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Infrared Breast Imaging

Infrared Breast Imaging, we call IRBI for short, has been in used since the 1960s. The technology was originally designed for the U.S. military to use for night vision exercises but was found to have many medical applications. In 1982, the FDA approved infrared imaging to be used as an adjunctive tool for the diagnosis of breast cancer. The designation was granted due to the difference in biology between a cluster of inflamed cells and a cluster of normal cells without inflammation. The increased heat, indentifying a problem, could be easily and non-invasively identified with an infrared scan.

Infrared breast scans have been dismissed by conventional physicians as unreliable, claiming that the tool produces "too many false positives". But a false-positive infrared scan means the image was abnormal, but did not have a corresponding abnormality found on a mammogram. However, unlike a false-positive mammogram, a positive-infrared image is the single most important marker and risk factor for a developing cancer. It is a warning sign of an abnormality requiring action to normalize and resolve the inflammation

Accuracy of IRBI scanning

The bulk of the research involving breast thermography was conducted in the 1980s. State-of-the-art, ultra-sensitive infrared cameras and sophisticated computer software have evolved to detect, analyze, and produce high-resolution images. The problems encountered with early generation infrared camera systems, such as improper detector sensitivity, excessive thermal drift, calibration problems, analog interface, first generation software, etc. have been solved for almost two decades.

Think about the difference between black and white televisions and new plasma screen TVs. Consider the evolution from the first computers which were housed in rooms, to the handheld gigabyte gadgets in common use today. Technology progresses in every area; tools used today for breast thermography are vastly improved over equipment used twenty years ago. The results proved its usefulness in the 1980s; the new tools make it even more valuable and effective today.

Many studies over the last 25 years have shown the value of adding infrared imaging to an abnormal mammogram. One example, done study done in 2008 and published by the American Society of Breast Surgeons, was a prospective clinical trial of 92 women who had an infrared scan added to a suspicious lesion identified by mammography. The scan correctly identified cancer with a sensitivity of up to 97 percent and a negative predictive value of 82 percent (
http://www.ajsfulltextonline.com/ar...)00475-3/abstract). For infrared nay-sayers, the facts speak for themselves. Infrared Breast Imaging, an IRBI scan, can provide important information as a stand-alone test and as a value-added to a suspicious mammogram. As an additional benefit, an infrared scan is painless and uses no radiation.

False positive and false negative mammograms

While radiologists use a strict set of criteria for interpreting the films, the interpretation of a breast x-ray is challenging. A mammogram looks like white blobs and scratches across a black board. If you've never seen one, ask your doctor to see your films the next time you have a mammogram. It's an educational moment worth having and can explain why mammograms do not - and cannot - detect every cancer, especially at its smallest, earliest stage.

A false-positive mammogram means that something appears abnormal on the film, but then turns out to be a false alarm. Over a 10-year period, approximately 24 percent of women who have an annual mammogram will have at least one false-positive mammogram (http://qap.sdsu.edu/screening/breas...). Suspicious findings require a woman to be called back for "extra views" and more radiation exposure. An inconclusive mammogram can lead to an ultrasound, and most likely a biopsy, where eight of 10 are found to be normal.

In 2006, the Cochrane Review published a meta-analysis of mammograms performed on 500,000 women throughout the US, Canada, Scotland and Sweden. The review concluded that for every 2,000 women who received mammograms over a 10-year period, 10 women have extra, unnecessary and potentially harmful treatments and the number of mastectomies increased by 20 percent (http://www.ncbi.nlm.nih.gov/pubmed/...).

A false-negative x-ray, on the other hand, means cancer is present but not detected by the mammogram or is overlooked the radiologist who did the interpretation. In 1982, the false-negative rate for screening mammography was found to be eight to 10 percent (http://caonline.amcancersoc.org/cgi...). A decade later, some authors have suggested the false-negative rate was as high as 25 percent (http://radiology.rsna.org/content/1...). Dense breast tissue can compromise the ability of a mammogram to detect a mass, and lesions located near the sternum (breast bone) or near the chest wall can be difficult to visualize. A false-negative test can explain why one year the report is normal and the very next year, cancer is diagnosed.

A decade later, some authors have suggested the false-negative rate was as high as 25 percent (http://radiology.rsna.org/content/1...). Dense breast tissue can compromise the ability of a mammogram to detect a mass, and lesions located near the sternum (breast bone) or near the chest wall can be difficult to visualize. A false-negative test can explain why one year the report is normal and the very next year, cancer is diagnosed.

Effectiveness of Mammography

Is mammography an effective tool for detecting tumors? Some critics say no. In a Swedish study of 60,000 women, 70 percent of the mammographically detected tumors weren't tumors at all. These "false positives" aren't just financial and emotional strains, they may also lead to many unnecessary and invasive biopsies. In fact, 70 to 80 percent of all positive mammograms do not, upon biopsy, show any presence of cancer.

Radiation Risks

Many critics of mammography cite the hazardous health effects of radiation. In 1976, the controversy over radiation and mammography reached a saturation point. At that time mammographic technology delivered five to 10 rads (radiation-absorbed doses) per screening, as compared to 1 rad in current screening methods. In women between the ages of 35 and 50, each rad of exposure increased the risk of breast cancer by one percent, according to Dr. Frank Rauscher, then-director of the NCI.

According to Russell L. Blaylock, MD, one estimate is that annual radiological breast exams increase the risk of breast cancer by two percent a year. So over 10 years the risk will have increased 20 percent. In the 1960s and 70s, women, even those who received 10 screenings a year, were never told the risk they faced from exposure. In the midst of the 1976 radiation debate, Kodak, a major manufacturer of mammography film, took out full-page ads in scientific journals entitled About breast cancer and X-rays: A hopeful message from industry on a sober topic.


The risk of radiation is apparently higher among younger women. The NCI released evidence that, among women under 35, mammography could cause 75 cases of breast cancer for every 15 it identifies. Another Canadian study found a 52 percent increase in breast cancer mortality in young women given annual mammograms. Dr. Samuel Epstein also claims that pregnant women exposed to radiation could endanger their fetus. He advises against mammography during pregnancy because "the future risks of leukemia to your unborn child, not to mention birth defects, are just not worth it." Similarly, studies reveal that children exposed to radiation are more likely to develop breast cancer as adults.


MRI scans lead to unnecessary breast cancer surgery

Magnetic resonance mammography (MRM) is even more sensitive than standard mammography, and is increasingly being offered to young women who have been judged at high genetic risk for breast cancer. According to a study in The Lancet, MRM detects 92 percent of early breast lesions, while x-ray mammograms detect only 56 percent.

But not all lesions lead to cancer. Indeed, the only major study of MRM use in early cancer detection found that women who used MRM screening had the same risk of cancer recurrence as women who had not used the devices. Breast surgeon Kefah Mokbel of the London Breast Institute estimates that MRMs have a false positive rate of roughly 25 percent.

Even more alarming is evidence that false positives are leading to unnecessary breast removal (mastectomy) surgeries. The same Lancet study found that mastectomy rates were seven times higher among MRM patients than among those not undergoing that type of screening.