcalcifications.

Philomena F. McAndrew, M.D.
 
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rachael67 replied to Philomena McAndrew, MD's response:
Thanks for addressing this issue. I recall when doing my original research, I hit on a discussion on thermography and was most interested.

How do the false positive rates with this compare to those with mammography?

It will be most interesting to see what this most recent trial proves or disproves.

Blessings.
Rachael
Just when the caterpillar thought her world was over, she became a butterfly! Don't give up five minutes before the miracle!!
 
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judyfams replied to Philomena McAndrew, MD's response:
Thank you for responding to my question in such detail. I would hope that CTI research continues as it sounds very promising.

Thank you for taking your valuable time to be a part of these discussions and answering our questions and addressing our concerns.

Judy
 
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Philomena McAndrew, MD replied to rachael67's response:
Dear Rachel,

To address your question on thermography and the false positive rates compared with mammography, thermography had been studied along side ultrasound and mammogram in the Breast Cancer Detection Project in the 1970s and the thermography arm was dropped due to the high false positive rates. It was felt that this would not be a sensitive screening method for the population in general. The thermography false positive rate is approximately 25% and in various studies it has ranged from 25 to 50%. Despite the fact there have been attempts to incorporate computerized reading into this digital infrared thermal imaging (DITI), so far no study has shown that thermography is an effective screening tool for finding breast cancer early. It should not be used as a substitute for mammography. Newer versions of this test are better able to find small temperature differences and may prove in the future to be more accurate that older versions. These are currently being studied to determine whether they may be useful in identifying cancers with more accuracy. Many cancers are detected as microcalcifications which can only reliably be seen with mammography. It is likely that in the future a variety of techniques may all be necessary to allow for the most sensitive and accurate diagnosis of breast cancer or premalignant lesions in the breast.

Thank you,
Philomena F. McAndrew, M.D.


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