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Breast Cancer Detection: Mammography Vs Thermography

In recent years, there has been a lot of deliberation over the accurate method for breast cancer detection. The screening methods help detect and identify breast cancer in women who have no physical symptoms. It helps in the detection of the cancerous growth in the early stage, thereby providing the opportunity to get treatments, at the right time. The debate over the effectiveness of the two tests, mammography and thermography are still ongoing with a larger section recommending mammography [1] .

Firstly, let's get to know the different types of screening tests and their effectiveness in detecting the symptoms of breast cancer.

What Is Mammography?

Mammography involves the compression of the mammary gland between two plates and an X-ray is transmitted through the breast tissue [2] . So, it is basically an x-ray picture of the breast. Mammography helps to detect the development of breast cancer in women who have no signs or symptoms of the disease, as well as any lump or other signs of breast cancer.

The images captured during the process are called mammograms, which is then used by the doctor to detect any tumour growth or abnormalities in the mammary glands [3] , [4] . Mammographies are recommended for younger women as well, who have symptoms or are a high risk of developing the condition [5] .

Procedure Of Mammography

According to the National Cancer Institute, mammography is of two types - screening mammogram and diagnostic mammogram. Mammography requires you to stand in front of an x-ray machine [3] . Your breast will be placed between two plastic plates, which will then be pressed to make it flat. Compression of the breast is required to minimize the amount of radiation used and to ensure optimal visualization of the breast tissue. Images at different angles will be taken of each breast. The procedure may cause some discomfort or pain [6] .

Some breasts with dense tissue will appear white on the mammogram developed and can mask the presence of tumours, as they also appear white on the image. In the case of low-density fatty tissue, it will appear grey on the image film and is much easier to detect the white tumours on these mammograms. Once the images are taken, the films will be examined by the radiologist to ensure that the films are clear and that no additional films are needed. And, you will most likely get the written report within 25-30 days [7] .

Benefits Of Mammography

There is evidence which asserts that mammography is associated with the reduction of deaths related to breast cancer. There is dissension regarding this as some studies assert that the screening procedure is not capable of providing any benefits [6] , [7] .

According to some of the studies which support mammography, it is asserted that in the coming 10 years the number of deaths due to breast cancer will reduce. That is, 5 out of 10,000 women aged 40 to 49 years, 10 out of 10,000 women aged 50 to 59 years and 42 out of 10,000 women aged 60 to 69 years will be saved with the help of detection [8] .

No, it does not cure breast cancer, but it helps to detect the cancerous growth in the very early stages. Early detection can help reduce the risk of the cancer spreading and treatment can be started earlier in the course of the disease [9] . Screening mammograms are the best method for detecting breast cancer early. The procedure helps detects the lumps, two or three years before a woman or her doctor can even feel them. According to a study, mammograms have helped reduce the death toll by 25 per cent, among women who are screened regularly [10] .

It is extremely beneficial for women in high-risk groups, such as older women, or women with a history of breast cancer in the family [11] .

Limitations Of Mammography

Along with the benefits it possesses in the early detection of the tumour growth, there are some risks and limitations pertaining to mammography and mammograms [10] , [12] .

  • Some cancers cannot be detected on a mammogram due to the location of cancer or due to the density of the breast tissue.
  • In some cases, they can lead to women choosing double mastectomies as a preventive measure.
  • They are not effective for women with breast implants.
  • They can lead to non-invasive cancers being diagnosed and treated.
  • The repeated exposure to radiation may cause a very small risk of cancer if used over a lifetime.
  • They have a high rate of false-positive results, which can result in unnecessary biopsies as well as additional screening.

What Is Thermography?

Also termed as infrared imaging of the breast, breast thermography or thermography detects and records temperature changes on the surface of the skin. Thermography uses an infrared camera to detect heat patterns and blood flow in body tissues. DITI or digital infrared thermal imaging is the type of thermography that is used in the detection and diagnosis of breast cancer. It helps in understanding the temperature differences on the surface of the breasts; which help detect the cancerous growths on the mammary gland [13] , [14] .

