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, 13 de mayo de 2013

Is Mammography an Stereotyped Procedure?

Good Morning , I woke up this morning with this question:

 Is mammography an stereotype behavior or medical , radiological procedure?

 I was taught that it is our better weapon against Breast Cancer.
I was taught that chances of surviving depend ONLY in is detection Capabilities.
I was taught it should be done annually starting age at 40 .
I was taught it lowered by 30 % mortality rates.
I was taught never to question or challenge this concepts.

 BUT

 Is it really our best weapon when IT SAVES In situ lesions never to develop clinical signs or even influence mortality?
Not to mention over diagnosis and over treatment ....
Does surviving breast cancer Excludes then our current BETTER Treatments?
What about women 40 years and younger? And how about evidence against Annual vs BIANNUAL?
And  starting until 50 (normal risk)
Was it really 30% reduction in mortality or closer to 10%?

 I think we Should we Challenge stereotypes and prove them wrong (when they are ) , and accept ADJUNCTIVELY WITH THE SATNDARDS OF CARE  some "old"  but 

  • logical , 
  • physical , 
  • reproductible , 
  • and methodical with a possible use , for a Better Detection , Less false positive Biopsies and help current recommended procedures.


 Stereotype means : "SOLID IMPRESSION"

 I believe we are entitled to rearrange strategies based on facts and evidenced associated to specific real human environments and scenarios....

 " Not everything that shines is gold, is it? " EMC

 Good day.
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