Abstract The current recommendation for breast cancer screening is mammography. However, it has a high false negative rate, is less sensitive in dense breasts, and is associated with radiation exposure to the breast. Thermography measures body surface temperatures. In conventional thermography, the patient sits in front of the camera. Infrared images of the breast are captured in three views. Rotational thermography (Illumina360°) images with 360° views of one breast are obtained at a time in two different controlled temperatures when it is freely suspended. Primary: Descriptive study of thermographic images and correlation with routine conventional imaging (mammography and supplementary ultrasonography). Secondary: To assess the diagnostic accuracy of thermography with conventional work up as the gold standard. It is a prospective observational study. Inclusion criteria are positive finding on mammography and age 18 to 75 years. Patients who cannot lie in the prone position, patients who are unable to follow instructions, patients with fever, and pregnant and lactating women were excluded. Setting: tertiary cancer care center. Patients with unilateral positive mammography and contralateral negative mammography, where available, underwent thermography and findings from both modalities were compared. Sample size: 100 patients (198 breasts). The sensitivity of thermography in comparison to mammography was 83.87%, with specificity 10.81%, diagnostic accuracy 56.57%, positive predictive value 61.18%, and negative predictive value 28.57%. Thermography has high sensitivity and low specificity with a high false positive rate and thus a low diagnostic accuracy. It could not reliably differentiate benign from malignant lesions based on temperature risk stratification. Mammographic breast density and menstrual status did not have an effect on its ability to pick up lesions. However, specificity and diagnostic accuracy in premenopausal women imaged in the first half of menstrual cycle were more than those in the second half. If breast thermography is explored as a screening modality for early detection of breast cancer, its limitations can be a lower detection rate of smaller cancers and false positive uptake in high proportions of normal breasts.
Kembhavi et al. (Tue,) studied this question.