Thermography in Breast Cancer

To the Editor. —Having used thermography in conjunction with mammography for over two decades in the evaluation of breast diseases, I find that Paul Cotton's1discussion of thermography presents an unbalanced review of the usefulness of thermography in breast cancer. While quoting an unfavorable report that "thermography detected only 39% of 130 proven malignancies,"2had he delved further he could have found the report entitled "Breast Thermography After Four Years and 10 000 Studies,"3and noted that among 5662 symptomatic patients there were 270 with proven cancer, and thermography had a true-positive result rate of 72%. In this group, the results of physical examination were positive in 82% and mammography results were positive in 85%. Accuracy was improved to 92% when all three modalities were considered. Among the 4393 asymptomatic patients, there were 36 clinically occult cancers, 30 (83%) detected by mammography and 22 (61%) suspected using