How is Breast Thermography Performed?

Your visit with us is a very thorough process. It begins with simple preparation steps that must be strictly followed before you arrive (Pre-Examination Instructions). Once in the office, you will be asked to complete a breast health history form. You will then meet with our experienced staff to go over the procedure. The examination begins with a visual inspection of the surface of the breasts. This is a standard procedure that correlates any surface findings with the infrared images. Once this is done, you will be left for 15 minutes in order for your body to reach a steady temperature state in equilibrium with the special temperature conditions of the room. After this brief waiting time, you will be positioned in front of the imaging system so that the surfaces of the breasts, upper chest, and under arms are imaged.



Computerized Medical Infrared Imaging Station


The images are captured in real-time from an ultra-sensitive medical infrared imaging camera and sent to a sophisticated computer for storage and analysis (the images are kept on archival media for precision comparison of future images so that the breasts can be monitored over time). Sophisticated computer programs allow the doctor to isolate temperature differentials, perform vascular analyses, dynamic thermal subtraction studies, and more.

Once the images are taken, our on-site Board Certified Clinical Thermologist will digitally process and grade the images. You have, as an option, the ability to meet with the thermologist to review the results of your thermogram immediately after your visit. Since a consultation time must be set aside at an additional fee, please arrange this prior to your exam time. Most patients opt to wait for their written report, which is mailed to you within two weeks.

After the images have been analyzed, they are graded using a strict standardized reading protocol. Each breast’s image is placed into one of five thermobiological (TH) categories:

TH 1 – Normal uniform non-vascular

TH 2 – Normal uniform vascular

TH 3 – Equivocal (questionable)

TH 4 – Abnormal

TH 5 – Severely abnormal

Depending upon the results of the exam, further tests may be ordered and/or future infrared scans performed at recommended intervals to monitor the breasts.


Bilateral Breast TH 1 – Normal Uniform Non-Vascular Image

COLD HOT

The hotter temperatures are the lighter colors.
In the normal TH1 image above, the color (temperature) patterns of the breasts are cool and very close to identical when compared to each other.


Bilateral Breast TH 1 – Normal Image

   

Bilateral Breast TH 2 – Normal Image

Left and Right Breast TH 2 – (Grade 3 Mastopathy)

Note the symmetrical streaks of orange and red in both breasts (blood vessels). This symmetrical increase in metabolism is commonly caused by the effects of hormones. In cases such as these, the patient is referred back to their doctor for further testing to confirm the findings and determine the cause. Many of these cases are found by the patient's physician to be a form of estrogen dominance. Finding this and correcting the problem may play a important role in breast cancer prevention.


Bilateral Breast TH 1 – Normal Image

   

Right Breast TH 3 – Equivocal Image

Right Breast TH 3 – Equivocal (Questionable) Image

Note the single hot blood vessel in the right breast. This finding will need to be watched over time for change. If it remains stable, or improves, the finding is normal for the physiology of this patient.


Bilateral Breast TH 1 – Normal Image

   

Right Breast TH 4 – Abnormal Image

Right Breast TH 4 – Abnormal Image

Note the increased temperature (metabolism) of the right breast. There are three suspicious areas of higher temperatures. Especially significant is the highly vascular area closest to the right nipple.


Bilateral Breast TH 1 – Normal Image

   

Left Breast TH 5 – Severely Abnormal Image

Left Breast TH 5 – Severely Abnormal Image

Note the intensely increased temperature (metabolism) and vascularity of the entire left breast. In this case, a recent mammogram was negative. The patient was referred back to her doctor with a recommendation for further tests. The biopsy results were positive for inflammatory carcinoma.


Dynamic Digital Thermal Subtraction

Dynamic digital thermal subtraction is a very sophisticated DII technique. Our state-of-the-art processing system allows us to perform this high level of analysis. The procedure consists of: (1) activating the sympathetic nervous system by challenging the body's thermoregulatory system with a cold stimulus (this is non-toxic and harmless to the body), (2) taking a series of images over a specific time period, and (3) performing computerized subtraction of the images in order to evaluate the body’s response.

Stimulation of the sympathetic nervous system causes a constriction of the normal blood vessels in the breast. The blood vessels supplying a cancerous tumor will resist constriction or fail to constrict (neoangiogenic vessels). This test ultimately raises the suspicion that a cancerous tumor might be present. However, the procedure is not mandatory and does not increase the sensitivity of the thermogram.

Right Breast TH 4 – Abnormal


Again, note the increased temperature (metabolism) of the right breast. There are three suspicious areas of higher temperatures. Of highest suspicion is the vascular marking closest to the nipple.

Digital Subtraction Graph of the Right Breast (TH 4)

Once the thermoregulatory challenge was complete, 50 images were collected over a 4-minute period. Four areas of increased metabolic activity in the right breast were selected for analysis. Included are the three suspicious areas shown in the image above (noted as #1-3 on the graph). The computerized graphic analysis shows one vessel beginning as a cool area and progressively warming in a linear fashion (purple line). This single area displays a normal blood vessel response. However, blood vessels #1-3 begin as high temperature areas with #1 and #2 yielding the highest suspicion as they quickly level off with no further increase in temperature.

Digital Subtraction Graph of the Left Breast (TH 2)

Four similar areas in the right breast were selected for analysis. The computerized graphic analysis shows all four vessels beginning as cool areas and progressively warming in a nearly identical fashion. This graph displays the normal blood vessel responses to a thermoregulatory challenge.


Computerized Digital Processing

The following series of images are examples of a case with a suspicious single hyperthermic blood vessel in the right breast. The black and white images demonstrate different methods of isolating the vessel for analysis using sophisticated computerized digital subtraction processing. The color images are a limited example of the many enhancement palettes available. The type of processing we use also provides for computerized digital quantitative analysis of the temperatures anywhere on the images. Our imaging center is equipped with one of the most sophisticated medical infrared imaging systems available.


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