What is thermography? Here's what experts say about cancer detection method at center of viral story

In May 2019, Bal Gill was visiting Camera Obscura & World of Illusions when she noticed a glowing red area on her chest as she stood in front of the thermal camera, one of the most popular exhibits at the Scotland museum.

After the 41-year-old mother and her family returned home to England, she came across the photo again and was compelled to research the possible significance of the abnormal hot spot.

That's when Gill discovered thermography, also referred to as thermal imaging — a method that uses a noninvasive camera to measure the temperature of the skin's surface to allegedly aid in breast cancer detection.OK

Upon further examination by a medical professional, Gill says, she learned she was, in fact, in the early stages of breast cancer and has since undergone two surgeries to remove the cancer, plus one more upcoming procedure to prevent it from spreading.

"Without that camera, I would never have known," Gill later claimed in a statement. "I know it's not the intention of the camera, but for me, it really was a life-changing visit. I cannot tell you enough about how my visit to the Camera Obscura changed my life."

Gill's story went viral, prompting renewed interest in thermography as a breast cancer detection tool, as well as questions on its effectiveness and legitimacy.

The concept was first proposed in 1956 by Dr. Ray Lawson, according to a July 2012 article published by naturopathic doctors Debi Walker and Tina Kaczor in the Natural Medicine Journal.

In a paper titled "Implications of Surface Temperatures in the Diagnosis of Breast Cancer," Dr. Lawson reported on a series of 26 women with proven breast cancers, for whom, he found, "the average detectable temperature rise in either the area of the tumor or the ipsilateral areola was 2.270ºF."

Although his methods are now considered outdated, Dr. Lawson's findings set off decades of research on how to turn the idea of noninvasive breast thermography into a useful screening tool, Walker and Kaczor note. 

However, a breakthrough study led by Stephen Feig, MD, in 1977 at Thomas Jefferson University Hospital in Philadelphia encouraged the National Cancer Institute to change its official recommendations on cancer screening methods in 1978 to be in favor of mammograms, turning researchers off of thermography.

Feig's study employed three methods — clinical exam, mammography and thermography — to screen 16,000 women between the ages of 40 and 64 for breast cancer and found that mammography detected 78 percent (109) confirmed cancer cases, while clinical exam detected 55 percent (76) confirmed cases. Feig found that thermography lagged behind, with just 39 percent (54) confirmed cases.

Although thermography devices have since been cleared by the Food and Drug Administration (FDA), the agency specifies they should only be used in tandem with another screening or diagnostic test, such as a mammogram, and not as standalone diagnostic tools.

In February 2019, the FDA released a public warning on "health spas, homeopathic clinics, mobile health units and other health care facilities" offering thermography "inappropriately as a standalone tool for breast cancer screening or diagnosis."

"There is no valid scientific data to demonstrate that thermography devices, when used on their own or with another diagnostic test, are an effective screening tool for any medical condition including the early detection of breast cancer or other diseases and health conditions," the agency said. "Mammography (taking X-ray pictures of the breasts) is the most effective breast cancer screening method and the only method proven to increase the chance of survival through earlier detection."

The statement came after the agency issued a warning letter to Total Thermal Imaging, of La Mesa, Calif., on Feb. 22 for "marketing and promoting thermography devices for uses that have not received marketing clearance or approval."

In their article in the Natural Medicine Journal, Walker and Kaczor echo the FDA's warnings, cautioning that "evidence indicates that breast thermography is not suitable as a standalone screening technique."

"While current technological advances in imaging and analysis may eventually deliver on the promise of thermography to detect occult or even precancerous lesions, there is no good evidence to date indicating that this use is appropriate," the two wrote.

Still, Walker and Kaczor added that as advances in breast thermal imaging arise, they should be "appropriately evaluated in clinical trials."

"Improvements in technology and interpretation will continue to emerge regarding thermography, and it is important to remain open-minded, as the possibility of validation or invalidation of thermography as a screening tool in the future are both still on the table," the two offered.

Following news of Gill's museum miracle, Caroline Rubin, vice president for clinical radiology at the Royal College of Radiologists, described the case as "serendipitous" and advised all women to continue scheduling routine mammography screenings.

According to official recommendations by the American Cancer Society (ACS) for the early detection of breast cancer, women who are at average risk for developing breast cancer should begin getting mammograms every year at the age of 45, until the age of 54. Then, the ACS says, women can switch to a mammogram every other year or can choose to continue yearly mammograms.

Women who are deemed at high risk for breast cancer based on certain factors should get a breast MRI and a mammogram every year starting at age 30, the ACS recommends, stressing that early detection and state-of-the-art cancer treatment are key in reducing the mortality rates associated with the disease.

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