Breast thermography or infrared imaging of the breast may hold a significant potential in breast cancer prevention. Due to the ability of infrared imaging’s detection of changes in the dermal circulation, any external pharmacological intervention or release of biochemicals by the body that have the propensity to alter blood flow may be detected. This is especially true of chemicals that are target specific for the tissues of the breast. Being a primary target tissue for the hormone estrogen, the hormone’s effect in the breast is anabolic to the ductal cells. As such, the outcome is one of increased cellular metabolism. This increase in cellular activity necessitates the need for nutrients above and beyond the norm. In order to facilitate this need, an increase in blood supply must occur. This translates to an infrared image demonstrating a uniform increase in vascular patterning.
The importance of this observation lies in one of the primary risk factors for breast cancer—lifetime exposure to estrogen. If infrared imaging has the ability to warn of increased thermovascular activity due to increased levels of estrogen in the breast (estrogen dominance), action can be taken to lower this activity and ultimately the patient’s risk for future breast cancer. Treatments can be monitored for positive effects by incorporating infrared imaging as a method of observing these effects. Studies have shown this effect and the positive outcome of tackling hormone imbalance in the body. Many patients with this condition also demonstrate signs and symptoms that include breast pain, tenderness, cysts, and benign lumps. In many patients, a reversal or reduction in these signs and symptoms are also noted when treatment is initiated. Infrared imaging’s ability to detect increased thermovascular activity secondary to levels of estrogen in the breast, and to monitor the effects of treatment targeted at the breast, may play a significant role in breast cancer prevention.
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 guidelines and 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, thermography 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 structural imaging. Used as a complimentary imaging technique, recent data suggests that thermography 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 techniques have emerged, most are designed to be used in selected cases where physical and mammographic examinations have already picked up an abnormality. Consequently, we are left with some patients who have adhered to current screening guidelines 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