Thermal images (thermograms) are difficult to analyze and interpret. Accurate and credible interpretations normally require a highly trained individual to perform the task. This obstacle is overcome by outsourcing thermogram interpretation requirements to specialized reading and interpretation services.
How Are The Images Analyzed?
The analysis is based upon deviations from the normal symmetry of the breast temperature. Temperature Patterns and Temperature Differences Between Breasts - The temperature is analyzed by looking at the patterns of warming and cooling (called notable temperature patterns) as well as the side-to-side differences between breasts.
The actual breast temperature is seldom a factor. Once identified, temperature patterns and temperature differences are evaluated to consider if they are significant enough to contribute to your risk rating based on the Thermobiological (TH) rating scale as taught by William Hobbins, MD. Findings that are considered significant along with findings that are being watched for change are recorded in your report.
Mastectomy– In the case of mastectomy, the ability to compare from side to side is lost. This is true even when reconstruction has been performed. The remaining breast and mastectomy region are analyzed based upon temperature patterns only and the mastectomy region is rated simply as low/medium/high risk rather than the standard TH scale.
Radiation – When radiation therapy for cancer is performed to the breast, it frequently warms the breast for a period of years subsequent to completing the course of treatment. Consequently, the untreated breast may be analyzed based on temperature pattern only. The irradiated breast is evaluated normally with the understanding that the radiation warming may be simulating signs of inflammation. The breast is then monitored for stability and eventual resolution as the effects of the radiation diminish.
TH RATINGS EXPLANATION
TH-1 - The first classification category in the Marseille system defines a normal thermal profile of the breasts that is devoid of any of the thermology signs or criteria associated with risk for malignant breast disease. All thermal features demonstrate normal and adaptive response to the autonomic challenge. Normal contours are discerned and no significantly hyperthermic focal or vascular features are presented. Some patients will demonstrate distinct and significantly hypothermic patterns that are frequently associated with established cysts and/or fibro-adenomas. This will modify the classification as a TH1F. Annual comparative restudy is recommended
TH-2 - The second category in the Marseille system defines a thermal profile of the breasts that features symmetrical, non-complex and moderately hyperthermic vascular patterns. All thermal features demonstrate normal and adaptive response to the autonomic challenge. The TH2 score indicates no thermal signs or criteria for malignant breast disease. However, while very unlikely, it is possible that some small malignant tumors may be in a quiescent state and their vascular development could be minimal. In this event, the very minor thermal characteristics may evade discernment, especially in an initial study. This thermology category is frequently associated with benign changes, This assessment is generally characteristic of multiple small-to medium size cysts, slow- to fast-growing fibroadenomas, fibrocystic dysplasia, micro-invasive carcinomas, T1 carcinomas, and a healthy breast. Annual comparative thermology restudy is recommended and more frequent restudy may be clinically indicated.
TH-3 The third category of the Marseille system defines a single thermology sign and indicates an atypical metabolic or vascular process. This may be based upon the discernment of an asymmetric and hyperthermic vascular or focal pattern, an asymmetric, diffuse and hyperthermic pattern involving a peri-areolar area or most of one breast, a discrete area in a vascular pattern that does not attenuate from the challenge procedure or an asymmetric physical distortion with local hyperthermia. This atypical category is associated with a minor or equivocal (<10-20%) risk of confirming malignant breast disease-This assessment is generally characteristic of fast-growing fibro-adenomas, multiple large cysts, fibrocystic dysplasia, in situ carcinomas, and T1 carcinomas (2.5mm). Clinical correlation is indicated for an association with a mass or abnormal skin changes that would have an additive effect on the overall risk for malignant disease. Strong familial or personal risk factors for breast cancer and are also additive. Other objective means of evaluating the breasts may be indicated. Experience demonstrates a targeted ultrasound as the most effective means of following-up on atypical or abnormal breast thermology. Blood markers such as CA15-3, CA125 and creatin-kinase-BB may be useful and mammography and ductal lavage may be indicated.
TH3M or TH3L The post-surgical woman receives a special modifier "M", designating Mastectomy or "L", designating Lumpectomy. These are frequently used with the third category of the Marseille system on an initial study when any atypical thermal features are evident. The surgical procedures, radiation treatments and chemotherapy typically produce significant tissue inflammation, edema, abnormal tissue metabolism, nerve damage and re-vascularization that will likely impede the normal regulation of blood flow in the breast and results in artifacts in the thermal patterns. These forms of artifacts limit the value of thermology for approximately three months post-procedural when their influence usually has abated. Thermology can be a very useful means of monitoring the post-surgical woman for indications of persistent or recurrent malignant disease, especially in the axillary or sternal regions. The initial study may be of limited value and its best value obtained as a baseline for comparative restudy.
TH-4 - The fourth category in the Marseille system defines two or more thermology signs or a single thermology criterion. This must be considered a positive thermogram and represents a significant (65-85%) risk for malignant breast disease. Benign processes and personal variant are possible but unlikely as a basis for this abnormal classification, especially on an initial study. A clinical correlation is indicated for regional masses or abnormal skin changes and all available means of objective evaluation are indicated. However, it must be considered that a positive thermogram may precede positive results from other objective testing by 5-8 years. Thermology restudy in 60-90 days should be an important part of a comprehensive testing panel.This high risk outcome is generally characteristic of young cystosarcoma phyllodes, inflammatory mastitis, acute abscesses, micro-invasive carcinomas, T1/T2 carcinomas, mid-size medullary, and colloid cancers. Thermology restudy in 60-90 days should be an important part of a comprehensive testing panel.
TH-5 - 5 The fifth category in the Marseille system defines two or more thermology criteria. This category indicates a very high (approx. 96%) probability of confirming malignant breast disease. Benign processes or personal variant are very unlikely. A clinical correlation is indicated for regional masses and abnormal skin changes. Clearly, a patient with such a score is indicated for a comprehensive panel of objective evaluation with all possible alacrity. A thermology restudy in 60-90 days should be a part of this evaluation. This severely abnormal, very high risk outcome is generally characteristic of most cystosarcoma phyllodes, inflammatory mastitis, acute abscesses, mature micro-invasive carcinomas, T1+ carcinomas, medullary cancers, and carcinomatous mastitis.'
SERVICE CHARGES & FEES:
Breast examination interpretation:
Charges shall be made for each examination submitted by the practitioner and evaluated by us, as evidenced by the generation of a Thermography Findings Report.
Charges are incurred concurrent with the generation of the Report and apply to thermogram and examination evaluations.
Fees Incurred: Fees are incurred concurrent with the generation and email delivery of the Findings Report.
Payment Terms: An invoice or debit memo accompanies each Report for your recording purposes. At the start of each month, a statement of outstanding charges is emailed to each client. Payment is due on receipt of this monthly statement.
Payments: Payments are made through. using PayPal© to process credit card or bank transfers.
Using the service is easy. Submit examination images for evaluation with a mouse click and receive a comprehensive Report of Thermographic Findings by email within 72-hours, and typically within 24-hours.