Abstract: Thermography or Digital Infrared Thermal Imaging (DITI) is coming of age. Once a secret military technology, it has found application in medicine as a breast health monitoring device. Perhaps, one day in the future, it may turn out to be an acceptable and effective tool to foretell if a person is at risk of breast cancer. This is because thermography is said to be able to detect physiological dysfunction eight to ten years before a mass is detectable. In short, thermography can “catch cancer” before it is there!
Chris K. H. Teo & Ch’ng Beng Im-Teo
CA Care, 5 Lebuhraya Gelugor, 11600 Penang, Malaysia.
Yeong Sek Yee & Khadijah Shaari
10, Jalan SS 19/1K, 47500 Subang Jaya, Selangor.
Tel: 03-56342775 / 019-3278092
Total Solution System Integrator,
4, Jalan Kota Raja J27/J, HICOM Town Centre, Seksyen 27, 40000 Shah Alam Selangor Darul Ehsan, Malaysia.
Tel: 603-51923212 fax: 603-51922728 mobile: 012-3730086
Copyright: This is an open-access journal and the reproduction of this article in any medium for educational purposes is allowed provided the original work is properly cited. The use of this article for commercial purposes, however, requires our prior permission.
What is thermography
Thermography or Digital Infrared Thermal Imaging (DITI) is coming of age. Once a secret military technology, it has found application in medicine as a breast health monitoring device. Perhaps, one day in the future, it may turn out to be an acceptable and effective tool to foretell if a person is at risk of breast cancer. This is because thermography is said to be able to detect physiological dysfunction eight to ten years before a mass is detectable. In short, thermography can “catch cancer” before it is there!
The currently promoted and acceptable method of breast screening is mammography and ultrasound. While these two methods are invaluable, they detect masses which are already there. The results produced are often too late – perhaps three to five years behind time.
Healthy breasts show symmetry – i.e., both the left and the right breasts should have similar temperature patterns. It stands to reason that any asymmetry or differences in temperature, means “something is amiss”. According to olden Chinese teachings, the flow of qi is not balanced and this will eventually lead to dysfunction, and if allowed to persist, may end up in the formation of mass.
It must, however, be emphasized that a different temperature pattern between the left and right breasts does not necessarily mean there is cancer. Thermography does not diagnose any cancer. What it does is to say: “there is a fever in there”. Fever? – we shall explain later.
Is thermography safe?
Thermogrpahy uses heat to “see” while photography uses light. The use of thermography is as safe as taking photograph with a camera. There is no ionizing radiation involved, as in mammography.
We were often asked if it is safe for pregnant ladies to go for thermography. Yes. It is as safe as her taking her passport photograph!
Scientific basis of thermography
The usefulness of thermography in monitoring health is similar to that of a thermometer (Fig. 1). A doctor sticks a thermometer into the mouth of a patient. If the temperature is about 37oC plus or minus 0.8oC, the patient is said to have a normal body temperature. If it exceeds this range by more than 2oC, the person is said to have a “high fever”.
Fig. 1. Oops, how about sticking the thermometer into your breasts?
Thermography measures the temperature of the surface of our bodies. In breast thermography, the temperature of every spot on the breasts is measured and the data sent to a computer. The computer translates and transforms this data into temperature patterns as shown in the images in this article.
It is not possible for us to detect a temperature difference of 2oC by “human touch” but nevertheless, a difference of 2oC between the left and right side of the body or breasts indicates a medical condition.
Cancerous tumour in the body consists of a mass of malignant tissues with “roots” or blood vessels that supply food to the every hungry cancer cells. Blood vessels are engorged with blood and these produce “heat”. As a result, cancerous tissue is “warmer” than the surrounding normal tissue. The infrared thermal imaging camera can pick up this temperature differences. The image of cancerous tissue appears as a “hot spot”.
In cases where we would like to further confirm if the “hot spots” in the breast are not artifacts, you are asked to undergo a “cold challenge”, by putting your hands in cold water for at least one minute. This causes the brain to constrict blood flow to the blood vessels in breasts. In cancer-friendly breast environment, the abnormal cells exert chemical control over the blood vessels in the breast and blood flow is NOT restricted. Hence, malignant tissues do not cool. They still appear as hot spots. Healthy tissues become “cooler”.
