Thermographic Breast Imaging

Ann is a 23 year old woman who just received her college degree. Not only did she manage the stress of getting through her studies, but she had also spent the year helping her mother who had been treated for breast cancer with surgery and radiation. Of course her mom’s diagnosis raised all sorts of fears for her own well being, but now the unbelievable had happened: her friend who was only 24 has just been told that she too has breast cancer. To Ann, it doesn’t seem as though she can escape from this horrible disease.

Ann’s story is not that uncommon-- many of us find our lives touched by a friend or family member who has had breast cancer. Breast cancer is the second-leading cause of death from cancer among women in the United States, after lung cancer. Unfortunately, younger women seem to be getting breast cancer. Currently an estimated 1 in 8 women or 12% will develop breast cancer in their lifetime. Women can do things to minimize the impact of breast cancer in their lives- prevention, early screening, and early detection are key. It is important for women to implement these prevention and screening strategies at a young age.

There are screening tests that catch breast cancer in its early stage, before a woman is able to feel a lump, or before she has other symptoms of breast cancer. The x-ray mammogram is the gold standard and the most common screening tool in early detection of an abnormal mass or lump. It involves exposing breasts to a small dose of ionizing radiation to produce pictures that should detect unusual masses. It is inexpensive, easily accessible, but it is estimated that 10-25% of cancers can still be missed. Additionally, x-ray mammography is somewhat limited in women with dense breast tissue. Some find it painful, and it may damage breast implants. Some women prefer not to expose themselves to radiation.

Another screening technique is breast ultrasound, which uses high-frequency sound waves to diagnose breast abnormalities after they are detected in an x-ray mammogram. It may be more reliable with dense breast tissue and can be used easily with breast implants. Ultrasound is better able to see if abnormal lumps in breasts are solid (which may be benign or cancerous) or liquid-filled benign cysts. MRI (magnetic resonance imaging) is another form of studying breast tissue which shows detailed contrasts between different densities in the soft tissue of the breast. This technology can be more reliable, but can also be expensive and, like the x-ray mammogram and ultrasound, it can only detect abnormalities once a mass has formed.

The American College of Obstetricians and Gynecologists recommend screening x-ray mammography for women age 40-49 every 1-2 years and annually after age 50. The American College of Physicians has new guidelines that now take into consideration each woman’s individual risk factors, such as: family history of breast cancer, smoking, use of synthetic hormones, exposure to carcinogenic chemicals, and prolonged use of antibiotics. Women with more risk factors may elect to have yearly x-ray mammograms, while those with fewer risk factors may elect to do x-ray mammograms less frequently, inorder to minimize radiation exposure, and to decrease the stress of receiving a false-positive result, and having to go through the worry and risk of unnecessary biopsies.

But, still, this process leaves someone like Ann worrying about her own breast cancer risk, and not wanting to wait until a lump is found. She wants to be more proactive in protecting herself, and to actually prevent cancer from starting. To Ann, x-ray mammography seems like a late test, and doesn’t help her on her quest to prevent disease.

While traditional screening tools like x-ray, ultrasound and MRI look at the anatomy of the breast and are usually able to pick up abnormal masses, they are not able to see breast physiology changes that take place before masses develop. Infrared mammography, formerly known as thermography, is a method of looking at breast physiology, to determine if there is any change in tissue at a cellular level. It may see abnormal changes 5-8 years before a mass actually forms, making it a desirable testing method for women who may want to know more about their breast health. And, it can be a form of testing for women who prefer not to expose themselves to the radiation from standard x-ray mammography.

Infrared mammography does not give radiation exposure, is non-invasive, and does not involve painful compression. Infrared mammography uses a special camera to pick up on the natural infrared radiation emitted by the body and is based on minute changes in body temperature. A picture of the breast is taken under normal conditions, and then the patient’s hands are placed in cooler temperatures, called a cold challenge, to see if there are any cells or vessels that are not under the control of the body’s regular temperature-control mechanism. Infrared mammography is based on the knowledge that angiogenesis, or new blood vessel formation, is required to supply blood to cancer cells, and that these atypical areas are typically not under the control of the body’s regular temperature-control mechanism. If these new areas of blood vessel development can be visualized early in their early developmental phase, then areas at risk for developing tumors can be identified. These changes can come from a developing cancer, from innocent fibroids, or cysts, so not all areas of abnormality will indicate a risk for cancer. However, once a woman knows there is an area at risk, she can be more diligent with lifestyle modifications and nutritional changes, as well as her screening tests. Typical recommendations would be for a woman to use a multi-modal approach: self breast exams, x-ray mammography, and infrared mammography.

There are many nutritional and physical things women can do to decrease their risks for breast cancer. Walking and using a reformer (small trampoline) can help move lymph fluids around breasts. Exercise and relaxation techniques can reduce stress hormones and improve the immune system. Research on Vitamin D and Calcium-d-Glucarate has shown to improve women’s breast health. Supplementation with iodine can also make dramatic changes to breast health for women who are deficient. Studies have shown that iodine can decrease breast pain and fibrosis, and in animal models, iodine replacement can even suppress tumor growth. The ingestion of cruciferous vegetables, like brussel sprouts, broccoli and kale have been shown to help premenopausal women convert estrogen by-products to safer end products, thus reducing the risk for estrogen-dependent tumors. And, for women who don’t ingest enough of these health-promoting foods, there are companies who make cruciferous vegetables capsules to help bridge the gap.

There are some other things women can do to minimize their risk of breast cancer. The use of alcohol has been linked to breast cancer: those who have 2-5 drinks per day have 32% the risk of developing cancer compared to those who do not drink at all. Weight management is also important, especially after menopause. Fat tissue is actually able to make estrogen, and estrogen can increase the risk of breast cancer in some women. This risk seems to be worse in women who gain weight as an adult (compared to those who have been overweight all their lives), and the risks may also be increased if the weight is gained around the waist area, as opposed to those who gain in the hips and thighs. Breast feeding seems to lower the risk of breast cancer (probably because it lowers the number of lifetime menstrual cycles).

So, for women like Ann, who want to stay healthy and focus on prevention, the good news is that there are things that can be done. First, always review your risk factors with your health care provider to understand what your risk factors are, and what changes you should make. Nutrition, exercise, stress management are important. Weight management and lowering alcohol intake can help. Infrared mammography can be an early testing modality to inform women of breast physiology, and x-ray mammography with ultrasound and/or MRI may be used to look at anatomy.

THINGS WOMEN CAN DO TO DECREASE BREAST CANCER

1. Eat 5-10 servings of fresh fruits and vegetables each day.
2. Eat extra broccoli, brussels sprouts, or kale, or consider a dessicated cruciferous vegetable supplement.
3. Decrease stressors in life when possible and use anti-stress techniques like yoga, mediation, or Pilates.
4. Ask you health care provider to check your vitamin D level. If it is low, get 30 minutes of sun, which increases the production of vitamin D or take cod liver oil or a natural, complete vitamin D supplement.
5. Get breast x-ray mammography as recommended by your doctor according to your risk profile.
6. Consider evaluation with infrared mammography.
7. Lose weight, even if you are only 10% over your ideal body weight.
8. Limit alcohol consumption.
9. Stop smoking.
10. Consider hormone testing to see if you are estrogen dominant
11. Consider urine testing for abnormal estrogen metabolites to see if you are at increased risk for estrogen-related tumors.