What is Breast Thermography - Verywell Health

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Thermography is a noninvasive imaging technique that measures variations in temperature over the body surface. Because the body emits heat where there is increased blood flow, the study will show increased heat in areas where there is:

• Active inflammation: The immune system sends white blood cells and other inflammatory cells into the bloodstream to protect you.
• Cancer: Cancer forms new blood vessels in a process known as angiogenesis to feed the cancer with oxygen and nutrients that help it to grow.

You can get a full body scan, or thermography can focus on a certain body part or area. Breast thermography is one use. Thermography is also used to look for diabetic neuropathy, vascular diseases, and other medical conditions. 

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Breast thermography relies on the fact that the breasts are on the surface of the body, not organs deep within the body cavity. This makes it easier to detect changes in body temperature that correlate with increased blood flow or inflammation.

Thermography may appeal to people who report discomfort with other studies, such as mammograms, which compress the breasts. People with breast implants may appreciate that their implants do not need to be moved to the side or compressed to get a good image.

The Food and Drug Administration (FDA) has approved breast thermograms for supplemental breast cancer screening. In other words, the technique can be used along with a mammogram, ultrasound, or magnetic resonance imaging (MRI) but should not be used as a stand-alone test to look for cancer.

Purpose of Test

A mammogram is the preferred screening test for female breast cancer in people at average risk. It is cost-effective and has been shown to save lives. While it does expose you to low doses of radiation, the amount of radiation is far less than what you get from your natural surroundings every year. 

Still, some people have looked for ways to decrease radiation exposure when examining breast tissue. Thermography can be used together with a mammogram to screen for breast cancer. It is not meant to replace a screening mammogram.

Thermography is also offered in many medical spas (hybrids between day spas and clinics that offer some medical procedures in addition to wellness, beauty, and relaxation treatments).

The procedure uses an infrared camera to look at heat emitted off the body's surface. Thermography can detect heat 5 millimeters under the skin's outer surface and does not look at deeper tissue.

Like a weather map, the hottest areas appear red or white, and the coldest areas appear blue or black. There is a spectrum of colors in between depending on temperature variations.

The camera is placed 5 to 8 feet from the body's surface, and multiple pictures are taken without touching your skin. Essentially, it is a contactless procedure that does not expose you to radiation. 

Although thermography can detect areas with increased blood flow, it cannot tell what caused the increase. Additional tests may be required if an abnormality is detected.

Risks and Contraindications

Breast thermography is noninvasive and does not pose a physical risk to anyone having the procedure. There is no radiation exposure, and it is pain-free.

There are, however, potential contraindications for the procedure (reasons not to use it). Specifically, people who are pregnant or who are lactating may have increased blood flow to the breasts. While the study is still safe to perform on these people, results could be difficult to interpret and may be unreliable. It is generally discouraged in these circumstances.

Before the Test

When you arrive, you will meet with a technician, called a thermographer, who will review your medical history and any symptoms you have before performing the test. Expect them to ask about the following:

• Close family members with a history of breast cancer
• Your menstrual cycle
• Your personal history of breast cancer and/or other breast conditions
• Your reproductive history (i.e., past pregnancies and, if applicable, births)
• Prior mammogram results, if applicable

Timing

On average, you can expect your evaluation to take an hour. This will include time to complete any necessary paperwork and talk with the thermographer about your medical history and concerns, and approximately 20 to 30 minutes for the test.

Location

Breast thermography is most commonly performed in a medical spa but can sometimes be completed in a medical office if your healthcare provider has purchased the necessary equipment. It is generally not offered in a hospital setting.

For your study, you will be taken to an exam room, where you will be positioned in front of the camera. Staff will enter the room to perform the test.

What to Wear

Anything that affects your body temperature could alter your thermography results.

Clothes worn that day should be loose because any imprints left on the skin could show up as hot spots. Likewise, you should avoid wearing heavy jewelry.

Because showering and bathing can change the temperature of your skin, avoid taking a shower or bath within an hour of your study. On the day of the test, you should not shave or use antiperspirant, deodorant, body lotion, cosmetics, perfume, or powder.

Food and Drink

Certain foods and drinks could affect your body temperature. For this reason, you are discouraged from drinking alcohol or caffeine before your test. You should also avoid smoking.

Except for anti-inflammatories, you can take your usual medications as prescribed. Anti-inflammatories, like Advil (ibuprofen) and Aleve (naproxen), are discouraged within four hours of your test. Because they decrease inflammation, these drugs could affect your body temperature in inflamed areas and make it harder to detect hot spots.

Cost and Health Insurance

Most health plans do not cover breast thermography, but some do. You will need to contact your insurance company to determine if it is an option.

Medicare does not cover thermography for breast cancer screening or any other indication, even when used with another study. The agency claims, "The available evidence does not support this test as a useful aid in the diagnosis or treatment of illness or injury.”

The average cost of breast thermography is $175 to $250. If insurance does not cover it, you may have to decide if it is worth the out-of-pocket expense.

What to Bring

If your test is being covered by your health plan, you will want to have your insurance card on hand. Otherwise, all you really need is your identification and a source of payment. Anyone without insurance will usually need to pay for the test upfront unless they make a payment plan with the facility ahead of time.

During the Test

The test is performed by a technician trained to use the equipment and take a high-quality set of images. This person is referred to as a thermographer.