Potential uses of thermography in breast research
We see two potential contributions of thermography to breast health.
One, thermography can be used as an additional monitoring device, like the blood tests. It will be able to give some indications as to the effectiveness of the treatment you have undertaken. It is claimed that the results of thermography is more than 90% accurate.
Two, as said earlier, we see thermography as a potential tool for monitoring breast health with a view to prevent breast cancer – catch it before it becomes cancerous. When a dysfunction is detected, suitable herbs are recommended with the aim of restoring the imbalance. When the stagnant flow of “qi and blood” is restored, the breasts become healthy again. There is no need to wait for a mass to be formed, and then detected, before you can do something for yourself. By the time the doctor finds a lump in your breasts, it is already too late!
It is indeed a privilege for CA Care to be able to collaborate with Total Solution System Integrator (TSSI) in this research. The infrared digital camera (Flir System as illustrated below) used in this study is provided by TSSI. It is beyond the means of CA Care (which provides free-consultation and services to cancer patients) to buy this kind of camera (Fig. 2) which costs about RM300,000.00 (three hundred thousand).
Fig. 2. The three hundred thousand ringgit camera.
In this study, all the image outputs are standardized at a temperature range of 32oC to 36oC with rainbow colour palette. With this setting, what appears white represents the highest temperature, followed by red, yellow, green, cyan, blue, pink and with black as the coolest.
It is worth noting that there are various colour palette to choose from. Thus, the same picture with the same temperature information can be presented in varying colour schemes as illustrated below (Fig. 3 and 4).
Fig. 3 and 4. Same breast image with different colour palettes.
a) Breasts without suspicious “hot spots”.
The breasts of these four persons (Fig.5 and Fig.6) above show good symmetry with no hot spots. This is the kind of results which all women should aim or hope for.
The breasts of these two persons (Fig.7) also show good symmetry with no prominent hot spots. Overall their body temperature seems to be a bit warmer than the above four persons.
b) Breast with suspicious “hot spots”.
Breast temperature pattern is not balanced (Fig. 8). The left breast seems hotter than the right. There are three hot spots on the left breast. There are two prominent hot spots are seen on the left breast – one spot is just above the nipple, and another larger spot at 1 o’clock position. There is a streak of hot spot at the left side of both these two spots.
The breast temperature is normal – cool and well balanced (Fig.9). The right breast has three cyan spots, indicating they are warmer than the surrounding tissue. In the left breast, at 11 o’clock, are two spots, one big and one small which are also warmer than its surrounding.
These spots are not alarming.
Medical history: She has a history of “lumpy” breasts, especially the left breast. She did yearly mammogram followed by ultrasound. The results showed presence of cysts. Six years ago, two lumps were found on the left breast and these were diagnosed as calcium deposits. Later, an ultrasound showed a cluster of complex cysts on the right breast plus two cysts on the left breast.
There is a warm spot at 12 o’clock of the right breast (Fig. 10). There are two hot spots on the left breast, at 11 to 1 o’clock region. Even if her hands were placed in cold water, these spots still persist (right photo). The spot on the right breast does not appear to be as prominent as the two spots on the left breast. In our opinion, the breasts do not show up as normal.
Medical report: October 2005. Bilateral mammogram with ultrasound showed a dominant opacity measuring 1 cm deep at the centre of the left breast. No obvious focal lesion noted. Benign looking nodes are seen in the left axilla.
On ultra sound, both breasts are mildly heterogenous in echotexture. A rounded hypoechoic nodule measuring 5.9 mm is present at 9 o’clock of the right breast. No dominant focal lesion, cyst or dilated duct is noted on the left.
Ultrasound on 8 May 2006. Normal breast echopattern. The previously noted 9 o’clockwell defined hypoechoic nodule in the right breast, is not significantly changed measuring 6 mm. No other focal abnormality is seen throughout the rest of both breasts.
