Understanding Breast DITI is a guest post penned by Brenda Witt and used by permission. Brenda and her sister Lynda are Level III Certified Clinical Thermographers, certified and trained by the ACCT, American College of Clinical Thermology.
Brenda says: “We challenge ourselves, our employees and advocates to convey accurate and reliable information regarding what thermography can detect and how it is best utilized as a tool for monitoring breast health. Our clients understand its effectiveness as a screening tool for determining RISK FACTORS for future disease and its use as an early detection of developing disease, both within the breast region and throughout the body.”
Although we feel we’ve covered this topic repeatedly, we’d like to review again the appropriate use of thermography in breast health.
Understand, thermography cannot (and is NOT designed) to “see” structures but rather, blood flow/temperatures related to the health of the breasts. It is in this fashion that thermography can detect the development of later biopsy-proven breast cancer potentially at a very early stage.
At your appointment, we also discuss the requirement to establish a stable baseline to which all annual studies are compared against. Any changes in that stable baseline indicates the early development of disease and for those with a mindset of prevention, it’s best to reverse this back to the previously-established, stable baseline. This is how thermography is best-utilized as a tool for PREVENTING future disease.
Understanding Breast DITI
So why does thermography sometimes not identify all breast tumors?
What is the physiological basis for a thermographically “missed” tumor?”
- Lack of activity.
In order to understand how a tumor could “hide” thermographically, understand that our cameras can only measure skin surface temperatures related to blood flow. If a tumor is no longer active and there is no blood flow feeding the tumor, we cannot tell the difference between the temperature of the tumor and the surrounding tissue. Thermographically, this would be (generally) one temperature and therefore, “missed” during thermographic interpretation.
Another possible reason for a “missed” finding is that a tumor may become dormant. Perhaps the immune system has encapsulated the tumor; walled off the tumor from the rest of the body and has contained it. When you think about it, this is one major role of the immune system. In this scenario, the immune system is protecting the body from the invading tumor but thermographically it is not seen due to the lack of activity (blood flow) of the tumor.
In some cases, some rare cancers may not be vascularized or may be non-inflammatory in nature. That would mean that there is not a sympathetic component (vasodilatation and vasoconstriction) connected to the activity of the tumor and this would be “missed” as well.
While some may think thermography “failed” they may want to consider whether they truly understand the proper use of this technology. We utilize DITI (Digital Infrared Thermal Imaging) to watch for changes over time and it is not to be used to find cancer. Certainly we come across changes that eventually lead to a diagnosis of cancer, but ultimately, DITI is not a cancer detection tool.
DITI is used by women (and men) who have shifted their paradigm from one of “detection of disease” to one of “prevention of disease.” Annual breast thermograms monitor for a change allowing early interventions to help shift you back to your stable baseline. This is the best use of Digital Infrared Thermal Imaging.
Earlier detection may lead to earlier diagnosis and possibly more treatment options, but ideally, it would be best to optimize breast health and prevent the advancement of disease.
If a tumor is not active, dormant, or not exhibiting any temperature differentials does that mean it’s not significant and I won’t need to do anything?
Cancer is unpredictable and it wouldn’t be prudent to make such a far-reaching assumption. The truth is we don’t know that it isn’t significant. We encourage you to talk to a medical practitioner about what options there are regarding this finding.
If a tumor is established, would this been seen in a mammogram?
Older, more established tumors can be radiographically dense and therefore have a higher chance of being seen by a mammogram. However, there is no test that has 100% detection rate. On average, mammography will miss 1 in every 6 tumors.
If I’ve had annual mammograms and they were all negative, would it be okay if I don’t have any more? (Then I could just use thermography annually)
Understand that mammography’s biggest limitation as an effective screening tool is breast density. As we age, breast density diminishes and the effectiveness of mammography would possibly increase. Although you may have had a negative mammogram several years ago, your breast density may have changed in such a way that what was difficult to see previously is now easier to visualize. This would likely increase the effectiveness of detection of tumors possibly not seen thermographically.
There has been a lot in the news about Stage 0 (DCIS) breast cancer not actually being a malignancy, can DITI see this type of breast cancer?
We actually have written about this research finding in another edition of our newsletter titled: The Dilemma of Stage 0 – DCIS. We understand the concern about this type of finding. DCIS, ductal carcinoma in situ is a small pileup of abnormal cells in the lining of the milk duct. You cannot feel it because there is nothing to be felt; there is no lump. But the cells can be seen in a mammogram, and when a pathologist examines them, they can look like cancer cells. The cells have not broken free of the milk duct or invaded the breast. And they may never break free. The lesion might go away on its own or it might invade the breast or spread throughout the body. That raises questions about what, if anything, to do about it.
It is often called Stage 0 cancer, but researchers say their view of cancer is changing. They used to think cancers began as clusters of abnormal cells, and unless destroyed, the cells would inevitably grow and spread and kill. Clusters of abnormal cells like DCIS can sometimes disappear, stop growing or simply remain in place and never cause a problem. The suspicion is that the abnormal cells may be harmless and may not require treatment. But no one has done a rigorous study comparing outcomes for women who get treatment to those who get no treatment. From a thermography perspective: Again, because all cancers behave differently, we may not see any changes on your thermogram, especially if the cells stop growing or remain in the milk duct and not develop further.
Can I have a thermogram every other year?
Preventive screenings are best utilized annually for comparative studies to help determine your “trend” over time. Are you trending toward inflammation and away from health? Our interpreting thermologists make this statement with respects to thermograms: Annual screening is the optimal time frame in ascertaining personal variants and reducing the chance of false-negative thermal findings. False-negative thermal findings may occur when the study interval is more than one year as the human body may have accommodated or encapsulated cancer cells and in that case, the developed cancer has become thermographically ‘silent.’
Ultimately, it’s your responsibility to look at all the data, talk to your doctor and decide what the best plan is for you. See chart below.
Screening thermography has the opportunity to detect changes at any stage in the development from the first year through to when a tumor is dense enough to be seen with mammography. Ideally, if change is detected it’s best to work with your doctor to evaluate this and make clinical recommendations and possibly prescribe other diagnostic testing.Earlier detection may lead to earlier diagnosis and possibly more treatment options. Ideally, it would be best to optimize breast health and prevent the advancement of disease.