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Thermograms versus Mammograms: Which test is best?

Thermograms detect infrared rays to show patterns of body temperature.

What most people I know who have gotten a thermogram don’t seem to have been told is that thermograms only detect surface bloodflow, so any cancer growth deeper than a few millimeters may not be detected unless it also happens to be large enough to disturb the surface blood flow patterns.

Thermogram. Circles show inflammation in the skin of the woman’s left breast (right side of image).

Mammograms use radiation to find calcifications hiding anywhere in the breast tissue, even deep ones.

What most people who’ve gotten mammograms don’t often hear is that mammograms are really difficult to interpret.

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The true power of any diagnostic image lies not in the technology but in the human brains behind the technology. Over decades, mammographers have been getting smarter and smarter, learning from mistakes and successes.

Mammogram. Arrows show abnormal calcifications in the breast tissue.
Mammogram. Arrows show abnormal calcifications in the breast tissue.

Radiologists have learned to detect cancers earlier and earlier because there’s been a group who have systematically studied cancer cases, going back to look at earlier mammograms to see if there were any abnormalities in the area of the tumor that, in retrospect, have become obvious.

This information is dissemenated at medical meetings and in journals, textbooks and so on. So now, after four decades of experience using the technology, mammograms can detect very tiny (1 mm), early cancers. (Unfortunately, they cannot determine whether the cancer has already metastasized, see post to find out why this makes screening mammography potentially risky.) Compared to this massive collective intelligence improving the interpretation of mammograms, thermography is in its infancy.

Thermography professionals have small and scattered associations. Mammography professionals have huge and highly organized associations and frequent meetings. The network of intellect behind mammography is huge. Thermography, not so. Not yet.

Diagram showing glands track deep into the breast tissue down the the muscle. Thermograms don't penetrate this deep.
Diagram showing glands tracking deep into the breast tissue down the the muscle. Thermograms don’t penetrate this deep.

Bottom line: If you want to find a cancer, you want to get a mammogram. Thermographic results are interesting when used in combination with standard mammography, but right now their diagnostic and prognostic value are too limited and I would recommend that women who want to use thermograms as a replacement for mammograms reconsider their position.

Now the real question is, if you find breast cancer early, does it prolong your life? You might be surprised by the answer. (See my post, Breast Cancer: Is Early Detection a Good Thing)

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This Post Has 10 Comments

  1. Thermography is an excellant early screening tool, especially for women ages 20 to 40 years old. This age group often does not consider mammography fir various reasons. In this age group, when cancer is suspected and confirmed by mammogram, the fatality rate is high. Mammograms detect tumors after they have formed density, whereas thermograms look for physiology (blood supply) feeding the tumor. The special thermal camera picks up the heat signature from the area of inflamation from this blood supply. Changes in physiology can be picked up 8 to 10 years before a physical tumor is detected. 20, 000 women in this age group die in the US per year . So it is now an additional diagnostic tool available to women (and men) of all ages.

  2. I have also heard that studies of women where mammography screening and infrared screening, or thermal imaging, was more accurate. The detection rate went from 84% to 95% when infrared imaging was added also. Your thread appears correct thermal imaging detects vascular changes, rather than tumors.

  3. Hi Dr. Cate,
    I’m curious if you have any updates on this issue since you posted this in 2009. I keep reading on some health blogs how harmful mammograms can be and am so confused about this issue.
    At what age are you recommending your patients to start mammograms?
    Also are you seeing epigenetic trends for those that are getting breast cancer (for example high sugar diets, toxin exposures etc…)?

    1. HI Lisa
      No updates on mammograms, but there is great new evidence that low carb diets are protective against cancer, including breast cancer.

      I still think the decision of how often needs to be made on a one-to-one basis in a discussion with your health provider while taking into account your family history, your history of breast health/usage, your risk factors ie smoking and other environmental toxic exposures like drugs, and of course your diet.

      Most of the controversy around mammography continues to be about frequency; should they be every year, every other year, less than that? The idea is to minimize radiation exposure to the coronary arteries while finding cancers, but not too many cancers because according to a Cochrane review a good percentage of cancers regress on their own.

      More on that here:
      and here:

  4. There is a growing concern that a given radiation dosage to a young woman’s breast is more mutagenic than to a post-menopausal breast, and a recent article has proposed that our practice of irradiating young women with family histories of breast cancer might actually have caused cancer in some cases. I’m not sure we can say that mammograms are the leading cause of breast cancer, however, when there are unfortunately so many other toxic exposures all around us.

  5. According to an increasing number of experts, mammograms are the leading cause of breast cancer…within a few years from now there will be a proliferation of law suits regarding this matter.

  6. I like the gentle way you divert attention back to mammograms.
    The problem with thermograms is just that, they are FDA approved ONLY as a supplement to a mmmg, but folks rely on them for primary screening.

    My main gripe is that when people bad mouth mammograms and say that they expose us to too much ionizing radiation…they forget that it is the same amount we receive in a cross country jet flight, or a year of living in Colorado, due to altitude and mountains….

    I came looking for more info on your books which I will buy!!

    Thanks for all you do to keep us healthy! Congratulations on another fine book. VB
    Thanks for all your efforts on promoting a healthful lifestyle.

  7. Brent,
    This is helpful information. If I read right, you are saying thermography is unable to detect lesions that don’t disrupt surface blood flow so you would do them in conjunction with mammograms. A very good point, and thank you.

  8. As an thermographer I believe that theromgraphy is a great way for early detection, but I also believe that mammograms should also be used. I believe that early detection on the surface with a thermogram can be detected but looking for deep cancer cells should be done with mammograms. It is a technology that can help but not used by itself.

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