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, 20 de enero de 2014

Breast Thermography Lacks Exact Tumor Positioning , but could it at least ORIENT?

Breast Infrared Image , Lacks Exact Tumor Positioning.

And that is why Fellow Radiologists will not ever consider to explore this technology again.

At least as an Screening procedure......

As We (main stream Drs)   learn mostly from ANATOMICAL studies ,  then we  do not understand biological infrared  spectrum meaning of the images it produces.

It is an unknown boundary..........a black hole.

Considered by all as useless.....

One Question : Since when does any MEANING is useless???

So a lady in her 80´s after feeling a lump in her left breast attends consultation with the following images: 




So , no doubt BIRADS V 95% chance of having a Breast Cancer in this case several foci and quadrants involved.

NO QUESTION ABOUT IT , MAMMOGRAPHY WILL EVER BEAT ANY OTHER ANATOMICAL APPROACH , since it is the more reasonable physically speaking way to investigate BREAST ANATOMY...... and that is that .

So does it makes sense at all to screen a lady in her 80´s??? Most will say no .......

And , if this is it , does it makes sense doing any other complementary procedure??? Most will answer no , recommend nothing else or even deny IR as a complement....

Guess you agree.

WOULD YOU LIKE TO SEE THE DIGITAL INFRARED ANALYSIS OF THIS PATIENT , OR YOU THINK IT IS A WASTE OF TIME?



P.S.  Does anyone out there HAS A LITTLE SCIENTIFIC CURIOSITY AT ALL ?

Isn´t it right that a BREAST SPECIALIST should handle and learn every possible language  and information around breast cancer???








jueves, 16 de enero de 2014

There is no DOUBT , Mammography is the GOLD standard , but it is simply NOT ENOUGH

Happy 2014 

There is no DOUBT : Mammography is the gold standard for Breast Cancer Detection . It is the most complete and the evidence cannot be denied.

"There is only  one problem : it is NOT ENOUGH . And regretfuly it will never be." EMC.

World wide ( specially in Low and Middle Income countries ) .....and you should care since more than 90% of countries apply :
  1. 95% of breast cancers are PALPABLE
  2. Around 70% are in Stages  III or IV
  3. There are no Screening Programms , with high quality control standards
  4. Younger women seem to "escape" from any kind of early detection.
  5. And MORTALITY at least where I live is around  40%.......

I have a question :

What if it could exist a PROCEDURE :
  1. Simple
  2. Sensitive
  3. Specific for : T1 Tumors in the aggresive type (GII or GIII)

Do you think this could help SOMEONE ????

Answer :



These are the Standard diagnostic radiological images we all know , done after clinical evaluation , physical exam. ( the other way around).......




Easy  to  understand  morphology images , that we recognize and understand as  .......BIRADS V , T2 lesion with even positive axillary lymph nodes seen... Stage IIb at least.....

What if we could use Digital Infrared Image as a Clinical Support for Physical Breast Exam , and the eventually locate around 2 cm tumors with possibly the help of a Mobile ultrasound equipment????

Then : 

Mammography in some clinical and sociocultural scenarios should be reserved only for:

Diagnostic purposes.

Total Contradiction from recommended standards of care. I know , but ; 

Reality Bites: We (90% of the world)  are losing this fight.......

"I see no no other path or option in the short , middle or long term." EMC

Hypothesis

I would love to creat strong EVIDENCE in the Mainstream Medicine that Demonstrates and Proves that State of the Art Digital Infrared Image of the Breast has a Detection Potential ( inferior than mammography I already know )  .

But that it actually can identify  Lesions around 2 cm : T1 and in their aggresive form ...

This strategy could approach women from  country  X  to  DIAGNOSTIC MAMMOGRAPHY.


It would ENHANCE and OPTIMIZE radiological resources , widening COVERAGE and IMPROVE substantially current statistics.

Numbers  DO NOT LIE : Early Detection DOES NOT EXIST practically in the vast majority of countries.

There is no Budget that can handle the economics of Screening....

It is imperative to create an ADAPTATIVE STRATEGY that improves our Breast Cancer Reality....

"Awareness ......Breast Self Exam .......Infrared Optimization .....Guided Clinical Breast Exam and Ultrasound" :

T1 Detection , with better treatment options : Better 5 Year Survival .....

DO YOU THINK I AM LYING????

WHAT IF I AM NOT?????.....

At your service.

EMC: emartindelcampo@yahoo.com