By Michael Gerber, MD, HMD
For more than fifty years thermography has been used in the military, law enforcement, industry and in health care. The evolution of breast and body thermography imaging has been especially rapid in the last twenty years with advances in computer technology providing more accurate assessment of the patient. Patterns of heat given off by the breast, for example, can predict disease far in advance of the usual mammography without the pitfalls of radiation exposure and the painful compression of the breasts during the examination both of which have been a deterrent to many thoughtful women. In the last several years Federal guidelines have been issued for women to begin routine mammography at age 50 instead of 40 because it didn’t change cancer mortality outcomes and produced many false positives that resulted in needless breast biopsies and invasive therapies which traumatized the patients. The more important issue is the impressive radiation dose.
The beauty of thermography is spotting abnormalities in blood flow and hot spots that may be tumors. The most common cause of heat abnormality is an excess of estrogen and its metabolites that have been directly linked to fibrocystic breasts and breast cancer. Abnormal blood vessels can also be seen that are feeding a tumor.
A good test can also be helpful for what it doesn’t find. For example a 37 year old mother of three came into the clinic with a painful egg sized lump in her right breast. The lymph nodes in her armpit were also painful and enlarged. She volunteered that she had been off her diet, eating lots of sugar and fast foods and that she hadn’t been taking supplements or her topical, bioidentical progesterone cream for some time and was under terrific stress. It was explained to her that a needle biopsy would be the standard course to follow to determine if the lump was cancerous. She promptly did the breast thermography and the results came back as a class one, normal. Since she was concerned that a biopsy might spread a cancer she decided to follow a conservative approach resuming her progesterone, supplements and doing lymphatic drainage. Within 10 days the lump and painful nodes had all disappeared. In this case thermography was very helpful to head off unnecessary, invasive procedures.
This approach to breast health is very appealing because when alerted to abnormal changes in breast thermography the woman can then change her body chemistry to promote a normal scan on follow up evaluation, usually in three months time if she falls in the higher risk categories. It is truly a revolution in breast health care by not only helping the physician, patient team to be proactive but also in avoiding exposure of the breasts to radiation that some studies have shown actually increase the incidence of breast cancer. Breast thermography has been approved by the FDA since 1983 for adjunctive screening for breast cancer. Recent studies have shown 97% sensitivity for detecting breast malignancy1. Breast thermography has been researched for over 30 years with over 800 peer-reviewed studies existing in the Index Medicus of well over 250,000 women with an average sensitivity and specificity of 90%.2 This is preventive medicine at its best!
Rating breast thermography is usually done on a one to five scale with a one or two rating indicating a normal scan with three being equivocal and four and five being at higher risk. Risk is judged by several criteria most importantly heat deviations from the same location of both breasts and lack of breast temperature response to cooling the patients hands in the second part of the examination, temperatures should decrease and especially not increase after a cold challenge. The higher risk reports should be followed up with another thermography in 3 months and taking an ultrasound of the breasts especially if there are suspicious findings on physical exam. Communicating with the patient is especially important with higher risk findings to let them know it doesn’t mean they have cancer only an increased risk of disease in the future. They, of course, may choose to have mammography; however, a negative ultrasound as backup testing is usually comforting for the more upset patient and avoids the radiation.
Treating hot areas (yellow and red appearing) which are of a more global appearance frequently represents estrogen dominance and can be treated with topical progesterone cream and other estrogen reducing strategies. Fibrocystic breasts can be helped with iodine/iodide supplementation to help convert estradiol to estriol and John Meyer’s technique of painting the cervix with Lugol’s solution and then giving an IV push of B6 and magnesium can be very useful for more difficult cases.
