The Breast Thermography Journal (Digital Infrared Analysis): marzo 2014

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¨

miércoles, 26 de marzo de 2014

Infrared Analysis of the Breast Can Help Biopsy site and better diagnosis

Living in a Low or Middle income country gives a clinitian a different perspective and experience than those main stream drs from Developed ones.
Access , economics , geography , resources cultural or even educational variables play a definite role in any Kind of Cancer Diagnosis and treatment.

So as a personal journey , and being an Oncologist , I started back in 2009 scanning women with clinical or radiological suspicion fro breast cancer , with a last generation IR detector.

55 year old woman , non specific symptoms in her left breast , sent to Mammo and ultrasound with the following images:

Simple and easy , T1 lesion less than 2 cm , multiple microcalcifications with intraductal extension No doubt : BIRADS V , 95% chance of Breast Cancer right?

As an independent research and as a Oncololical Clinitian I scanned this patient with the following images :

After more than 100 cases I personally developed a Method or Interpretation Language based on 18 variables that can be identified from the images you just saw , with the following report and result:

After more that 5 years of performing IR analysis in Breast Patients , what this procedure meant back then is :

" A highly metabolic area , coincidental with morphological tests , of a fast duplication rate or inflammatory component"

Severe assymmetry in this case 204 vs 10 and ALL of the "subjective" variables being POSITIVE in the Side of clinical Interest means that : More Severe Oncological Therapeutical Decisions Need to be made.

Independently as standards of care demand:

An Ultrasound Guided Biopsy was scheduled with the following pathologic result :

Surprinsingly : A SIMPLE INTRADUCTAL HYPERPLASIA WAS DIAGNOSED.

Medical Practice fortunately will always be an ART , practised by trained skilled highly specialized humans .

We should not rely ONLY in what some images or results might conclude.

Experience and Innovation or correct applicability of Logical Statements need to be introduced and supported till the end....

I SCHEDULED an open biopsy , introduced the IR system to the OR with the following images:

Makes sense to me , coincidental with morphological and clinical suspicion , this INTRAOPERATIVE IR image gave me the area where I should take a biopsy.......

IR Assisted Breast Biopsy: To all the main stream Drs. That think Thermography is an Absolute Fraud I apologize I had to do it .......I kindly suggest that you give it a try in controlled prospective clinical trials......would you dare?

Some might feel even angry or daunted , believe I was too , special procedures in special clinical scenarios , in special hands with special minds produce : Better Diagnosis , since we can embrace different kinds of information of a biological phenomena......... Same result : different algorithm : It really does not matters how you or I identify a Cancer , as long as it is detected....

STAY TUNED , HAVE A GREAT WEEKEND NEXT MONDAY : FINAL PATHOLOGY RESULT AND Follow up of this patient.

EMC.