Case Number #3. Well differentiated breast carcinoma

Case Number 3.

71 year Old female , without any other risk factors for Breast Cancer.

History of aproximately 6 months , during self examination : asymptomatic palpable nodule in the left upper inner quadrant .

Medio Lateral Oblique View , clearly identifies a dense nodule with espiculate bordes , without any lymph nodes seen in the axillary region.

Cefalo Caudal View : same lesion is identified in the posterior and inner quadrant of the left breast.

Ultrasound Image : 2.1 cm nodule of regular profile.

DIGITAL INFRARED ANALYSIS : Basal series (right) in both glands positive hyperthermias (red) are seen , witha symmetrical pattern . Functional series ( Left) persistance after a cold simutli two of them , each in the inner quadrants (green).

The Left suspicious lesion in the Upper Inner Quadrant (palpable) is not coincident with the thermal Summit of both glands , and after the evaluation of the 15 infrared variables :

As a complementary study : Abnormal Infrared Finding for the left breast due to the alternate signs : rised vascular pattern in the interest area (UIQ) , positive pinpoint sign (vascular network that signals the lesion) with a DELTA T between basal and functional series(GAP) of only 0.4 degrees.

Translated finally to a CCan Score of 156 for the right breast and Only 47 in the left breast .

" Final Clinical , radiological and infrared diagnosis of a possibleLeft Low Grade Breast Carcinoma "

Final Pathological Report: Well Differenciated Ductal Invasive Carcinoma.

"The DIRA as a complementary procedure offers valuable information even before biopsy , and its score is associated with the biological behaviour of the suspected lesion " EMC.

In this case the initial Surgical Oncologist offered a Radical Mastectomy (previous to the biopsy result) . Finally the patient was sent to the OR where Lumpectomy 2 cm margins and selective axillary dissection (Sentinel Lymph Nodes ) were negative .

"As a complementary study , prediction of the biological behaviour of the supicious lesion COULD UNIFY CRITERIA BETWEEN BREAST SPECIALISTS."

"In other words , DIRA offers itself as a useful tool in the day by day therapeutical decisions"

Prospective essays could reafirm these initial report .

"Without a doubt : Therapeutic Decisions did not change whatsoever , yet DIRA meaning exists and could be incorporated in our current oncological Breast Scientific language" EMC.

Case Number #2. High Risk - Breast Implants

High Risk in her 60,s female ( Mother : Stage III breast cancer diagnosed al 86). Two previous aesthetic breast implant surgeries . Under self exam , detected a minimal asymptomatic lump in her left breast.

Digital Mammogram Images SUSPECTED LESION in the LEFT UPPER QUADRANT

vas non detected in these 2 views (Eklund views were not performed).

Ultrasound Images , under DOPPLER 1.2 cm irregular shaped nodule with augmented surrounding blood vessels. BIRADS IVc

ADIR Images , Base line study (LEFT) little assymetry between both breasts , yet in the functional or cold series , the Highest Thermal measure in the both glands , was coincident with the suspected nodule. With little or non associated thermovascular network , a summit of just 31.2 centigrades , a Surrounding Tissue Difference (STD) of 1.2 and a Contralateral Difference or Delta CTLD of 2.0

CCan ir-score of 165 , proved to be a Infiltrating Ductal Carcinoma Well Differenciated , with 3 Negative Sentinel Lymph Nodes. Her 2 neu Negative . Estrogen Receptor Positive 100%

Score Lesser than 170 , is associated with a BETTER Prognosis. Based on the analysis of 15 independent different variables

As a complementary Study , DIRA gives additional information about the biological behaviour of the interest lesion (ir-behaviour)

"Non standard procedure or information that could be considered worthless , time consuming or even useless since it was already detected"

Yet : is useful information always worthless or considered EXTRA?

DIRA is noninvasive 5 to 10 min procedure. As a surgical Oncologist´s , prospective controlled essays can give rise to data that can be incorporated to our every day therapeutic decisions , safely and under our current standard of care"

"Attitude or decision making may not be changed , yet comprehension of the biologic behaviour of a suspected lesion can be anticipated" EMC

Add: By the way this particular patient is under control after 2 years and she actually is MY MOTHER.

Possible Clinical Scenarios : High Risk Patients : INTERVAL PROCEDURE (ir-interval) , and BREAST IMPLANT POSTMENOPAUSAL PATIENTS (ir-implants)

Case Number # 1. High Risk Non Palpable Lesion

The Digital Infrared Analysis (DIRA) of the Breast , previously named Thermography has been investigatedprospectively

Since January 2009 , patients referred with either clinical o radiological suspicion for breast cancer were de Scanned with latest IR technology (FLIRA320) device and analysis with an special software (ThermaCam Researcher) to evaluate the Meaning of the Infrared Image in such scenario.

So after 3 year we start to publish here as an open source in non profit manner , our personal results (Enero 2012)

EIn this space we will offer Breast Cancer Positive Cases and their correlation between : Mammogram , Ultrasound and Infrared images , as well as clinical datas and final pathological finding.

"There is no other way to know the meaning of a given language (IR)he meaning and practice it every day"(EMC).

" Translation of an unknown language depends of it´s relation and association with the one considered as STANDARD"(EMC).

Note: If you are interested for the images to be published in an strict and ethical way , please do nor hesitate and contact me : emartindelcampo@yahoo.com

*Otherwise used with any pother purpose will give rise to a legal action

First Case :

High risk 56 year old female (mother and sister breast cancer survivors) Asymptomatic , with the following screening images : (Non PALPABLE lesion)

Desity assimetry (2 stellar images) ,medial and slightly superior and posterior.

Ultrasound: Size calculated less than 1 cm for each of them . (Finally a horseshoe unic lesion) With local vessels visible with DOPPLER.Final size 1.1cm.

DIRA , in the FUNCTIONAL SERIES (after a cold challenge) , it can be delineated in the Upper Left Quadrant a single and persistent Functional Hyperthermia , with a moderate Thermovasular Associated Network , that Pinpoints the already described nodule.

With a Peripheric Tissue DT (Thermal Delta or difference) of 2.0 celsius and 1.1 to the contralateral exact same site .

Thermal summit (TS) of 32.9 grados and coincident to the clinical interest area.

ir SCORE: 148 ( SUM OF THE 15 DIFFERENT IR VARIABLES)

Final Pathologial Report : INVASIVE DUCTAL CARCINOMA , MODERATELY DIFFERENTIATED , WITH AN SBR OF 6 , NEGATIVE AXILLARY LYMPH NODES .

DIRA is directly related to: Tumor Grade , Size , Number of POSITIVE lymph nodes and to the presence of Angioinvasion. ( All prognostic in breast cancer)

"Possible Future Clinical Scenarios":

1. High risk patients , post menopausal , as a complementary study in BIRADS 0 , 3,4, or 5 .
2. Interval study between Mammograms
3. Rural or third world countries with little or no access to recommended standard procedures

As a complementary study gives data that can be related to the biological behaviour of the lesion (previous to the pathological report) .

As an screening procedure : it seems possible and with an easy access due to its portability , to identify this specific ir-pattern in this specific populations.