| > | | | | missedUltrasound |
| | | | - Structural test, can pinpoint the location of suspicious |
| Many women after their initial assessment with | | | | area |
| thermography may be asked to follow up either with | | | | - Uses sound waves with moderate contact |
| an ultrasound or mammogram or both to rule out the | | | | - High frequency sound waves are bounced off the |
| existing pathology. Frequently some will be relieved | | | | breast tissue and collected as an echo to produce an |
| that their mammogram or ultrasound test result show | | | | image |
| no abnormal findings, however this does not | | | | - Able to detect some tumors missed by |
| necessarily mean that nothing is going on with their | | | | mammography |
| breasts. | | | | - No data available on detecting pre-invasive tumors |
| "Written by Dr. Alexander Mostovoy submitted by Dr. | | | | - May be affected by the hormonal influence due to |
| Cynthia Simmons" | | | | the menstrual cycle, (i.e. cystic changes) |
| One of the most frequent questions I am asked as a | | | | - All areas of the breast and Axillary region can be |
| clinical thermographer is: What exactly is the | | | | analyzedUltrasound - continued |
| difference between mammography, ultrasound and | | | | - Good for distinguishing between solid and fluid |
| thermography? There seems to be some | | | | masses, helpful in investigating an area of concern due |
| confusion on this subject by thinking that one replaces | | | | to mammography, thermography or physical |
| the other as tests, nothing could be further from the | | | | examination findings |
| truth. Both mammography and ultrasound are structural | | | | - Average Specificity 66% (34% false positive) |
| (anatomical) tests, while thermography is a functional | | | | - Average Sensitivity 83% (17% of cancers |
| (physiological) test. None of these tests are truly | | | | missed)Thermography |
| diagnostic technologies. Thermography images the | | | | - Functional testing, able to detect physiological |
| breast and surrounding area and provides us with risk | | | | changes, cannot pinpoint the exact location of |
| assessment, while mammography and ultrasound | | | | suspicious area |
| detect structural abnormalities. If a breast abnormality | | | | - No radiation, non-invasive, no risk, can be used as |
| is found that could possibly be malignant, a biopsy is | | | | often as necessary to observe the effectiveness of |
| performed. A biopsy removes a tissue sample for | | | | treatment over time |
| examination under a microscope. | | | | - Uses infrared detectors to detect heat and increased |
| Many women after their initial assessment with | | | | vascularity that may be related to angiogenesis |
| thermography may be asked to follow up either with | | | | - Can detect physiological changes many years prior |
| an ultrasound or mammogram or both to rule out the | | | | to any other method of screening |
| existing pathology. Frequently some will be relieved | | | | - Very sensitive to fast growing aggressive tumors |
| that their mammogram or ultrasound test results show | | | | - Hormonal activity in the breast will affect |
| no abnormal findings, however this does not | | | | thermographic imaging but not to the point of |
| necessarily mean that nothing is going on with their | | | | abnormality |
| breasts. Several other factors may be contributing to | | | | - All breast shapes, conditions and areas are within the |
| a high risk (abnormal) thermogram, such as: hormonal | | | | scope of imaging |
| imbalance, early angiogenesis (proliferation of blood | | | | - Earliest warning system with breast tissue and |
| vessels), lymphatic swellings and poor function and | | | | physiological changes that usually precedes tumor |
| other contributing factors — all of these are | | | | formation years prior to its occurrence |
| important contributors to breast disease and | | | | - Average Specificity 90% (10% false positive) |
| malignancy and are not detected by mammography or | | | | - Average Sensitivity 90% (10% cancers missed) most |
| ultrasound as these factors do not appear as | | | | of these are slow growing tumors with low metabolic |
| structural changes. | | | | rate in the area with a high rate of survival |
| The following is a list comparing all three types of tests | | | | Of course everyone has heard by now that early |
| with their pros and cons:Mammography | | | | detection prolongs life expectancy, this is a given. |
| - Structural test: can pinpoint the location of suspicious | | | | However if cancer has been detected early, it would |
| area | | | | mean that you already have cancer. Prevention should |
| - Compresses the breast | | | | take precedence over detection. Prevention means |
| - X-ray radiation produces an image; the area of | | | | not getting cancer in the first place. If we are going to |
| concern must have greater density to stand out | | | | reverse the present trend of the epidemic proportion |
| against regular tissue | | | | of breast cancer, we need to come up with a more |
| - Can detect tumors in mainly slow growing stage or | | | | proactive approach, which needs to become the norm |
| pre-invasive stage | | | | for patient assessment. Cancer starts with one |
| - Cannot detect fast growing tumors in the | | | | abnormal cell, and it takes nearly 8 years for that one |
| pre-invasive stage | | | | abnormal cell to replicate to one billion cells. One billion |
| - The use of hormones decreases sensitivity | | | | cells produce a detectable lump that is one centimeter |
| - Large, dense and fibrocystic breasts are difficult to | | | | in size. This is the size of a lump that can be seen on |
| read | | | | a mammogram. This is not an early finding. |
| - The upper portions of the breast including the tail of | | | | Every woman should know her risk for breast cancer. |
| the breast and the Axillary region cannot be visualized | | | | With proper risk assessment that includes different |
| - Can detect tumors 1-2 years earlier than physical | | | | testing modalities, the patient is able to determine her |
| examination | | | | risk factors and develop an action plan on how to |
| - Average Specificity 75% (25% false-positive) 9 out | | | | improve the breast tissue or even reverse the existing |
| of 10 biopsies initiated by mammography are negative | | | | trend. The current screening strategy is not enough to |
| - Average Sensitivity 80% with 20% of cancers | | | | protect women from breast cancer. Medical infrared |
| missed in women over age 50in women under age 50 | | | | imaging should be added to every woman’s |
| Sensitivity is 60% or 40% of cancers | | | | regular breast health care. |