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  The  use of Digital Infrared Imaging is based on the principle that  metabolic activity and vascular circulation in both pre-cancerous tissue  and the area surrounding a developing breast cancer is almost always  higher than in normal breast tissue. In an ever-increasing need for  nutrients, cancerous tumors increase circulation to their cells by  holding open existing blood vessels, opening dormant vessels, and  creating new ones (neoangiogenesis ).  This process frequently results in an increase in regional surface  temperatures of the breast. DII uses ultra-sensitive medical infrared  cameras and sophisticated computers to detect, analyze, and produce  high-resolution images of these temperature variations. Because of DII’s  extreme sensitivity, these temperature variations may be among the  earliest signs of breast cancer and/or a pre-cancerous state of the  breast (3,6,7,8,9) . |  
                            
                                
                                    |  Current  methods used to detect suspicious signs of breast cancer depend  primarily on the combination of both physical examination and  mammography. While this approach has become the mainstay of early breast  cancer detection, more is needed. Since the absolute prevention of  breast cancer has not become a reality as of yet, efforts must be  directed at detecting breast cancer at its earliest stage. As such, the  addition of Digital Infrared Imaging (Breast Thermography) to the  frontline of early breast cancer detection brings a great deal of good  news for women. |  
                        
 WHAT MAKES DIGITAL INFRARED IMAGING SO UNIQUE  
                        
                         While  mammography, ultrasound, MRI, and other structural imaging tools rely  primarily on finding the physical tumor, DII is based on detecting the  heat produced by increased blood vessel circulation and metabolic  changes associated with a tumor’s genesis and growth. By detecting  minute variations in normal blood vessel activity, infrared imaging may  find thermal signs suggesting a pre-cancerous state of the breast or the  presence an early tumor that is not yet large enough to be detected by  physical examination, mammography, or other types of structural imaging (3,6,7,8,9).
 Certain types of cancers will not be detected (approximately 20%) by mammography for various reasons(10), but some of these cancers will be discovered by DII (3,6,7,8,9). 
                        
                        Difficulties in reading mammograms can occur in women who  are on hormone replacement, nursing or have fibrocystic, large, dense,  or enhanced breasts (6,8). These types of breast differences do not cause difficulties in reading digital infrared scans.   
                        
                        
                        DII AS A RISK MARKER FOR BREAST CANCER 
                        
                        Studies show that an abnormal infrared image is the single  most important marker of high risk for developing breast cancer, 10  times more significant than a family history of the disease (5).  Consequently, in patients with a persistent abnormal thermogram, the  examination results become a marker of higher future cancer risk (4,5).  Depending upon certain factors, re-examinations are performed at  appropriate intervals to monitor the breasts. This gives a woman time to  take a pro-active approach by working with her doctor to improve her  breast health. By maintaining close monitoring of her breast health with  infrared imaging, self breast exams, clinical examinations,  mammography, and other tests, a woman has a much better chance of  detecting cancer at its earliest stage and preventing invasive tumor  growth. 
                        
                        
                            
                                
                                    | Angiogenesis, or new blood  vessel formation, is necessary to sustain the growth of a tumor. Digital  Infrared Imaging may be the first signal that such a possibility is  developing (3). |  
                        
                        Just as unique as a fingerprint, each patient has a  particular infrared map of their breasts. Any modification of this  infrared map on serial imaging (images taken over months to years) may  constitute an early sign of an abnormality. However, if a pathology is  suspected, this information is used to recommend further examinations  and tests. 
                        
                        
                        TECHNOLOGY, INTERPRETATION AND COMPARATIVE IMAGING 
                        
                        As is the case with mammography and all other imaging  modalities, access to sophisticated technology and the expertise to  interpret the findings are of prime importance. To help distinguish a  normal process from an abnormal one requires proper training, clinical  experience, strict adherance to protocols, and meticulous image  acquisition. While not all tumors are visible on a mammogram, not all  tumors are associated with a high level of blood vessel activity; thus,  escaping infrared detection. Less aggressive lesions can be associated  with less evident images. Therefore, in these select cases, DII may be  an indicator suggesting a much better overall prognosis. 
                        
