Breast cancer screening can identify breast cancer before a person notices any physical symptoms. Early detection can enable a person to undergo less invasive treatments with better outcomes.

Health authorities and doctors recommend that females have a regular breast screening mammogram. When they would have it depends on their age and individual risk factors.

However, some facilities offer thermography as an alternative to mammography.

While both tests screen for breast abnormalities, thermography does so by detecting variations in temperature in breast tissue, while mammography takes an X-ray of the breast.

The resulting image from a thermogram is like a heat map with different temperatures represented by different colors. A mammogram X-ray is an image of the inside of the breast that can show abnormalities such as cysts, fibroadenomas, and calcifications.

The Food and Drug Administration (FDA) recommends that doctors only use thermography to complement mammography, with mammography being the primary screening method.

Sex and gender exist on spectrums. For the purposes of this article, we use “male” and “female” to refer to a person’s sex assigned at birth. Learn more.

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Thermography uses a type of infrared technology that detects and records temperature changes on the skin’s surface. It can help screen for breast cancer.

A thermal infrared camera takes an image that shows different temperatures in the breasts. The camera displays these patterns as a sort of heat map.

When cancerous growth develops, cancer cells reproduce and require extra blood. Areas of excessive blood flow in the breast tissue show up on the infrared image as areas with a higher skin temperature.

The American College of Clinical Thermology recommends this method for the following reasons:

  • It is a noninvasive, noncontact procedure that does not involve compressing the breast.
  • It does not involve radiation exposure, and people can use it safely over time.
  • When used alongside mammography, it provides doctors with more information to help make a diagnosis.
  • It can detect changes in breasts with dense tissue and implants.
  • Hormonal and menstrual changes do not affect the procedure or the results.

Drawbacks of thermography

The ACCT notes that breast thermography does not detect cancer. It can only alert a person to changes that may need further investigation.

Thermography is also limited because:

  • It provides limited information. Although thermography can show changes in heat and vascular features, it does not show how the breast has changed.
  • It can detect changes that are not cancerous, and a person would need to have a mammogram to clarify the results.
  • Sometimes, thermography does not reveal cancerous changes that are present.
  • Medical insurance often does not cover the cost of thermography, whereas it usually covers regular mammogram screening.

Learn more about breast thermography here.

A mammogram is an X-ray of the breast. It involves compressing the breast between two metal plates and taking an X-ray image of the breast tissue.

The image can show if there are unusual changes or masses in the breast tissue that may need further investigation.

Mammography is the most common way of screening for breast cancer. It can help detect early-stage cancer, which can reduce the risk of dying from the disease by 25–30% or more.

Factors affecting who will benefit from regular mammograms include:

  • whether a person has a personal or family history of breast cancer
  • the presence of certain genetic factors, such as changes in the BRCA1 or BRCA2 genes
  • a person’s age
  • how often they undergo screening
  • how dense their breast tissue is, as this may affect the resulting image

Learn more about how age affects the risk of breast cancer here.

Drawbacks of mammography

Mammography has some drawbacks, which include:

  • Regular testing means repeated exposure to low levels of radiation, which may very slightly increase the risk of cancer.
  • Mammography can also reveal noncancerous changes, leading to false-positive results. This can lead to short-term anxiety, further tests, and treatment, which may be unnecessary and costly.
  • Mammogram results may be less accurate for women with dense breast tissue or breast implants. This is because dense breast tissue can appear white on a mammogram image, which can mask the presence of tumors, as these also appear as white. On the other hand, low-density fatty tissue appears gray on the image, making it easier to see any changes.
  • Mammography can be uncomfortable, as it involves compressing the breasts. For this reason, it is best to avoid undergoing screening just before menstruation, when the breasts can be more tender than usual.

Learn more about what to expect from a mammogram here.

The U.S. Preventive Service Task Force (USPSTF) gives the following recommendations for breast screening:

  • Females ages 40–49 may wish to begin breast screening every 2 years. Each individual should weigh the potential radiation harm posed by an X-ray against the potential benefit of detecting cancer early.
  • Females ages 50–74 with an average risk should have a mammogram every 2 years.
  • Females ages 75 and older with an average risk can base their decision to undergo screening on the balance of benefits and harms.

Other institutions give different recommendations. For instance, The American Cancer Society recommends that women ages 45–54 have a mammogram every year.

A 2021 report in the Journal of the American College of Radiology states that all females should have a risk assessment by the age of 30 and begin screening at the age of 40.

According to the same report, one-third of all breast cancers in Black, Asian, and Hispanic females are diagnosed under the age of 50. Compared to non-Hispanic white females, females belonging to other ethnic groups are:

  • 72% more likely to be diagnosed with invasive breast cancer under the age of 50
  • 58% more likely to have advanced-stage breast cancer under the age of 50

The report goes on to say that people who identify as lesbian, gay, bisexual, transgender, or queer are less likely to attend regular breast screening. This may reduce the chances of doctors detecting breast cancer at the early stages in these individuals.

Transgender individuals who have transitioned from male to female and have used hormones for more than 5 years should have annual screening from the age of 40. The same recommendation applies to people who have transitioned from female to male who have not had a mastectomy.

In 2019, the FDA warned that homeopathic clinics, health spas, and other facilities offer thermography as an alternative to mammography.

They warned that there is no scientific evidence to support this use of thermography, and they urged people to attend regular mammography as their doctor recommends.

The FDA issued the following warning:

“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.”

Doctors can use thermography to gather more information about changes in the breast. However, mammography is the most reliable screening test available for now.

Mammography and thermography are two different types of screening tests that doctors use to detect signs of breast cancer.

Experts recommend mammography screening once every year or every 2 years around the age of 40, although recommendations vary. A doctor will assess a person’s individual risk factors, such as age and family history, before recommending breast screening.

Doctors may suggest thermography in order to gather more information about changes in the breast. However, mammography is seen as the most reliable method of breast screening.

Q:

I am confused because my doctor tells me I should have a mammogram every 2 years, but my friends say I should worry about radiation. They say that thermography is better because there is no radiation. Is this true?

Anonymous

A:

For cancer detection, doctors recommend having a mammogram every 2 years depending on a person’s age range and risk level. I would heed the doctor’s advice.

Mammograms involve a small amount of radiation but not enough for one instance of the test to cause damage to the cells.

The benefits far outweigh the risks. As this article highlights, thermography may have its advantages, but there is not enough research or evidence to support its use as a standard of care for cancer diagnosis.

Christina Chun, MPH
Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

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