Procedure Of Thermography

Before beginning the test, you will be required to be acclimated to the room temperature. Your body has to be in line with the room temperature to avoid the difference in your body temperature and room temperature. Then, you will be required to stand in front of the imaging system, and the technician will take a series of six images, including front and side view of your breasts [15] . The images will show areas of different temperature in the breasts and display it in the form of a heat map. The cancerous cells have a higher temperature than the surrounding tissue because, they grow more blood vessels and has more blood flow, and have higher metabolic rates than normal cells [14] .

Thermography uses temperature differences to identify cancerous growths. The excessive formation of blood vessels and inflammation in the breast tissue will show up on the infrared images as areas with a higher temperature than the surrounding areas [15] , [16] . Some women choose thermography because it does not involve being exposed to radiation or being squished by a machine. The test takes around 30 minutes and once the analysis is carried out, the results will be given to you in a period of 10-15 days.

Benefits Of Thermography

  • It is a non-invasive and non-contact procedure and does not involve compressing your mammary glands [17] .
  • It does not involve exposure to radiation and can be continued for a long period of time safely.
  • In comparison to other procedures, it can detect vascular changes in breast tissue associated with breast cancer many years in advance.
  • It is applicable to all women, including those with dense breast tissue and breast implants.

Source: Kansas city health&wellness magazine

Limitations Of Thermography

Like any other procedure, thermography also has certain drawbacks pertaining to it [18] , [19] .

  • It has a high false-positive rate (that is, it sometimes finds cancer when none is present) which can result in the requirement of undergoing a mammogram.
  • It is rarely covered by medical insurance.
  • If the temperatures are very close in range, the infrared imaging can lead to misleading information.
  • It is less-efficient in detecting early cancers when compared to mammography.

Mammography Vs Thermography

The debate over mammography and thermography for effective cancer detection has been ongoing for some time now. The benefits and the limitation pertaining to both types of tests have incurred the confusion of choosing the most effective as well as safe method. And, the reminder from the U.S. Food and Drug Administration (FDA) which states that thermography is in no way a substitute for mammography [20] . The larger section tends to think that, as thermography doesn't touch your skin or compress your breast like a mammogram, and has no radiation - it is the best suitable option [21] .

However, FDA is adamant and determined on spreading awareness on the dilemma by clarifying that thermography is in no way a better measure than mammography. On February 25, 2019, FDA issued a safety warning to women, patients recommended for breast cancer screening, healthcare providers, and cancer treatment advocacy organizations that thermography should not be used in place of mammography to detect, diagnose, or screen for breast cancer [22] .

It was backed with the assertion that there is no "valid scientific data to demonstrate that thermography devices, when used on their own or with another diagnostic test, are an effective screening tool for any medical condition, including the early detection of breast cancer or other diseases and health conditions" [23] .

Thermography is best suitable to be used along with other tests such as mammography and not as a lone diagnostic test for breast cancer [24] . There have been a plethora of reports suggesting that various hospitals and health care providers are misleading the masses with the false assertions that thermography is a proven alternative to mammography.

However, studies with scientific proof say otherwise and point out that mammography is the best primary screening tool for breast cancer [25] . Both the American College of Radiology and the Society of Breast Imaging (SBI) do not endorse thermography for detecting breast cancer.

Thermography, according to FDA, is nothing but an adjunctive tool used for breast cancer detection. And that women who underwent thermography should not depend on the results as they cannot accurate, and in some cases false [26] .

To this day, mammography is the ultimate standard for early breast cancer detection. Because, it helps detect breast cancer at its earliest possible stage, and offer detail and clarity of breast tissue regardless of age or breast density [27] . According to the FDA, "mammography is the most effective breast cancer screening method and the only method proven to increase the chance of survival through earlier detection". Women who depend on thermography have the risk of missing the chance to detect cancer at its earliest and most treatable stages, thereby resulting in possible death [25] .

On A Final Note...

Consequently, both mammography and thermography are screening tests and not tests that allow the prevention of breast cancer from developing in the first place. Mammography help detect the cancer growth at very early stages and thereby, providing the women with the option of getting it treated at the earliest and reducing further risks [28] .

Although thermography possesses benefits such as no radiation and no discomfort of breast compression, it is extremely misleading and increases the level of risks. It is true that mammography also has certain risks pertaining to it, which has resulted in the search for new alternative methods of screening and detection of breast cancer.

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