HISTORICAL OVERVIEW OF BREAST THERMOGRAPHY

 
EARLY HISTORY – 1950'S TO THE MID-1970'S:

Early infrared camera technology of the 1950's was primitive and produced poor quality images. It wasn't until the late 1970's that the thermobiology of the breast was sufficiently understood to permit the emergence of a credible, accurate and objective method for interpreting the thermal patterns of the breast. And, until 1983, there were no published environmental controls or formalized patient pre-examination protocol. Thus, from breast thermography's earliest years until the early-1980's, breast thermograms were haphazardly acquired and subjectively interpreted by individuals with little or no understanding of the procedure.


When breast thermography was introduced in the early 1950's, several physicians and manufacturers touted it as the ultimate screening process that would replace the mammogram. The legacy of their eagerness to proceed without adequate expertise, equipment or environmental controls still haunts the science. The low quality images were subjectively interpreted resulting in an abundance of incorrect diagnoses, followed by unnecessary surgical procedures. When it was realized that thermography was not measuring up to the exaggerated claims of practitioners and vendors alike, the technology was dismissed as a non-specific and unreliable test for detecting the presence of breast cancers.


In 1972, the American Cancer Society and National Cancer Institute sponsored the "Breast Cancer Detection and Demonstration Project" (BCDDP), in which women were screened using a combination of medical history, physical examination, mammography, and thermography. Untrained radiologists with no knowledge of breast thermography performed the thermographic examinations and the subsequent subjective interpretation of the images. The resultant high error rate and low sensitivity quickly resulted in the discontinuance of thermography as a routine element of the BCDDP.


These two chapters in breast thermography's history explain and support the medical community's basis for not adopting breast thermography. They plainly illustrate that the subjective interpretation of breast thermograms leads to unusually high and unacceptable error rates. That which continues to fuel this adversarial argument is not so obvious.

MID-1970'TO THE EARLY 1980'S – BREAST THERMOGRAPHY'S RENAISSANCE…

The mid-1970's to the early 1980's appeared to promise the dawn of a new and promising era for breast thermography:


  • After almost two decades of accumulating and analyzing clinical data on more than 110,000 breast cancer patients, Gautherie et al published an accurate and objective breast thermogram interpretation protocol. Gautherie's analytical methodology employing twenty thermal markers quickly became, and remains today, the gold standard breast thermogram assessment protocol.
  • Shortly after the introduction of Gautherie's protocol, Jay, in collaboration with Gautherie, authored and published the first version of TAS's Breast Thermogram Evaluation program, embodying the Gautherie protocol. Clinical trials demonstrated 90% inter-reader reproducibility of results using the program, and soon, even the most vociferous opponents of breast thermography praised the program as the first and only objective interpretation method available.
  • In 1982, a rigid pre-examination protocol was developed and published by Jay. It imposed various controls to breast thermography to maximize the integrity of the examination.
  • Along with the advances in interpretation protocol, a new, low cost imaging technology was introduced – Liquid Crystal Contact Thermography – bringing an inexpensive solution to the breast thermography image acquisition.
A fatal marketing error…

The arrival of low cost contact thermography was also the harbinger of increased opposition to breast thermography by the mammography industry.


As advances in thermology were published, radiologists financed by manufacturers of mammography equipment and who were still influenced by the BCDDP experience, increased the assault against breast thermography. As a result, radiologists were not a viable market for contact thermography devices, so device manufacturers directed their marketing efforts to gynecologists. The rationale was that since gynecologists are the first front against breast diseases, the thermographic examination should be conducted during a woman's annual gynecological examination. This proved to be a disastrous marketing error. When the radiology community realized that gynecologists were being sold image acquisition equipment, it predicted results similar to the BCDDP, i.e., subjective interpretations of images by novices delivering erroneous results. The radiology community responded vehemently against the use of breast thermography by gynecologists.


