BY CHRISTINE SCHRUM
Pam Ryerse of Radiant Thermal Imaging uses a sophisticated infrared camera to detect abnormal vascular activity in the breasts. The laptop shows a sample generic scan.
According to a 2003 Wake Forest University study of 200 women, the pain caused by a breast mammogram is mild and comparable to, say, “a pair of tight-fitting shoes or a mild headache.” According to my friend Sandra, in Canada, “It’s more like having your boob squished in a vice.”
Not that temporary discomfort is any reason to forgo a diagnostic procedure that could potentially save your breasts, let alone your life. Today the AMA recommends an annual mammogram for all women over age 40 to help detect and fend off breast cancer.
But aside from the discomfort factor (which women may or may not experience), the mammogram as a diagnostic measure has other, more worrisome, drawbacks. For one, experts say it can take years before a cancer is large enough (1 cm) to be detected by the machine, leaving early diagnosis outruled. Further, in scanning for abnormal structures, mammograms frequently confuse dense breast tissue with tumors; as a result, far too many women receive unnecessary biopsies each year, to say nothing of the accompanying high levels of anxiety. And then there’s the radiation—a mammogram delivers 1,000 times more radiation than the common chest x-ray, according to experts.
With facts like these, it’s no wonder forward-thinking women are seeking alternatives to annual mammography. According to Pam Ryerse, MLT, CCT, a procedure called Thermal Breast Imaging (or Breast Thermography) may be an ideal adjunct. Says Pam, the FDA-approved testing method offers both a less invasive protocol and the opportunity to detect breast cancer much earlier.
Breast Thermography Basics
Breast thermography is a simple, painless testing procedure that takes 5 to 15 minutes. Using highly sophisticated infrared cameras first developed for the military, certified thermal imaging technicians like Pam capture colorful, heat-based photos of the breasts. The images are then sent via secure intranet for analysis by M.D.s who are board-certified in thermography.
“What are the doctors looking for? They’re looking at color, patterns, symmetry,” explains Pam, a Fairfield-based clinical thermologist certified with the American College of Clinical Thermography at Duke University Medical Center. “A mammogram—that’s a test for structure. The radiation penetrates the scan and looks for dense structure. With thermography, it’s a test of physiology. We’re not going to see the tumor, we’re going to see the vascular activity.”
If a doctor detects abnormal vascular patterns in a set of images, he or she will recommend further testing through methods like mammograms, ultrasound, or clinical breast exams. Ultimately, a pathologist will make the final call as to whether or not breast cancer is present.
“There is no 100-percent perfect diagnostic tool out there, and I think that’s important for women to understand,” says Pam. “But a tumor has to be growing 8 to 10 years to be big enough to be seen by a mammogram, so if you want early detection, mammograms really aren’t so early.”
For this reason, Pam recommends that, starting in their early 20s, women of all ages should establish a “baseline” set of thermal imaging photos from which to monitor their breast health over the years.
“They could come in, say, every 3 to 4 years [for new images]. If they’re high risk, if their mother has breast cancer, they should come in maybe once a year. Then at around age 50, they’re menopausal, their breast tissue has changed—that’s a good time to start having a mammogram.”
Following this protocol, says Pam, women can take a proactive stand against breast cancer without undergoing unnecessary bouts of intense radiation, which, studies suggest, may actually lead to cancer.
“The great thing about this procedure is it does no harm,” says Pam, a former hospital lab technician of 20 years. “Nothing in the radiology department is harmless, nothing.”
When I meet Pam at her breast thermography clinic in Fairfield, she seems mildly disappointed to hear I’ve never had a mammogram. “It’d be great if you had something to compare it to,” she says as I disrobe waist-up and prepare to have my first thermographic photos taken.
Despite my lack of firsthand experience, I’ve read and heard enough about mammograms to conjure up the gist of the ordeal. First, you strip off your sweater and bra. Then, you allow a technician to maneuver your breast onto a cold metal plate. Finally, you watch as a second plate comes down and compresses your breast while it is X-rayed.
By contrast, I have to admit that breast thermography seems a breeze. Behind the privacy of a curtain, I sit on a swivel stool while Pam instructs me to turn my torso this way and that while an infrared camera snaps photos. On the other side of the curtain, Pam registers colorful thermogram images on her laptop. She takes six images in all: direct front, direct left, oblique left, direct right, oblique right, and then one of my back.
“Believe it or not, the camera is taking tens of thousands of temperature readings off your body,” says Pam. “People say, ‘Oh how can that be?’ It looks like a shoebox!” According to Pam, the readings are exceptionally precise, down to one-eighth of a degree centigrade.
After I dress, we examine the images on her laptop and she explains what the colors and patterns mean.
“Obviously you’re going to have warmer readings in areas like the underarms, the carotid arteries, and under the breasts,” says Pam. Indeed, my photos show a predominance of reds, oranges, and yellows in the areas she mentions. The breasts themselves appear in symmetrical, “cool” blues, greens, and blacks—a sign of good health, according to Pam.
“If you had cancer growing,” she says, “your body is supporting its growth, so you’d see increased vascular activity there.” She goes on to show me several thermograms of a woman with advanced inflammatory breast cancer. One of the woman’s breasts appears fiery red in the center. “See?” says Pam, “she’s really got something cooking over there.”
Depending upon the clinician’s rates, breast thermography screening costs about $100 to $150, comparable to the cost of a mammogram without insurance coverage. Although the technology is FDA-approved, it is not yet covered by most insurance companies because the AMA claims there’s no proof it’s effective. Still, many experts feel it’s extremely helpful when mammography results are unclear.
“Mammography is limited in a woman who’s got dense breasts,” said Dr. Jeanne Stryker in a recent 2006 NBC news clip on breast thermography. “. . . you can miss 10 to 15 percent of breast cancers.”
The obvious advantage of early detection through thermography, said Stryker, is the ability to jumpstart th,e healing process before the cancer grows out of hand.
“You balance the hormones,” she said. “You get them up to speed with better nutrition and supplementation and have them come back in three to six months.”
According to the NBC clip, roughly 212,920 new cases of female breast cancer will be diagnosed in the U.S. this year, and about 40,970 will die from the disease. Incidences of inflammatory breast cancer, a rare but aggressive strand that accounts for 5 to 10 percent of all breast cancers, are also on the rise. Even men aren’t entirely immune, as 1 percent of all breast cancers in the U.S. are found in males.
With earlier detection, says Pam, “patients have a much better opportunity in terms of a good outcome because they’ve got more time. And if you’re into alternative medicine and treatments, you need more time.”
An Invaluable Adjunct
While breast thermography offers a great deal of promise, it may not detect certain slow-growing cancers, where vascular levels remain largely unchanged. Still, proponents like Pam feel the technology can play an important role in a comprehensive breast screening program.
“Thermography doesn’t replace mammograms—it’s an adjunctive. Studies have shown that with breast exams, thermograms, and mammograms combined there’s a 98 percent accuracy rate—that’s indisputable. I think that, ethically, physicians owe it to all their patients to let them know that there are different screening methods out there, so the patient can use their own creative intelligence to decide what they want to do for themselves.”