The Breast Thermography Journal (Digital Infrared Analysis): marzo 2013

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¨

lunes, 18 de marzo de 2013

Glimpse to the future .

FACTS:

Thermography historically has failed as an screening procedure.
Ultrasound is not recommended as viable option too
MRI is unavailable and quite expensive for it to be an standard all population method.
And Mammography our champion is currently in the edge of criticism mainly because of its cost benefit ratio -overdiagnosis + overtreatment numbers and its consequences.

YET :

They all HAVE a main disadvantage :

TIME and INTERVAL ( Initial screening procedure, frequency)

AND:

IN MOST CASES IT COULD BE A YEAR OR MORE.....

Now:

What if there could be a method of

CONTINUOS MONITORING.........

That is right the only logical option is thermal or infrared monitoring.

I believe with our current knowledge and technology , Thermometry in any of its forms , coupled to current standard recommendations and methods , clinical or radiological , will eventually assist detection of breast cancers, Specially the high metabolic ones or the aggresive forms of the disease.

Here is an example...... hope you enjoy it.......

Remember the last case : BIRADS III Left breast that eventually turned out to be a breast cancer?

And then 2 years later a secondary CONTRALATERAL breast cancer detected or pin pointed by IR image previously?

Clinical "drawing" of the original 1 cm nodule , and the corresponding infrared image.
In some cases and locations , some tumors might not be detected by mamogram either because of density , technical or anatomical reasons.

DIRA interpretarion demostrated a higher score for the left breast , but also pin pointed independently high infrared emission areas on the right breast.....

Now 2 years later:

Infrared Images after treatment , clearly signal RIGHT area , now well defined as the Highest IR peak or "Thermal Summit"

IR as I mentioned earlier could assist , enhance and improves performance of Breast Physical Exam and could guide Ultrasound for millimetrical or close to 1 cm lesions.....NOT BAD i Think.

Here comes a vision..........already mentioned in 2007 trying to introduce the first "Smart Bra" , with the fact that even 6 years later nothing has happened.

And in last October a company in the US published their own system with great expectation for the future.

So : what if my patient would have been wearing such a device or a monitoring system:

No Comments , except that :

The images are clear enough for anyone , the message is simple , and evidence of that new possibility is actually in the right path.....

"Intelligent Thermal or Infrared Monitoring systems WILL aid detection of breast cancers and can be safely introduced in the Clinical Care for our Patients."EMC

I have no other option but to commit myself into this idea and mission.

The How , Who and When is up to you and your collaboration.............

Have a nice day.