Breast Thermal Imaging, the paradigm shift

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Technology, especially in light of the desk top PC and the Pentium processor, has at last reached a stage of development and cost effectiveness that makes the availability of dynamic quantitative and reliable thermography a definitive reality.

In the past, the quantitative (or numbers) measurement of actual spot temperatures was difficult. Many thermographer s' used liquid crystal imaging (much like the temperature strips we use on our children's foreheads). While bright, colorful and reliable images could be obtained, no precise measurement could be made. This is called qualitative imaging. (quality of image)

While the quality of a properly performed thermogram can provide immediate thermal imaging information to the unaided eye, (excluding the estimated 15% of the population who are color blind), errors can be made in the interpretation by assuming that a color change is significant when in fact it may not be.

(authors note: due to the email capabilities of this type of correspondence, the original text and illustration presented below have been modified to meet the standards available for download)

Qualitative thermography uses color or gray scale images for comparison of left to right, as in the right nipple as compared to the left, or the full breast, right compared to left. With qualitative imaging, a color scale is presented as a crude marker for comparison to the patients actual temperatures. It was assumed that a color change indicated a pathology as illustrated below. This was based on a ten color scale, 1 degree centigrade between colors. So as represented in the diagram, a shift from yellow to orange was assumed to be a 1 degree centigrade increase in heat, left compared to right.

Sample Color Scale Representation .1 degree increments

So, if the right breast were orange on the qualitative image, and the left breast were red, a pathology was assumed to exist as a 1 degree centigrade increase in heat had occurred thus shifting the color scale..

WRONG! Please notice that the beginning of each color block has a temperature selected. They increase in 1 degree centigrade increments. Also notice that there is a "0" in the tenths position. This means the system is measuring unit values of 1/10th degree centigrade. Because the color "scale" is assigning only one color to a block of temperature, all temperatures falling within that "block" are assigned by the computer, the same color.

Therefore, a difference as little as .1 degree centigrade or as much as 1.9 degrees centigrade could shift the color assignment. Obviously a .1 degree centigrade shift is minimal and non diagnostic. A 1.9 degree centigrade shift is quite severe and indicative of pathology. Both however, would assign with these outdated systems, the same relative color shift and thus the reason for misdiagnosis and the reporting of the so-called false positives.

In my thermography lecture series, I devote one hour with graphic slides explaining this phenomenon, which is so easily corrected once the "concept" is grasped

I have now designed software that differentially measures the actual spot temperatures in the contralateral tissues so that this error can no longer occur, yet many clinicians still utilize, and rely upon the outdated and dangerous qualitative imaging techniques.

CONCLUSION: I would like to restate, that thermography of the human breast is not a stand alone tool as some have suggested in the screening and diagnosis of breast cancer. It is adjunctive. We can not ignore thermographys' tremendous role as an early risk indicator or as a monitor for treatment.

When a thermogram is positive, a closer look at the patient's diet, exposure to environmental toxins and pollution and lifestyle is in order. Clinical blood work in addition to mammography is essential.

When mammography and blood work are negative or equivocal, thermographic monitoring on a quarterly to semi-annual basis should be performed in those patients with suspicious thermograms.

In this way changes in tumor angiogenesis can be evaluated and other procedures can be ordered to aid in the earliest possible diagnosis. The procedure is non-ionizing and safe and there is no reason to simply "wait and see" any longer.

It is here that the paradigm needs to shift. We can no longer accept the "wait and see" attitude just because a mammogram is negative. Perhaps some day with a more universal and a-political approach, thermal imaging markers can be even further classified into more effective and even pathognomonic categories. This will require a team approach, worldwide.

Until that time, one thing is certain. In the presence of cancer or not, an abnormal thermogram is indicative of abnormal physiology, and this can not be ignored any longer.

Reprinted with permission from Dr. William Cockburn

1. Hardy, JD: The Radiation of Heat from the Human Body, J. Clinical Investigation, 13:539-615

2. Hobbins, Wm, Abplanalp. K., Barnes, C., Moner, B.: Analysis of Thermal Class TH-V Examinations in 37,050 Breast Thermograms, Thermal Assessment of Breast Health MTP Press Limited, 25: 249-255, 1984

3. Gross, C., Gauthries, M, Archer, F. et al: Classification Thermogaphique des Cancers Mammaires, Bull Cancer (Paris), 58:351-362, 1971

4. Nyirijesy, J., Abernathy, MB., Billingsley, FS., Bruns, P.,: Thermography and Detection of Breast Cancer, a review and comments, J. Reproductive Medicine, 18/4 165-175

5. Cockburn, Wm., Breast Thermography, to screen or not to screen: J International Academy of Clinical Thermology, Vol1 No2, 17-44 1989

This article was first submitted for publication 24, October 1994

Accepted December 1994

Dr. Cockburn may be reached for comment or discussion at thermodoc@verizon.net

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