Each picture taken by mammography has from 100 to150 times the radiation of a chest x ray. If at least four exposures are taken during a mammography session that would be up to 600 times the radiation dose of a chest x ray or 4 to12 mSv (millisieverts) or more. A chest x ray radiation dose is 20 microsieverts. Flying from New York to Los Angeles exposes travelers to 40 microsieverts. See the Radiation Dose Chart.3
The sievert (symbol: Sv) is the International System of Units (SI) HYPERLINK “http://en.wikipedia.org/wiki/SI_derived_unit” \o “SI derived unit” SI derived unit of HYPERLINK “http://en.wikipedia.org/wiki/Equivalent_dose” \o “Equivalent dose” dose equivalent radiation. It attempts to quantitatively evaluate the biological effects of HYPERLINK “http://en.wikipedia.org/wiki/Ionizing_radiation” \o “Ionizing radiation” ionizing radiation as opposed to just the HYPERLINK “http://en.wikipedia.org/wiki/Absorbed_dose” \o “Absorbed dose” absorbed dose of radiation energy, which is measured in HYPERLINK “http://en.wikipedia.org/wiki/Gray_(unit)” \o “Gray (unit)” gray. It is named after HYPERLINK “http://en.wikipedia.org/wiki/Rolf_Maximilian_Sievert” \o “Rolf Maximilian Sievert” Rolf Maximilian Sievert, a HYPERLINK “http://en.wikipedia.org/wiki/Sweden” \o “Sweden” Swedish medical physicist renowned for work on radiation dosage measurement and research into the biological effects of radiation.
An older unit for the equivalent dose, is the HYPERLINK “http://en.wikipedia.org/wiki/Roentgen_equivalent_man” \o “Roentgen equivalent man” rem, still often used in the United States. One sievert is equal to100 rem. One rad is equal to one rem:
1 rem = 0.01 Sv = 10 mSv
1 mrem = 0.01 mSv = 10 μSv
1 mSv = 100 mrem = 0.1 rem
1 μSv = 0.1 mrem
Mammography poses a wide range of risks of which women worldwide still remain uninformed. Read “ HYPERLINK “http://www.preventcancer.com/press/editorials/march14_01.htm” Mammography’s Mixed Blessings” by Seaman and Epstein 4
“Radiation from routine mammography poses significant cumulative risks of initiating and promoting breast cancer 5-6-7. Contrary to conventional assurances that radiation exposure from mammography is trivial— and similar to that from a chest X-ray or spending one week in Denver, about 1/ 1,000 of a rad (radiation-absorbed dose)— the routine practice of taking four films for each breast results in some 1,000-fold greater exposure, 1 rad, focused on each breast rather than the entire chest. Thus, premenopausal women undergoing annual screening over a ten-year period are exposed to a total of about 10 rads for each breast. As emphasized some three decades ago, the premenopausal breast is highly sensitive to radiation, each rad of exposure increasing breast cancer risk by 1 percent, resulting in a cumulative 10 percent increased risk over ten years of premenopausal screening, usually from ages 40 to 50; risks are even greater for “baseline” screening at younger ages, for which there is no evidence of any future relevance”
It is interesting to note that when looking at internet sites for mammography radiation dose they mostly allude to a low safe dose and don’t give any radiation exposure figures.
Thermography is very helpful in looking for disturbances in the rest of the patient as well. Many problem areas can be demonstrated. For example lack of blood flow to the head can highlight carotid artery disease and arteriosclerosis as can lack of blood flow to the extremities . Inflamed sinuses and diseased, infected teeth can also be pinpointed. Musculoskeletal inflammation can also documented by abnormal thermography of spines, shoulders, hips and anywhere in the body. Documentation of inflamed spines, for example, can also be important in disability cases if there is any doubt of malingering. Cold thyroids can tip off hypothyroidism. Pelvic and abdominal tumors can also show up with whole body thermography. Body thermography is a vast new field that can aid immeasurably with diagnosis and response to treatment.
Effectiveness of a noninvasive digital infrared thermal imaging system in the detection of breast cancer. Nimmi Aurora, M.D., Diana Martans, B.S. et al. Department of Surgery, New York Presbyterian Hospital-Cornell, New York, NY. The American Journal of Surgery Vol 196, issue 4, Oct. 2008, pages 523-526
A review of breast thermography Amala, William The Breast Journal (4): 245-251, July 1998
Radiation Dose Chart xkcd.com/radiation
Mammography’s Mixed Blessings Dr. Samuel Epstein and Barbara Seaman Chicago Tribune, March 14, 2001
Gofman, J. W. Preventing Breast Cancer: The Story of a Major Proven Preventable Cause of this Disease. Committee for Nuclear Responsibility, San Francisco, 1995
Epstein, S. S., Steinman, D., and LeVert, S. The Breast Cancer Prevention Program, Ed. 2. Macmillan, New York, 1998
Bertell, R. Breast cancer and mammography. Mothering, Summer 1992, pp. 49– 52