Thermography vs. Mammography
In honor of Breast Cancer Awareness Month, the physicians of Rosa Gynecology dedicate this episode to a deep dive into breast cancer screening modalities. By exploring the differences between mammography and thermography, the doctors equip listeners with the facts needed to make informed, science-based decisions regarding their own healthcare and early detection strategies.
Key Takeaways
- The Goal of Screening: A true screening test is designed to detect early disease changes before they become evident, ensuring the highest chance of successful treatment and cure.
- Mammography Explained: A breakdown of how mammograms work (both 2D and 3D Tomosynthesis), why breast compression is necessary, and why the FDA and medical standard boards heavily regulate the equipment to ensure accurate imaging.
- The Thermography Misconception: While thermography (thermal imaging) is painless and involves no radiation, there is no scientific evidence proving it is a reliable, standalone screening tool for early breast cancer detection.
- Managing Callback Anxiety: The doctors share their own personal experiences with dense breasts, abnormal results, and mammogram callbacks, normalizing the anxiety while emphasizing the importance of follow-up care.
- Radiation Concerns: Addressing fears around X-ray exposure, noting that the radiation received from a modern mammogram is minuscule and less than the average environmental radiation an individual is exposed to annually.
Transcript:
00:00:05 Unknown: Welcome to Take Good Care an endeavor of Rosa Gynecology. Our aim and mission is to serve as a source of vital information and discussion for women of all ages, races and walks in life.
00:00:19 Dr. Mironda Williams: I’m Dr. Mironda Williams.
00:00:21 Dr. Deanna Guthrie: I’m Dr. Deanna Guthrie,
00:00:22 Dr. Karen Greene: and I am Dr. Karen Greene.
00:00:25 Unknown: Welcome to our show.
00:00:35 Dr. Mironda Williams: For nearly 40 years now, the month of October has been designated for breast cancer awareness. And so all over the country, there will be programs and initiatives really hoping to educate and encourage women, as well as men to be aware of breast cancer strategies, how to look out for yourself, your family members and your loved ones. And for years now, my partners and I have talked with patients about various breast cancer screening modalities and what we feel is the best one for early detection. And over the years, thermography has really become an option that some women would rather utilize because of their thinking that it may be less invasive, not as uncomfortable, decrease in decrease in radiation exposure. So we thought that this would be a good time for us to give a little discussion on thermography, thermography versus mammography, and to talk about what the differences are with them and why. The American College of Obstetrics and Gynecology still favors mammography as the screening standard for breast health and breast cancer. So on today’s show, we’re going to break that down and offer some information that we hope will be good for you to utilize. As you have, you make your own informed decisions about what you would like to do going forward for your own health care.
00:02:12 Dr. Mironda Williams: And thermography, which is also called thermal imaging, uses a special camera to measure the temperature of the skin on the breast surface. It is a noninvasive test that involves no radiation. Thermography is based on two ideas because cancer cells are growing and multiplying very fast. The theory is that blood flow and metabolism would be higher in an area where a cancerous tumor may be developing as blood flow and metabolism increase, the skin temperature goes up is the theory.
00:02:49 Dr. Mironda Williams: Mammography or rather thermography. Thermography has been available for several decades, but there is no evidence to show that it is a good screening tool to detect breast cancer early. And I think that’s the fact that we really want to drive home to individuals who are trying to determine what they want to do for breast cancer screening. Again, a good screening test for any disease is should be designed so that it detects early disease changes when things can be most treatable. So again, thermography, though it has been around for several decades, there has been no evidence that shows that it is able, as a screening tool to detect brand breast cancer early.