                        When digitally produced, and interpreted by qualified  doctors, abnormalities or changes in infrared images provide invaluable  information. This is particularly true in patients with dense breasts,  non-specific physical or mammographic findings, or women with a previous  history of breast surgery or radiation. The use of serial infrared  imaging can draw additional attention to areas that require further  evaluation or closer scrutiny during initial or subsequent exams. This  further evaluation may include additional imaging such as mammography,  ultrasound, or MRI. Used as a complimentary imaging technique, recent  data suggests that DII may also help monitor the effects of some of the  newer proposed anti-angiogenesis therapies (currently recognized as a  promising treatment strategy) (6,8). Since we have not been able to prevent breast cancer as of  yet, there is a consensus among experts that more lives will be saved  with earlier detection. Since both physical and mammographic examination  cannot detect all cancers, particularly smaller tumors in younger  patients and those with dense breast tissue, there is currently much  interest in finding new ways to improve our abilities in early  detection. While some new promising techniques have emerged such as MRI,  doppler ultrasound, and scintimammography, most are designed to be used  in selected cases where physical and mammographic examinations have  already picked up an abnormality. These tests also do not address the  limitations of combined physical examination and mammography in  frontline detection. Consequently, we are left with too many patients  who have undergone these two screening tests and are still left with  undetected breast cancer. Therefore, experts have concluded that no one  procedure or method of imaging is solely adequate for breast cancer  screening (1,2,6). 
                        
                        
                        EARLY DETECTION MEANS LIFE 
                        
                        Breast cancer is the most common cancer in women, and the risk increases with age (1).  Risk is also higher in women whose close relatives have had the  disease. Women without children, and those who have had their first  child after age 30, also seem to be at higher risk. However, every woman  is at risk of developing breast cancer. Current research indicates that  1 in every 8 women in the US will get breast cancer in their lifetime (1). 
                        
                        
                            
                                
                                    | Studies show an increase in survival rate when breast thermography and mammography are used together(3). |  
                        
                        DII’s ability to detect thermal signs that may suggest a  pre-cancerous state of the breast, or signs of cancer at an extremely  early stage, lies in its unique capability of monitoring the temperature  variations produced by the earliest changes in tissue physiology  (function) (3,6,7,8,9).  However, DII does not have the ability to pinpoint the location of a  tumor nor can it detect 100% of all cancers. Consequently, Digital  Infrared Imaging’s role is in addition (an adjunct) to mammography and  physical examination, not in lieu of. DII does not replace mammography  and mammography does not replace DII, the tests complement each other.  Since it has been determined that 1 in 8 women will get breast cancer,  we must use every means possible to detect cancers when there is the  greatest chance for survival. Proper use of breast self-exams, physician  exams, DII, and mammography together provide the earliest detection  system available to date (3,7,8,9). If treated in the earliest stages, cure rates greater than 95% are possible (3,6). 
                        
 REFERENCES 1. American Cancer Society – Breast Cancer Guidelines and Statistics, 2009-20102. I. Nyirjesy, M.D. et al; Clinical Evaluation, Mammography  and Thermography in the Diagnosis of Breast Carcinoma. Thermology,  1986; 1: 170-173.
 3. M. Gautherie, Ph.D.; Thermobiological Assessment of  Benign and Malignant Breast Diseases. Am. J. Obstet. Gynecol., 1983; V  147, No. 8: 861-869.
 4.	C. Gros, M.D., M. Gautherie, Ph.D.; Breast Thermography  and Cancer Risk Prediction. Cancer, 1980; V 45, No. 1: 51-56.
 5.	P. Haehnel, M.D., M. Gautherie, Ph.D. et al; Long-Term  Assessment of Breast Cancer Risk by Thermal Imaging. In: Biomedical  Thermology, 1980; 279-301.
 6.	P. Gamigami, M.D.; Atlas of Mammography: New Early Signs in Breast Cancer. Blackwell Science, 1996.
 7.	J. Keyserlingk, M.D.; Time to Reassess the Value of  Infrared Breast Imaging? Oncology News Int., 1997; V 6, No. 9.
 8.	P.Ahlgren, M.D., E. Yu, M.D., J. Keyserlingk, M.D.; Is it  Time to Reassess the Value of Infrared Breast Imaging? Primary Care  & Cancer (NCI), 1998; V 18, No. 2.
 9.	N. Belliveau, M.D., J. Keyserlingk, M.D. et al ;  Infrared Imaging of the Breast: Initial Reappraisal Using  High-Resolution Digital Technology in 100 Successive Cases of Stage I  and II Breast Cancer. Breast Journal, 1998; V 4, No. 4
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