The whole body appears heaty as indicated by the white colour in the thermograms (Fig. 11). This may be due to various reasons: a) the high metabolic rate of the body, b) exposure to the hot sun before taking the thermogram, c) the body is not sufficiently “cooled” before taking the thermogram, d) abnormality or poor breast health.
The right breast has a patch of white, which means it is “hotter” than the surrounding tissue.
The hottest spot in this “hot patch” is 37.0oC, compared to the coolest spot which is 34.1oC. There is a difference of about 3oC, which is undesirable.
Left breast also has a “hot patch”. The hottest spot is 36.6oC and the coolest is 34.7oC.
Medical history: 12/01/2002. There is a 2 cm lobulated nodule in the left upper outer quadrant, retromammary region. On the right, there is a nodular pattern of which at least one in the lower quadrant appears dominant. There is no suspicious calcification.
Ultrasound revealed bilateral nodules. On the left, the one seen on the mammogram was in the periphery of the breast, is lobulated and measures about 1.5 cm in diameter. On the right, small nodules at 12.00, periareolar region (7 mm) 10.00, periareolar/areolar (8-9 mm) and at 8.00, periareolar region (9 mm) were visualized.
Comments: There is probably bilateral benign nodules, although the left lesion is larger and also has a lobulated margin.
Histopathology report: 6/3/2002. The specimen consists of left breast lump measuring 2x1x1 cm. The mass is well circumscribed and shows both ductal and stromal proliferation. The ducts show mostly an intracanalicular pattern of arrangement.
Diagnosis: benign intracanalicular fibroadenoma.
Radiology report: 23 April 2004. Nodular parenchyma pattern of the breast. The previously seen mass in the left breast is not there anymore with presence of post surgical changes. There is no other dominant lesion seen or suspicious microcalcification.
Conclusion: no mammographic evidence of malignancy.
Breast Cancer Cases
c) Those with breast cancer who underwent chemotherapy / radiotherapy / hormonal therapy.
Fig. 12 (left) Fig. 12 (right)
Left thermogram (Fig. 12): Her whole body appears heaty (white, red and yellow color). Overall the right side of the body is cooler than the left side. The temperature pattern is not balanced.
Right breast: rather cool but above breast at 12 o’clock, is a patch of hot spot.
Left side: a big patch of hot spot.
Medical history: Left mastectomy – June 2002, had six cycles of chemotherapy but no radiotherapy or tamoxifen. Taking Chinese herbs (not CA Care herbs) and supplements since 2002 (after operation).
Right thermogram (Fig. 12): The temperature pattern is not balanced. The right side being hotter than the left.
Medical history: ??? lumpectomy. Underwent six cycles of chemotherapy and 25 times of radiation treatment.
Left thermogram (Fig. 13): Very heaty body. The left side of the body is hotter than the right side. We are unable to comment further.
Medical history: She had Stage 2 breast cancer and underwent a left mastectomy in February 2005. She underwent two cycles of chemotherapy but no radiotherapy. The chemotherapy was done on 2nd and 24th March 2005. She started taking tamoxifen, but after a while she stopped. Then on 13 December 2005, she started taking tamoxifen again. She has been on Chinese herbs and supplements like multivitamins. She stopped taking CA Care herbs about eight months ago. Currently she is taking ProSure (weight-gain drink, started around April 2006).
Right thermogram (Fig. 13): Her right breast has been removed. It is cooler than the left breast. There is a patch of “warm” area above the left breast from 11 o’clock to 2 o’clock. Just above the nipple at 11 o’clock is also a “hot” spot. All these warm/hot spots indicate dysfunction. However, hot spots do not necessarily mean tumours.
The yellow line below the arm pit above the right breast may be a due to the scar of the operation. There is no obvious warm spot on this breast.
Medical history: She was diagnosed with Stage 2 breast cancer in May 2002. A right mastectomy was done. No lymph nodes were involved. She did not undergo any chemotherapy or radiotherapy but was on tamoxifen from June 2002 to April 2004 (almost two years). In November 2005, the doctor detected endometrial thickening but cells were normal. She stopped taking tamoxifen. Since then the doctor had checked her breasts and found nothing. She stopped taking Breast L (CA Care herbs) as well.
d) Those with breast cancer who took herbs and DID NOT undergo chemotherapy / radiotherapy / tamoxifen.