00:03:52 Dr. Mironda Williams: And again, there was a recent article that was published by M.D. Anderson that looked at mammography versus thermography. And I’m just going to point out some of those some of that information. And again, regular screening mammogram is used to detect breast cancer early when it is easiest to treat successfully. Patients at M.D. Anderson in the Houston location sometimes are given information about the differences between these two tests. But it is their recommendation, and the only thing they offer as a screening test for mammography I’m sorry, is a screening test for breast cancer to be mammography. Sometimes, depending on a woman’s study, they may end up getting a 3D mammogram or Thomas synthesis. And again, now Dr. Guthrie is going to talk about mammography in particular and talk and give us information about why it is such a good screening tool. Because, again, what we’re trying to emphasize during the month of October is breast cancer awareness and screening through mammography. Dr. Guthrie.
00:05:08 Dr. Deanna Guthrie: Thank you. Dr. Williams. So as Dr. Williams mentioned before, a screening test is some is a test that you do when you’re not suspecting any disease, whatever you’re looking for. But it is a good test that can, she said, pick up early changes that are most treatable. So a mammogram, it’s a low dose stress the ward low dose X-ray picture of the breasts that aids in detection of breast diseases or lesions. Not everything in the breast is going to be cancer. So there are things like calcifications. You can have cysts. You can have little firm tumors that are not cancerous but benign.
00:05:46 Dr. Deanna Guthrie: Just to kind of describe the process for women who have not had a mammogram, your you disrobe from the waist up and you have a gown on that opens in the front. And the mammography her will place your breasts on a platform. And then another plate comes down slowly to compress your breast because compressing the breast tissue gives a better picture so they can see lesions. There’s a misconception that they just slam your breasts into something. They’ve had mammograms. That’s about what happens during a mammogram. Also, you should not wear any deodorant. And the reason for that is, is that deodorants have metallic substances in them. And aluminum is the most common metal in it. And when you do a mammogram, if any of it gets anywhere on your breast, the metal in the in the deodorant will pick up as if you have calcifications in your breast, which then confuses the issue, which then makes them have to do more workup when there’s really nothing wrong. So that’s why they will ask you to remove any deodorant before you have a mammogram done.
00:06:53 Dr. Deanna Guthrie: When you do a mammogram, the screening. So there are two types of mammograms. There’s a screening mammogram. That’s the test that’s done. Again, you’re just coming in. Nothing is suspected. And when you do a screening mammogram, they take two. Each breast gets two images from different angles. And that’s the regular screening mammogram. Now, if anything is seen on that screening mammogram, then you elevate up to what’s called a diagnostic mammogram. And now that area of concern, they’re going to concentrate and take more views of that area. So a lot of women will come in for the exam thinking, oh, it’s time for my yearly. I’m going to tell them that I felt something and just get my regular mammogram. That will not be the case if an issue is pointed out that it is. It behooves us to then investigate that area. So you cannot have a screening mammogram for an identified problem. Whether or not you feel something or if something is seen, you do need and more elevated tests to to find out and to better analyze the area.
00:08:05 Dr. Deanna Guthrie: Dr. Williams also mentioned technology is getting better and better. When we first had mammograms, we actually like took pictures like you used to do on film, like you used to have your Polaroid camera. So whenever you had a mammogram done, they stored all your images on film and it was very bulky. You had to find a place to store them and things like that. But as technology has developed, we now have digital mammography. The mammogram is performed the same way. It has nothing to do with how the mammogram is performed. So you still come in, you still get your breast compressed and pictures taken, but now we can manipulate the pictures to better diagnose problems so they can enhance the picture. If there’s a spot that looks kind of shadowy, they can, just like you could do on your iPhone, you can change the picture so you can see it better. You can make it lighter in the background so that they can actually do better as far as diagnosing any lesion.
00:09:02 Dr. Deanna Guthrie: So it’s not changing how a mammogram is done. It’s changing how the images are developed and they can be stored as data. So again, much less bulk. So there are no films to carry around. You used to have to go get your films and carried around. Now digital film, digital images can be sent electronically so you don’t have to go pick up your films. And then an added technology is now 3D mammogram that Dr. Williams mentioned as tumor synthesis. And so they’ll take both 2D, which is regular pictures and 3D images of your breasts. Again, just a better way of seeing and delineating any lesions there for classes to your mammogram or forecast to the results when you have your mammogram done.