The contact thermography equipment provided the gynecologists with easy access to reasonably good quality images, but left the question of image assessment unanswered. The computer system was costly, so a thermogram reading service using the early TAS program was established. Physicians mailed images to the reading service for an assessment of the images, which were supplied by return mail. Unfortunately, the physicians ultimately chose to not use the service, because the time and overhead involved in mailing the images along with the wait to receive reports proved burdensome. Unfortunately, the gynecologists made a decision antithetical to conventional wisdom and began to [subjectively] interpret the images themselves. The resulting barrage of appropriate criticism from the medical community forced the use of breast thermography to be put on hold by most practitioners.

THE 1980's TO THE PRESENT:

Notwithstanding a continued onslaught by the mammography industry to impede the use of breast thermography, thermology stalwarts continued their efforts to demonstrate the efficacy of the technology. More than 800 peer-reviewed clinical studies comprising 300,000+ patients, some tracked for twelve years, have been reported in the literature since 1980, all with results favorable to breast thermography use. These include:


  • Breast thermography has an average sensitivity and specificity of 90%.
  • Breast thermography is able to detect early signs of breast cancer up to 10 years before other procedures are capable of.
  • Breast thermography can augment long-term survival rates by as much as 61%.

While breast thermography advocates achieved demonstrable proof of the technology's efficacy, clinical studies of mammography screening were reporting mammography's lack of efficacy and health risk (Mammography). Although mainstream medicine became somewhat aware of mammography's drawbacks, the mammography industry largely ignored or argued against the clinical studies, and continues to this day to promote mammography as though it is efficacious and free of health risk. Sadly, the mammography industry also ignores the progress made by thermologists and continues its attempts to squelch breast thermography (» Squelched).

Today: Alternative Medicine Practitioners Offer Breast Thermography

Today, breast thermography screening examinations in the US are widely available only from alternative medicine professionals, e.g., chiropractors. This situation was driven by two significant events.


From the early 1980's, chiropractors employed thermography for neuromusculoskeletal (full body) thermographic studies for both diagnostic purposes and the "documentation of pain" for personal-injury lawsuits and Workers' Compensation claims. Due to the inappropriate actions of some scurrilous attorneys and errant practitioners, thermography's acceptance was abruptly reversed in the early 1990's. Many chiropractors were left with little hope of recovering their investment in a high-cost thermography system. At about the same time, the mammography industry's campaign to thwart the use of breast thermography succeeded and the medical establishment abandoned the use of breast thermography. As a result, women were de facto foreclosed of their option to undergo a favorable alternative to dangerous and ineffective mammography.


In 1982 the US Food and Drug Administration approved breast thermography for breast cancer risk assessment, but did not regulate the technology. Chiropractor thermography practitioners seeking alternative revenue sources found a new opportunity. By adding breast thermography screening examinations to their practice, they satisfied a growing market need with technology they already owned. Key to the success presented by this opportunity was proper training.


A few practitioners established appropriate training programs teaching others how to establish and conduct a credible and profitable breast thermography practice. Their efforts spawned many chiropractors qualified to perform breast thermography examinations. The efforts of a few other enterprising practitioners have not been as rewarding.


Breast thermography continues unregulated and without certification requirements. Virtually anyone desiring to practice breast thermography, with or without proper training, may do so. Some practitioners regularly violate examination protocol and/or use incomplete and subjective image analysis. They completely lack credibility, but teach others, resulting in the widespread improper use of a good technology. Other practitioners decided the interpretation method they were taught was too complicated and time consuming, so they invented their own abbreviated, incorrect and subjective method for evaluating thermograms. These errant practitioners provide the fodder for breast thermography's detractors. To wit, a standard, accurate and objective method for interpreting breast thermograms is of unparalleled importance, but lacking in many breast thermography practices. Given such conditions, breast thermography lacks credibility.


This website seeks to alter the present course by offering breast thermography practitioners the best solution for breast thermogram interpretations with an easy-to-use, inexpensive computer program that conforms to the gold standard intrepetation protocol.