From the Guidelines
No, a patient should not substitute thermography for a mammogram. Mammography remains the gold standard for breast cancer screening and is the only screening method proven to reduce breast cancer mortality 1. The USPSTF recommends biennial screening mammography for women between the ages of 50 and 74 years, as it has moderate certainty that the net benefit is moderate in this age group 1. Thermography, which detects heat patterns in breast tissue, lacks sufficient scientific evidence to support its effectiveness in detecting breast cancer.
Some key points to consider:
- Mammograms can detect breast cancers up to two years before they can be felt, while thermography has high rates of both false positives and false negatives.
- The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of screening mammography in women 75 years or older, as well as the benefits and harms of digital mammography or magnetic resonance imaging instead of film mammography as screening modalities for breast cancer 1.
- For most women at average risk, screening mammograms should begin at age 40 and continue annually or biennially depending on individual risk factors, with the decision to start regular screening before the age of 50 being an individual one that takes into account patient context, including the patient's values regarding specific benefits and harms 1.
- If a patient has concerns about mammography, they should discuss alternative screening approaches with their healthcare provider rather than choosing thermography as a substitute.
From the Research
Thermography as a Substitute for Mammography
- Thermography has been studied as a potential screening tool for breast cancer, but its effectiveness compared to mammography is still a topic of debate 2, 3, 4, 5, 6.
- Some studies suggest that thermography can be a useful adjunct to mammography, particularly in certain situations or populations, such as younger women with dense breasts 3, 4, 5.
- However, other studies have found that thermography is not as accurate as mammography in detecting breast cancer, and therefore cannot be used as a substitute for mammography 2, 6.
- A 2016 study compared the accuracy of thermography and mammography in detecting breast cancer and found that mammography had higher sensitivity, specificity, and accuracy than thermography 6.
- A 2022 review article discussed the potential benefits of thermography as a breast cancer screening technique, including its non-invasive and low-risk nature, but noted that further research is needed to confirm its effectiveness 5.
- A 2018 prospective comparative study found that ultrasound had higher sensitivity, specificity, and accuracy than thermography in diagnosing malignant breast lesions, suggesting that thermography may be more useful as an adjunctive tool rather than a substitute for mammography 3.
Comparison of Thermography and Mammography
- Studies have compared the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of thermography and mammography in detecting breast cancer 3, 6.
- The results of these studies have been mixed, with some finding that thermography has lower sensitivity and specificity than mammography 6, while others have found that thermography can be a useful adjunct to mammography in certain situations 3, 4, 5.
- The 1980 study found that thermography can be useful in combination with other factors in reducing the number of women who should receive routine mammograms for screening purposes 2.
- The 2009 review article discussed the potential benefits of combining thermography with other screening tools to improve sensitivity and specificity 4.