00:09:51 Dr. Deanna Guthrie: If you do your mammogram and it’s and it’s normal, it’ll read out as a as as a code. I’m going to just use the word code, code one, and that just means everything. That’s fine. You come back in the year, there’s a code two that’s also normal. They may see some fiber cystic changes that are all benign, but again, everything is normal. You come back in the year if you do have to have a diagnostic mammogram, if they look at that area and they think it’s probably normal, they will say that. But they’ll say just in case, let’s look again in six months to make sure nothing has changed. If there was a cyst, it hasn’t gotten any larger. And so you’ll get a code of code three and it says probably benign. And you need a short follow up. When you have that follow up, if everything looks the same and looks normal, you’ll go back to a class one or two where you just have your mammograms done every year, and then there’s class four where something does look suspicious. And then they do recommend intervention, whether that be a biopsy or a follow up at the surgeon for for better care. So that’s kind of like the breakdown of getting your mammograms every year.
00:11:02 Dr. Deanna Guthrie: And before Dr. GREENE goes into a discussion, we found an article about the FDA in thermography versus mammography.
00:11:10 Dr. Mironda Williams: The other thing that I wanted to point out is that there are very stringent standards for the mammogram machine. Yes. As well as how mammograms are done. And for our mammography curves, we have mammography on site at our Rosa Gynecology office location. And Dr. Guthrie is a physician that helps oversee the management of our imaging area where we have mammography and pelvic ultrasound available. And we can confirm that it is a very involved, tedious, tedious and stringent process to be certified their quality standards that have to be met every week so that we make sure that the machine is functioning properly, that the images are generated properly, so that the radiologist who is reading these images is able to see what they need to see.
00:12:07 Dr. Mironda Williams: Because, again, we’re going to keep keep hammering this point home to you that the whole point of this discussion is that we’re talking about screening tests. We want to find something before it is evident, because that is when we can treat for cure. Thermography does not detect cancer in early stages. It does not also, there are not any standards for quality or effectiveness that have been determined that can be reproduced. Time after time after time. Dr. Greene is going to go a long way just as a doctor, whereas he’s talked about, in fact, our facility.
00:12:49 Dr. Karen Greene: We just passed our. Yes. So it’s like you said, they’re very stringent codes and things that you do every week. You have to check your machines every week. There are things that you do every year. And then there’s a big one that’s every three years. And just to let you know how detailed it is, they send out a notice eight months in advance because you have to start taking pictures. You have to show all along the way in that 6 to 8 month period of time that your pictures are all consistent. You have to show that you are keeping up with maintenance. You have to show that the level of radiation that that’s there is not too much, you know. So it is a very, very stringent process. And so if thermography does not have any of that, there is no from each facility. Facility, you do not know the quality of testing that you’re getting done.
00:13:41 Dr. Karen Greene: And so that’s that’s really the bottom line. Of course, obviously, we’re supportive of of mammogram, but it’s not just the fact that we have one in our office is the fact that we know that it’s regulated. We know it’s regulated, we know it passes tests. We know that it’s going to do the best care for our patients by detecting early disease. I cannot say that enough that when you detect the disease early, it’s a greater risk of cure. One in eight women will develop breast cancer. That number hasn’t changed. No matter what we do, that’s going to happen and most of these women are going to have a family history.
00:14:16 Dr. Karen Greene: And so saying that, will my breast feel fine and I don’t have any family history. One in eight women develop breast cancer. So if you want to do something that’s going to give you the most chance of surviving potentially a disease that you didn’t realize you have, you want to do the best tests. And so the FDA, of course, has to get involved when it comes to things that may be misleading. As we said before, mammogram identifies tissue types with different densities. Thermography shows patterns of heat on or near the surface of the body. There is no regulation of how these machines are detecting these patterns of heat. And does a pattern of heat develop when there’s an early stage disease? There is no scientific evidence that that is the case.
