Breast Digital Infrared Analysis (DIRA) , a forgotten and set aside procedure.

Visita: termografiamamaria.blogspot.com (Version en Español)

Breast DIRA (previously named Thermography) already proved in the past that it´s use as an screening procedure had low specificity and high sensitive values for it to be recommended as an standard care Breast diagnosis tool .
Yet , until recently (last 5 years) active research mainly by Surgical Oncologists or Breast Surgeons have published interesting results.( Cornell NY , Addenbrooke Cambridge , Ville Marie Montreal , Taiwan and Mexico CEPREC)
FDA previous published criteria were prohibiting DIRA as well as the A.C. of Radiologists ( as an initial SCREENING TOOL)

Yet it has been cleared by the FDA approval as an adjunctive screening tool for breast cancer .( under 510 k) .

DIRA´s meaning is not an ANATOMIC or ARCHITECTURAL procedure ,it is a METABOLIC or PHYSIOLOGIC ONE so at first it ´s current recommendation should be only as a COMPLEMENTARY STUDY.

As such DIRA could help in specific scenarios, BIRADS 0,3,4 and give potential useful additional data in BIRADS5. EVEN BEFORE BIOPSY
Could aid mammogram in young,dense and breast prosthesis patients, and should be evaluated in other clinical scenarios as a Neoadyuvant Monitoring tool.
Finally as an early detecion procedure specifically in underdeveloped countries , could Triage in search of aggresive forms of the disease(T1,G2_G3). And aid Physical Exam of the Breast .
This site is dedicated to open mind Breast specialists ONLY .
¨EXPANDING OUR CURRENT COMPREHENSION, UNDERSTANDING AND APPROACH OF IMAGE AND DIAGNOSIS IN BREAST CANCER¨

jueves, 12 de enero de 2012

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.
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