THERMOLOGY: DISCUSSION

As a functional study breast thermology complements rather than competes or replaces structural-based imaging methods, such as X-ray mammography, ultrasound and MRI. Exactly as does every other objective diagnostic imaging modality, a positive breast thermology study provides indications of risk for breast cancer and a specific indication for comprehensive evaluation but not a definitive diagnosis. In the truest sense, a diagnosis of breast cancer is not possible until a pathologist performs a histological evaluation from a biopsy. Experience indicates targeted ultrasound as the single most effective means of following-up an abnormal thermology study.


Breast thermology has a very high sensitivity (approximately 97%) but is less specific, as inflammation or infection may cause false-positive findings, especially on initial studies of an individual (1, 2). Women may also have vascular malformations in their breasts thermal character as a consequence of mastitis or personal variant that may cause false-positive thermology. However, the stability of atypical thermology features in repeated studies over time is usually sufficient to attribute them to personal variant and distinguish them from breast cancer. False-negative errors are rare and usually a consequence of a latent or lag stage in the development of a breast cancer.


Breast thermology is most effective on a population of women for whom X-ray mammography is rather insensitive. This includes pre-menopausal, pregnant or lactating women as well as women with fibro-cystic disease, dense tissue, prosthetic augmentation, surgical reduction, previous biopsies and unusually small or large breasts. This also includes post-menopausal women taking hormone replacement therapy. Clinical studies have demonstrated a strong correlation between the highest thermology markers and an aggressive character of the cancerous tumor (3, 4). Thermology can also select the best sentinel lymph node in the determination of metastasis. Thermology has real value in monitoring post-surgical patients following a baseline study. Thermology has demonstrated application in evaluating the need for and the effectiveness of anti-angiogenic therapies. Breast thermology regularly provides specific indications of breast cancer years before specific features are detected by mammography (5, 6, 7, 8).


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Sources


1. Usuki H. Takashima S., Sacki H., Moriwaki S. Thermographic diagnosis of breast disease. Gan No Rinsho 1986;32:958-960.

2. Usuki H. Evaluation of the thermographic diagnosis of breast disease relation of thermographic findings and pathologic findings of cancer growth. Nippon Gan Chiryo Gakkai Shi, 1988;23:2687-2695.

3. Bartl W., Euller A., Pfersmann C., Bernaschek G. Breitenecker G. Diagnosis of breast cancer in the clinical state T1. Wein Klin Wochenschr 1984;96:722-727.

4. Sterns E.E., Zee B. Thermography as a predictor of prognosis in cancer of the breast. Cancer 1991;67:1678-1680.

5. Keyserlingk JR, PD Ahlgren, E Yu, N. Belliveau. Infrared imaging of the breast: initial reappraisal using high-resolution digital technology. The Breast Journal, 1998(4);4:245-251.

6. Gamagami P. (1996) Atlas of Mammography: New Early Signs in Breast Cancer. Blackwell Science, Cambridge, MA.

7. Gauthrie M. (1989) Atlas of Breast Thermography with Specific Guidelines for Examination and Interpretation. Milan, Italy. PADUSA.

8. Gautherie M, Gros CM. Breast thermography and cancer risk prediction. Cancer 1980;45:51-56.