00:14:59 Dr. Karen Greene: And so the FDA in this particular article wanted to remind us that mammogram, the low dose x ray imaging of the best of the breast is still the most effective primary cancer screening test. They’re not aware of any scientific evidence to support the claims that thermography is a proven alternative to mammography. One of the greatest the greatest dangers from mammography is that those people that opt for that method think that, you know, mammogram might hurt. So let’s just take the heat. But they’re going to miss the chance of actually getting something early on by looking at just color patterns.
00:15:35 Dr. Karen Greene: They actually show a picture on the particular article of the difference between the two. So if you’re actually looking at, you know, mammograms here and thermography is here, the mammograms actually detecting, you know, this could be a calcification, this could be assessed. This could be an actual palpable lesion. Thermography is just showing heat changes. And that’s part of the problem that there’s really no standard. So when are mammography or when the radiologist looks at a mammogram film, the digital film, they’re looking to see what those changes are. They’re actually looking to see, okay, this might be suspicious going whether or not it’s a you know, a stage four. It might not be it might be something that we can follow a code three, you know, but they actually have regulatory standards. Thermo Graham doesn’t have that.
00:16:18 Dr. Karen Greene: And so one of the reasons that, you know, the FDA is concerned is the fact that, you know, people are being missed. They’re getting their thermo grams year after year. And we have patients that come in and say, well, I had a thermal gram. And so I have to tell them the same thing. Thermo Graham isn’t regulated. There’s no scientific evidence that the place that you go to may be different from some other place. The FDA has even taken a stringent steps to keep people from actually getting firmer grams by sending letters out because they are a regulatory commission. It’s not like they can actually do anything to stop them. All they can do is let them know that this is not right. This is not something that we support. This is not detecting disease. Women seek thermography because it’s painless. A mammogram isn’t that painless? It is uncomfortable. I think that uncomfortable is worth it when it comes to detecting something early.
00:17:12 Unknown: Exactly.
00:17:12 Dr. Mironda Williams: You know, and everyone thinks this and it’s and it doesn’t take a long time. It really does. You go in, as Dr. Guthrie said, you have your breast compressed. Your breast is compressed, but it doesn’t hurt. Some people think, well, my breasts are big. How are they going to see anything? Because it’s a regulated machine that actually can detect breast cancer in any size breast, big or small. It doesn’t matter. The bottom line is talk to your health care provider. Talk to your health care provider about what your risks are. Talk to your health care provider about what your concerns are. Because if it is a concern that I am doing something that’s going to hurt me less and that’s why I don’t want to do it. If you asked the facts, if not us, somebody else who’s going to recommend why a mammogram is better, why you should have mammogram? The facts behind the data behind the mammogram that we can actually go over with you so that you have a little more less reservation about having the mammogram.
00:18:07 Unknown: Two points. And it’s not to say that you can’t have a thermal thermal gram done. It’s just that it is not a stand alone test to detect breast cancer early. So for early disease, that’s the point, again, that we want that we want to make that some women like that.
00:18:24 Dr. Mironda Williams: Dr. Green says, well, choose only to get it through thermography and then feel that they can rely on that. There’s a statement, since it can be used as an adjunct, tells me that there’s something abnormal on a mammogram. If you wanted to get a thermal gram to see if that area does light up, you can use it that way, but not as a standalone test.
00:18:41 Unknown: Exactly.
00:18:42 Unknown: Also, another concern women have is about radiation. So mammograms have slightly more radiation than a regular chest X-ray. But I read an article it says, but it’s less than the radon that you are exposed to in your home. Right. So so that’s another concern about women that so you have radiation all around you every day. It’s a it’s a constant just because you’re getting it right at that one time. But it is less than the overall radiation that you exposed to at your home.
00:19:12 Unknown: They also compared it to everybody is exposed to they said about three. There’s a there’s a unit of measurement. It’s called a milli let’s hang on me as a milli. But millisieverts that’s the that’s the that the unit of radiation a mammogram is point four the average exposure for a year for the average US citizen is three of these units. So they’re saying they’re comparing it to that, getting a mammogram done is it is like is if it’s like seven weeks worth of radiation but you get one time and that’s it and then it’s still less than what you’re being exposed to at your home. So it’s you’re not getting measured. You’re not going to start glowing in the dark when you get a mammogram then. Right.
