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, 5 de septiembre de 2013

Dense Breast Aid , SIMPLE AND EASY

Simple and easy there is no doubt and Standards are Changing and including by LAW the comment that includes BREAST DENSITY .

Dense breast tissue  not only is at  risk for more active tissue , but it is obviously a 
VISUAL Obstacle for Xray definition.

Even Clinically suspicious as the following case are reported  surprisingly as totally benign : BIRADS I 





 Morphological complement with Ultrasound clearly defines the even palpable nodule , great complement fortunately , enough for clinical decision making ........

Complementary Digital Infrared Image were these:


 Basal Frontal 



Basal Oblique Right


 Basal Oblique Left  Views


Functional Frontal 


Functional Right Oblique


Functional Left Oblique 


Close up.

COMMENT :

For me there is no DOUBT , Dense Breasts cannot rely only on Mammography , I am guessing everyone agrees.

Complementary procedures are obviously Needed.

Ultrasound when clinically evident is great.

"Infrared when clinically ASYMPTOMATIC , could help guide ULTRASOUND and define :

SUBCLINICAL POSITIVE BREAST CARCINOMAS"
 

EMC

And you can quote me on that ........

So here is the thing : around 30-40 percent of cases are diagnosed in women 45 years or younger , population defined radiologically as Possible DENSE BREAST .....

That is why even after 40 MILLION mammograms in  the US every year 20-30 percent are clinically evident.

And will be , if we do not try anything else...

To include an adaptative strategy for non INVASIVE or  IONIZING Screening in these women that are not candidates for Mammography or Have an anatomical BARRIER for Xrays.

It not only MAKES SENSE but it is a true LOGICAL POSSIBILITY.

Think about it and SMILE.

Welcome to open your minds and eyes.....

I think you should give it a try....

See you.

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