Fig.14 (left) Fig. 14 (right)
Left thermogram (Fig. 14): A nice cool temperature pattern. Since her right breast has been removed, the temperature on the right side of her chest is about the same as the overall body temperature. The left breast appears cooler than the overall body temperature (which is usually the case). The yellow pattern on the right breast could be the result of the surgery.
There are no “hot spots” in the breast to indicate “poor” breast health.
Medical history: She had a right mastectomy in August 2002 but declined further medical treatment. There was no chemotherapy, radiotherapy or tamoxifen. She started to take CA Care herbs up to this day.
This is a Grade 2 carcinoma with 17 lymph nodes infected with cancer. Lymph node involvement indicates poor prognosis with high risk of relapse. It has been almost four years and she is still doing fine.
Right thermogram (Fig.14): Both the breasts appear balanced and cool. There is no suspicious “hot spots”in this thermogram.
Medical history: She underwent a right mastectomy and axillary clearance on 25 January 2003 with immediate reconstruction. She had two lumps in her right breasts but the pathologist reported only one lump: 1.8 cm x 1.6 cm. No lymph nodes were involved, ER positive, PR negative, cerbB2 focal positive, Grade 2. Margins are clear.
She declined further medical treatment and started to take CA Care from 13 January 2003 up to this day.
It has been three years and she is doing fine.
Fig. 15 (left) Fig. 15 (right)
Left thermogram (Fig. 15): The temperature of both breasts seems to be well balanced. Overall the body is also not “hot”. It seems that if patients are on chemotherapy / radiotherapy / tamoxifen, their whole body seems to be “like on fire” as illustrated earlier by the thermograms.
There is no suspicious hot spot in the right breast. There is one line of hot spot (yellow colour) in the left breast. This is probably due to the scar of the surgery. Scar gives rise to hot spot.
Medical history: She underwent a lumpectomy in 2003 followed by a left mastectomy in 2004. She declined chemotherapy, radiotherapy or tamoxifen. She took CA Care herbs and other health supplements like spirulina, vitamins C & E. She was also on a very strict diet, since 2003.
Right thermogram (Fig. 15): Temperature patterns of both breasts are balanced. Due to the removal of her right breast, the breast temperature on this side is similar to the overall body temperature. The temperature on the left breast is cooler than the overall body temperature (whlch is the norm).
There is a hot spot on the right side. This hot spot correspond to the scar due to surgery.
Medical history: She underwent a right mastectomy in October 2004. It was a grade 2 carcinoma of the breast, oestrogen receptor positive, progesterone positive, c-erbB-2 negataive, with metastasis to 1 of 17 axillary lymph node. She declined further medical treatment and opted for herbs instead. She came to CA Care on 28 November 2004 and has been taking herbs since then.
We are indeed fortunate to have this new imaging tool to monitor the breast health of both healthy women and those who had cancer. We would like to record our sincere gratitude to Total Solution System Integrator (TSSI) for their kind support and use of the infrared camera.
This study has shown that thermography can reveal many “mysteries” not uncovered or detected by mammography and ultrasound.
This research revealed that:
a) women with no history of breast problems have healthy, cool and symmetrical
b) women with a history of breast problems have unbalanced temperature patterns with “hot” spots. These hot spots could be is a subject of speculation and further research.
c) women who had breast cancer who had undergone chemotherapy / radiotherapy / hormonal therapy, have “heaty” body. What such chronic over-heated body would mean in the future is also a subject of speculation and further research. Is an “over heated body” similar to an “over-heated engine”?
d) women who had breast and who had undergone surgical resection but who declined chemotherapy / radiotherapy / hormonal therapy, have cool body.
Now what is left for many of us, is to “believe” in order to see. If we are not prepared to see beyond our own “coconut shell” or get out of the comfort of our traditional “box” we cannot see anything.