THERMOLOGY: CLINICAL INDICATIONS

image115

The incidence of breast cancer has rapidly increased in the past fifty years. What was once a disease largely limited to women over sixty years of age and with a life-time incidence of one-in-twenty, has increased its incidence to a life-time rate of one-in-eight with a disproportionate increase in younger women (1). While rare, we have confirmed cases of breast cancer in pre-teens and breast cancer is now the leading cause of death for women aged 29-45 (1). 


Recent published studies have demonstrated a rather low benefit to routine screening with X-ray mammography and many serious adverse complications (2, 3). The 2009 US Preventive Services Task Force could not determine any meaningful benefit to routine screening X-ray mammography for women less than fifty years of age or for screening X-ray mammography more than every other year for women between ages fifty and seventy-four (4). Every woman is at risk for breast cancer and the inadequacies of screening X-ray mammography to save lives should not diminish the importance to screen women younger than fifty years or between biennial X-ray mammograms. While screening X-ray mammography remains the standard of care, we assert that it is insufficient as a stand-alone modality due to its insensitivity for large populations of at-risk women and a very high rate of false-positive results.

The high sensitivity of thermology for younger women and its absolute safety are compelling reasons to indicate routine screening thermology for women under fifty years of age and in the year between routine screening X-ray mammograms for women between fifty and seventy-four years of age (5).


BACK

Sources

  1. NIH SEER Statistical Review 1975-2003.
  2. Kalar M., Zelen M., Langmark F., Adami  H.O.,  Effect of screening mammography on breast-cancer mortality in Norway. N  Engl J Med 2010;363:1203-1210.
  3. Welsch H.G. Screening mammography  a long  run for a short slide. N Engl J Med 2010;363:1276-1278.
  4. Screening for Breast Cancer: US Preventive  Services Task Force Recommendation Statement. Ann Internal Med 2009;
                         151;10:716-726.
  5. Parisky  Y.R, Sardi A., Hamm R., Hughes K.,  Esserman L., Rust S., Callahan K. Efficacy  of computerized infrared  imaging analysis to evaluate mammographically suspicious  lesions. AJR.  2003;180:263-269.