Results will later be interpreted by a physician certified in breast thermography. Keep in mind the healthcare provider interpreting these scans may not always be on the premises. Sometimes these images are sent to them electronically for review.

Pre-Test 

When you arrive for your test, your body temperature could be higher or lower than normal depending on the weather (outside temperature, humidity, sunlight, or wind). It is important to adjust to the temperature in the facility to get the best results.

You will be asked to remove clothing from the area being looked at (waist up for breast thermography) and sit in the exam room with your arms lifted off your body for at least 15 minutes. Some facilities may even have a cooling bed for you to lie on.

For modesty's sake, you will be given a loose gown to wear while you wait.

Throughout the Test

The thermographer will position you in front of the camera for the study. When pictures are taken, they will ask you to place your hands on your head. This will allow images of the breast to be taken easily from all sides. 

On average, the test takes 30 minutes to complete. Please let your thermographer know if it is uncomfortable to keep your hands on your head this long. They may be able to accommodate you with rest periods or guide you to move your arms in other positions to get the best possible images.

Post-Test

When the test is completed, your thermographer will let you know when to get dressed. Once you check out at the reception desk, you are free to leave the facility. You will be notified with the results.

Interpreting Results

Breast thermography results are unlikely to be available on the same day. Most facilities will provide you with your test results within a week. Some will provide you with copies of the images and a copy of the written report.

The study should be interpreted by a physician who has completed a certification program in thermography. Many physicians do not receive adequate training for this technique in medical school or residency programs.

The person taking your pictures should be trained in thermography too. If the technician does not provide the doctor with quality images, it could increase the number of false positive tests or missed diagnoses.

Reputable organizations that provide thermography certification for physicians and technicians include the American Academy of Thermology, the American College of Clinical Thermology, and the International Academy of Clinical Thermology. Several other university courses and certification programs also provide training in this field.

Be proactive and seek out a facility that staffs people with these credentials. Consider that a red flag if a facility is unwilling to confirm if or where their staff was certified.

Legal Uses

Anyone can buy an infrared camera. To be used for medical purposes, though, those cameras need to be registered as a medical device with the FDA. This means the camera has gone through a rigorous approval process showing that it works and has clearly defined indications for use (conditions or reasons to use the device).

Any facility using this equipment can only do so for FDA-approved indications. This assures that the devices are not marketed for inappropriate or misleading reasons. The FDA has had to send warning letters to facilities for illegal marketing practices and has threatened financial penalties or closure of facilities to protect the public from false claims.

Follow-Up

How often you get breast thermography depends on the reason for the test.

If you do not have symptoms, you could have the test to supplement your routine breast cancer screening (i.e., mammogram and/or ultrasound). In those cases, you may consider breast thermography annually to keep it in sync with your other studies.

Some facilities recommend getting two breast thermograms three months apart the first time you get tested to establish a more accurate physiologic baseline on which to compare later studies.

If you have symptoms (i.e., breast pain, a breast lump, nipple discharge, etc.) or your thermography is abnormal, you may require more frequent thermography tests. Generally speaking, you will want to reach out to your healthcare provider for further evaluation.

Other studies may be needed to make a diagnosis. This could include a biopsy (removal of tissue to be analyzed in the lab).

Other Considerations

The FDA first approved breast thermography in 1982 but with a caveat. At that time and today, the FDA made it clear that the study is not meant to be used as a stand-alone study to screen for breast cancer. However, it may be used in conjunction with other tests like a mammogram.

That is because thermography is not always accurate. It has a high false-positive rate. This means people could be told they have cancer when they don’t. For example, a person could have a non-cancerous condition like mastitis (inflammation or infection of the breast) that shows up as a hot spot. This could lead to unnecessary tests and worrying.

This accuracy relates to sensitivity and specificity. Sensitivity is the ability of a test to correctly identify someone who has a disease (a true positive), while specificity is the ability to correctly identify someone who doesn’t (a true negative).

Even with technological advancements, breast thermography is less reliable than mammography. A 2016 study shows breast thermography may have sensitivity as high as 81.6%, but its specificity remained low at 57.8%. Mammograms fared far better, with a sensitivity of 80.5% and specificity of 73.3% in that same study.

The American College of Radiology does not currently recommend thermography for breast cancer screening. This does not mean it could not be beneficial in some cases.

Breast thermography can be a helpful add-on test when there are questions about an abnormal mammogram or another imaging study. A thermogram could gather extra information that could help you decide what steps to take next.

It's important to keep an open dialogue with your healthcare provider. Talk about any concerns or symptoms you are having. Be sure to discuss the risks and benefits of breast thermography and ask if the study could be helpful in your situation. With this information, you can make an informed decision about the test.

Summary

Mammograms remain the standard of care for breast screening tests, but they are not perfect. If you are interested in additional studies, breast thermography may be an option. This test uses an infrared camera to look at hot spots in the breast that could indicate inflammation or cancer.

However, keep in mind that thermography is not reliable enough to detect breast cancer on its own. Be wary of claims that it has the ability to find cancer. When looking for a facility to perform the study, make sure the staff is properly trained and that they are compliant with FDA regulations.

A Word From Verywell

It can be anxiety-provoking to wait for a test result, especially when you are being screened for cancer. That’s why it is so important to keep communications open with your healthcare provider. Once your results are available, they can walk you through them, answer any questions, and address any next steps as needed.

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