Screening to detect breast cancer early may become a reality if thermography that is in the early stages of testing is perfected. The trial is jointly done by the Indira Gandhi centre for atomic research (IGCAR), kalpakkam and the Chennai based Sir Rama Chandra medical college (SRMC).thermography detects infrared radiation emitted by a body, and the wavelength of the infrared radiation is correlated to the temperature.
“Any cancerous/abnormal cells will cause increased blood flow. Increased blood flow result in increased temperature.thermography looks for such increase in temperature in any part of the breast,” said Dr.B.Enkatraman, Head, Quality assurance Division at IGCAR.
However, not all cells that exhibit an increased temperature due to increased blood flow are cancerous. Hence its ability to identify all cancerous cells and only the cancerous cells is crucial. The performance and ability of thermography to deduct breast cancer were first tested on 25 patients who had come to the department of atomic energy hospital at kalpakkam with pain/indication of breast cancer.
The clinical standardization (determining the ambient temperature at which the screening should be done etc) has already been done at SRMC.results from themography were compared with mammography and tissue biopsy in nearly 200 patients. Patients above the age of 40 and who complained of pain in the breast were chosen.
High sensitivity:
“The sensitivity is about 98 percent (ability to detect positive cases) and the specificity (ability to pick up only the positive cases) is 88-90 percent,” said Dr.P.Surendran, associate professor in general surgery, SRMC.the sensitivity and specificity were derived during the process of clinical standardization according to him, the specificity is as high as 96 percent in well established breast cancers and about 85 percent in the case of early lesions (about 1 cm size).
Following the clinical standardization, thermography has been used on 60 patients at SRMC.the analytical standardization-to know which cells/areas exhibiting abnormal temperature are actually cancerous-is in progress. Analytical standardization would help provide accurate information of the sensitivity and specificity.
“What we have done now is to see if thermography can be more sensitive than mammography, so we can pick up cases at a much earlier stage and confirm it with mammography and tissue biopsy,” said Dr.S.P.Thiagarajan, director of medical research at Rama Chandra University. It will be an ideal and a superior tool for screening compared with mammography if the specificity is also high. For instance, unlike mammography, thermography detects breast cancer non-invasively.
Several advantages:
There are several other advantages as well. Patients are not subjected to any radiation, it is not expensive, is a painless procedure, and can be done quickly. But the most important advantage is that thermography can pick up cancerous/abnormal cells immaterial of the age of patient and the type of breast. “Mammography can not pick up smaller lesions in younger patients(less then 40 years) and when the breast density is high. That is its biggest disadvantage,” said Dr.Surendran.”Mammography is useful in older patients and smaller breasts”.
“Our aim is to perfect it so we can use it as a screening tool in rural setting, “said Dr.Baldev Raj,Director of IGCAR,it is, however,too early to say that thermography can be used as a screening tool. But it will surely turn out to be an invaluable tool if the specificity issue is addressed.
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