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We’ve had so many inquiries from women about breast thermograms during the past year that we decided to do some homework before offering it to our patients.
The test’s complete name is “digital infrared thermal imaging,” or DITI. For the test, your breasts are photographed with an infrared heat-sensing camera that picks up different temperature patterns in breast tissue. You could also use DITI on other areas of your body, resulting in a sprained ankle that appears “hot” because it’s inflamed, while your fingertips appear “cold” because they don’t receive as much circulation as your palms. But thermograms are mainly used for breast imaging
Having a thermogram is a piece of cake. You’re in a private room with a woman technician and a thermal-imaging camera. You disrobe from the waist up, don a cloth gown, stand in front of the camera, and snap!, the heat patterns of your breasts appear on a video monitor and are recorded. You dress and leave, usually in less than 15 minutes flat. The image is then sent to a radiologist for interpretation and, in a few days, her report is sent to your home.
Women generally consider a breast thermogram for three reasons:
1. They dislike the physical discomfort of mammograms. Not knowing myself what this was like, when I asked my now-retired nurse Mary to explain, she replied “How would you like your testicles squashed in a cold refrigerator door?” “Yikes,” I yelped, as my toes curled. Comfort-wise, thermograms win hands down.
2. They’re concerned about radiation exposure from annual mammograms. My counter argument is that the radiation is minimal, especially when you consider the diagnostic value of mammograms. With that said, it’s always a good idea to keep radiation exposure as low as possible.
3. They have anxiety that something might be missed, even with regular breast self-examination and mammograms. A thermogram does add another preventive layer. Mammograms pick up anatomical and structural changes, but thermograms can identify temperature irregularities even before a mass is detectable with self exam or mammogram.
Is a thermogram an adequate substitute for a mammogram? No. A mammogram remains the gold standard for breast cancer detection. However, the current guidelines for mammograms are not consistent. The American Cancer Society recommends annual mammograms after age 40. The National Cancer Institute recommends every 1 to 2 years after 40, leaning toward annual if the woman is from a high-risk family and every other year if she has a low-risk family along with 2 to 3 years in a row of negative mammograms. This also assumes you’ve been performing regular breast self-exams (to examine your breasts, follow these steps).
So who might benefit from a breast thermogram?
1. Women under 40 who want to monitor breast health before their first mammogram.
2. Women over 40 who fall into the every-other-year, low-risk group who choose to cover their mammogram-free year with a thermogram.
3. Women with a strong family history of breast and/or ovarian cancer who, in addition to their annual mammograms, want the benefit of an extra, non-invasive diagnostic test.
4. Women who (for whatever reason) refuse to have a mammogram. For this group, regular self-exams and thermograms are better than no imaging at all.
You can read more about thermograms by clicking here. We offer them on selected Saturdays at the Lincoln Avenue office of WholeHealth Chicago. On the down side, it seems every day we receive notification from health insurance companies of yet another diagnostic test ineligible for coverage, and thermograms are now on the list. The cost of a breast thermogram is $235, which covers everything, including the radiologist’s report.
David Edelberg, MD