00:20:03 Dr. Mironda Williams: And the reason we really wanted to bring this out and talk about this in detail is, again, I think you all know who listen to us in previous seasons or who are our patients. We are heavy proponents of patient education and giving you information so that you can make an informed decision. We’re not here to tell you what to do. We’re just here to provide you with the information that we feel is grounded in science and fact and reproducibility. And so that is why we wanted to highlight the issue as it relates to thermography versus mammography.
00:20:36 Dr. Mironda Williams: Again, as the article and the representatives of M.D. Anderson mentioned, even if a patient comes in with an abnormal, abnormal therm exam report, then they have to get a mammogram because you cannot base any treatment decisions or anything based on the thermal gram because it is not a regulated standard of care for the detection of early disease or for following any disease processes once they have been managed and treated. So this is to provide the information so that you can make an informed decision. It that mammograms are safe, the amount of radiation that you’re exposed to is minuscule in comparison to other things that we’re exposed to every day.
00:21:21 Dr. Mironda Williams: Mammograms may be uncomfortable, but as Dr. GREENE mentioned, to be uncomfortable for a few seconds, getting a mammogram, that will help me to detect anything early that I can then get treatment for for cure. I’m okay with that, as opposed to having to deal with potentially a lifetime of disruption in my lifestyle or life span because of undetected disease. Again, we’re all women, we’re all of mammogram age. And so we’ve had mammograms. And so we understand that there may be some discomfort and some habits and some hesitancy, but this is something that we also do on a regular basis. I’ve had mammograms every year since I turned 40. I’ve never had an abnormal mammogram, thank goodness. I don’t know if my partners want to talk about you know, we understand that, you know, having a test can be anxiety provoking. And if you get that call back to say, well, we see something, we think we need to give some additional studies that can cause you some anxiety. Even as a physician, even as a health care provider. But that’s the point we’re trying to find. If there is anything there that needs to be addressed, find it early so that it can be taken care of. Do you all want to talk about your experiences in having to?
00:22:36 Dr. Karen Greene: Well, I got a call back on my last mammogram. And of course. Yes, you’re you’re nervous. You’re not sure. Is there something really there? But you have to keep in mind that that’s that was the reason for doing the test. I have people who say, well, they said my mammogram was abnormal. And then when they did everything, everything turned out fine. That’s that’s what we want. Yes. So that it’s not that the mammogram was wrong. It’s just that if there was something there, they would have found it early to take care of it. So that’s what you have to keep in the back of your mind. And that’s what I kept telling myself, right, that this is the whole reason that they if there is something there, then I want to know and I want to take care of it. Right. So yeah, we get nervous, we’re human and I want to take care of it early, right?
00:23:23 Dr. Deanna Guthrie: I probably get in about three callbacks. It’s like every other year, every other breast, and a lot of reasons that you get callbacks or something is different is because of breast densities. Younger women have really dense breasts and some women have really, really, really dense breasts. So even with the compression, they see something. They’re not really sure what it is they want to do a as we say, a, you know, highlighted view of one particular area to see what that is. So first call back, you know, it was probably ten years ago and I was like, oh my God, you know, and I have a family history of breast cancer. So of course my mind went there. So I get it. I get it. My mom went there and I had already planned my double mastectomy. And I remember not telling my husband that I had to call back because he would go into overdrive. And so I was like, I’m just going to go get my additional study and everything’s going to be okay. Yeah, talk myself off the ledge. And it was. It really was.
