Can Breast Thermography Replace Mammograms?

Don’t you just love mammograms? The comfort, the privacy, the instant and clear results? All so much fun right?

Isn’t there a better way?

I often get asked if there are any options other than a mammogram for breast cancer screening or follow-up. One of those options that you may have heard about is breast thermography. In this post I’ll discuss what breast thermography is, how effective it is at picking up breast cancer, and whether or not it can replace the incredibly enjoyable mammogram.

Thermography or thermal imaging is supposed to detect differences in temperature on the surface of the breast at the skin. The idea is that since cancer cells are so metabolically active, dividing rapidly, and may have more blood flow than surrounding tissues, they are generating heat that can be detected on the skin of the breast by one of these devices.

This idea has been around for a long time and makes sense on some level. After all, we have exploited the metabolic hyperactivity of cancer cells in imaging before. That’s what a PET scan is. We inject glucose with a radioactive tracer that can be detected by an imager, and the glucose gets taken up by metabolically active cells. Since cancer cells are more active, they take up more of the glucose. We use PET in many cancers, but it is not sensitive or specific enough for breast cancer screening.

Can we really detect differences in heat at the surface of the breast to find breast cancers? In short, no. The American College of Radiology regularly publishes updates on appropriate methods of breast cancer screening. In this review, breast thermography and other “alternative” methods such as breast-specific gamma imaging, positron emission mammography, and optical imaging were not supported by scientific evidence for use as a screening tool.

In fact, in studies of known breast cancers, thermography was woefully inadequate as a cancer detection device even when we knew the cancers were there. And, yes, this includes the modern version of thermography known as digital infrared thermal imaging or DITI.

Breast thermography is often offered by alternative or natural health providers. They often claim that it is a substitute for mammography or can be used in addition to mammography to evaluate suspicious lesions. This health claim got them in hot water with the FDA. It is illegal to advertise thermography as a substitute for mammography. To protect the public, the FDA put out a safety bulletin warning people that breast thermography is not a substitute for mammography. Here is a portion of the warning:

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.

Mammography (taking X-ray pictures of the breasts) is the most effective breast cancer screening method and the only method proven to increase the chance of survival through earlier detection. (https://www.fda.gov/medical-devices/safety-communications/fda-warns-thermography-should-not-be-used-place-mammography-detect-diagnose-or-screen-breast-cancer)

Mammography is the standard for breast cancer screening. This may be supplemented with MRI and/or ultrasound for additional evaluation.

Breast thermography may sound promising or even too good to be true. And you know what we say about things that sound too good to be true…Unfortunately, there is no substitute for a mammogram when it comes to detecting breast cancers. So, until we can come up with something better (and more comfortable), we just have to make the best of it.

If you are a breast cancer survivor and want to know more about Integrative Oncology or how to reduce your risk of a breast cancer recurrence, there is a ton of information on my website. In fact, I have a short video series on nutrition that really may interest you. You can find it here: https://www.lisaschwartzmd.com/the-biggest-mistakes-video-1-247.