00:24:14 Dr. Deanna Guthrie: And so the next year, mammogram was fine. The year after that got a callback and I was like, okay, you know, and I and I and I, so I and I always tell myself that as a physician, you are still human and you still have those same feelings that your patients do. And so I get what patients feel when they think I never called back, but it was okay before, why do I have to do it? And I had the whole conversation in my head and then I left it myself because I thought, well, if I was the doctor listening to this conversation, I’d say because that’s what the mammograms force was designed. So I went in and I got my you know, I got my additional views and everything was fine the next year. Everything was fine too.
00:24:52 Dr. Deanna Guthrie: And then I think the third callback back, I said, you know, I’ve got dense breasts. Maybe I need to do a different type of mammogram so I don’t get the callbacks. I don’t have the anxiety. Now, that being said, when I had my mammogram this year, because it’s on the off year and last year, 3D mammogram was normal, if I get a callback, I’m still going to have that conversation in my head. But I still will go back and do the additional mammogram if I need to. And you get your annual mammogram. It doesn’t keep it doesn’t keep me from being, you know.
00:25:19 Dr. Deanna Guthrie: And so I think that’s the point that we really want to drive home, that a screening test, any screening test. But we’re highlighting mammogram as a screening test for breast cancer is designed to detect early disease. So you may get callbacks because they see something that is abnormal that requires additional study and that means it’s a good test. It’s a good screening test because it is doing what it is designed to do so that we don’t miss anything.
00:25:48 Dr. Deanna Guthrie: And again, we want every woman to be informed about their decision. And I have patients who just refuse to get a mammogram and who may say they only want to get a thermo graham and if is abnormal, then they may do something. If that is your decision, I want it to be an informed decision so that you understand that the test that you’re choosing to have is not designed to detect an early process. It’s it’s just not it’s not regulated in a way that it can be reproduced so that from year to year to year, you can compare different images to see if there’s something changing. If there’s something abnormal seen on a thermo graham, then you have to get a mammogram as a next step in terms of imaging.
00:26:38 Dr. Deanna Guthrie: So we just want you to have information to know what the facts are based on the these different tests and how they’re designed and how they’re used. So we in all of our episodes and with everything we do with our calling as being physicians, we want you to know your options. We want you to know yourself. We want you to advocate for yourself. But please, if you have questions or concerns, we want you to go to respected resources. We want you to talk to your health care provider or find a health care provider that you can talk to to provide you with information. You can also go to other resources, health departments on the Komen breast care hotline and Komen is with the K k OMI in. And that hotline number is 1877 go komen 877gokom in cdcr also has a wealth of resources.
00:27:41 Dr. Deanna Guthrie: We know everyone is googling and you can find you can find a resource for everything, but check the validity and the history of who you’re getting your information from so that you know, if is something that you can rely on it because your life depends on it. This is about your life and your quality of life. Should something be detected?
00:28:01 Dr. Mironda Williams: Ladies, any other comments you have?
00:28:04 Unknown: Get screened.
00:28:05 Unknown: Yes, we can’t emphasize it enough. And even for those patients that come in and either decide not to have a mammogram or decide to have a Thelma gram, we’re going to give you the information. You know, we have to give you the information because it’s personal to us. You know, as women, as women that have had mammograms, as women that have known people that have gotten breast cancer, it is very important because it is treatable in its early stages. And so being that the mammogram will detect it in the early stages, we want people to get it. Yes, absolutely.
00:28:35 Dr. Mironda Williams: So once again, we appreciate you taking your time to listen to us. We hope that this information has been helpful, has been informative, and we, again, always want to encourage you to be your own advocate for your health. Please share us with your family and friends. You can always visit our website at rosagynecology.com. Listen to us wherever you get your podcasts and until the next episode. I’m Dr. Mironda Williams.
00:29:01 Dr. Deanna Guthrie: I’m Dr. Deanna Guthrie.
00:29:03 Dr. Karen Greene: And I’m Dr. Karen Greene. Take good care.
If you’ve wondered how thermography stacks up against mammography, the short answer is that mammography remains the evidence-backed standard for breast cancer screening. Our On-Site Digital Mammograms page covers what our 3D mammography technology offers and why it’s still the recommended first line of screening.
