Thermography: The Breast Cancer Screening Method No One Told You About

Breast Screening thermography by Thermography of Miami, LLC

Everyone agrees that early detection of breast cancer saves lives, but there is one little problem. Mammograms are very problematic for the 45% of women who have dense breast tissue. For these women, the sensitivity of a mammogram can drop under 60% and to as low as 30% in women with very dense breasts. At the same time, this subset of women has a higher-than-average breast cancer risk.

The reason mammograms don't work as well for these patients is right there in the name: “dense breasts.” They are thicker, denser, and harder to see through. The tissue is shown as white instead of black on a mammogram, often obscuring abnormalities, which also present as white.

With mammogram-only screening missing an average of 50% of cancers in these women, a secondary method of imaging is required, although not always standard of care.

There are many doctors who still only prescribe mammograms. Those who do only schedule an ultrasound after the radiologist has read the mammogram and assigned one of the two problematic categories from the Breast Imaging-Reporting and Data System (BI-RADS) Guidelines: "heterogeneously dense" or "extremely dense."

Women who fall into one of these categories of dense breasts know the drill. Even if the mammogram is clean, they will be asked to schedule an ultrasound as it can see things in dense breasts that radiation can’t.

So why don’t women with “dense breasts” just start there? Why not save us all the pain of smashed breasts and radiation exposure? After all, women with dense breasts are at a 6-fold higher risk of breast cancer, so more intense, frequent radiation in the form of additional scans may not be great for them.

The visible progression of breast cancer on thermographic scans

However, ultrasound is not recommended as a stand-alone screening method. So why not pair it with thermography and save the mammograms for suspicious activity or periodic checks at longer intervals? That's what a lot of women with dense breasts who see functional or integrative practitioners do.

"When these two are paired together, they find 85% of breast cancers," explains Jennifer Kaufman of Thermography of Miami, LLC, an ACCT-certified clinical thermographer. This number is similar to the 87% accuracy of mammography for women with normal or "fatty breasts." This is very good when you consider that mammography is only accurate about 65% of the time for women with dense breasts and can fall to as low as 30% in women with extremely dense breasts.

Aside from low accuracy, there is another risk with mammograms. "We know radiation is a cause of cancer and it's cumulative over your lifetime," says Kaufman. Indeed. With the help of AI, I calculated the absolute risk of having yearly, typical 2-view digital mammograms from age 40 to 74. It is 1 in 800. When you add in additional radiation exposures one may get for various medical reasons, such the three CT scans I had after a burst appendix in 2022 or a CT of the chest or spine, or a guided biopsy (I've had TWO), then your cancer adds go up to 1 in 250 from radiation exposure alone. CT scan area is more diffuse, and not as targeted as mammograms or dental x-rays, allowing for more overlap. While the risk is small, it does mean that statistically, there must be quite a few women who got breast cancer FROM breast cancer screening.

I visited Kaufman at her Coral Gables office and had a breast scan, as I fall into the dense (possibly extremely dense) breast category and have been looking for ways to manage my radiation exposure (I keep a spreadsheet). After she gained a thorough clinical history, we did the scan, which will serve as a baseline for another scan in 4-6 months. They will be reviewed by doctors looking for small hints of activity, heat images, or changes.

"It's very sensitive, says Kaufman. "Thermography can detect the subtle physiologic changes that happen during cancer, fibrocystic disease, infection, and vascular disease."

This patient had estrogen dominance and related activity. She reversed it 3 years later.

It's true, that it may be more likely to give a false positive than a false negative, but that is due to the high sensitivity.

To illustrate what cancer looks like on a thermogram, she showed me various sample images, including one of a man in whom she'd found breast cancer.

“Cancer is very vascular, and where there is increased blood flow, there is increased heat,” says Kaufman. But she is not the final word on reading the scans. She will send the scans to a doctor for final interpretation, although the uninterrupted green on the scans is a good sign as cancerous activity is usually hotter in tone (red or orange).

A recent article in the New York Times written by Roni Rabin on the subject explained that "mammograms can miss tumors in women with dense breasts." She tells readers that an ultrasound or MRI is needed to catch early-stage cancers in this subset of patients. The gist of the article was that often these secondary tests are not covered by insurance, and it is putting many women with dense breasts at risk. That is true, but it's also an incomplete picture of the options available for women with dense breasts.

As I read, I was waiting for her to mention thermography as it can detect some cancers up to 10 years before mammography, especially in women with dense breasts, which she was focusing on. She didn't. That's a shame because these scans can pick up on small variations of heat caused by tumor angiogenesis, which is the formation of new blood vessels the tumor uses to feed itself.

It's also much less expensive than the absolute cost of mammography. The trouble is, insurance doesn't cover it despite studies showing it's strength, especially when paired with another inexpensive and safe screening such as ultrasound. (There was strong evidence in a 2024 report from the Archives of Breast Cancer.)

Why thermography is not more commonplace might have something to do with the billions to be made from mammograms for corporations like GE, Siemens, and Hologic. There is no similar profit center and industry around thermal imaging.

One drawback of thermography is that it is not a once-and-done scan. You will need a follow-up to assess subtle changes.

What's interesting is thermography can scan a lot more than breasts. It can be done on the whole body and pick up infections, for example in an oral cavity.

If you’ve had a lot of imaging, have dense breasts, have been a frequent flyer, or are just trying to manage your radiation exposure, you might want to consider thermography.

As we are always seeking the healthiest approach, we are very interested in this type of screening, but not recommending women with regular breasts to forgo mammography, for whom it is a very effective, life-saving tool. Rather we are suggesting considering integrating thermography into an arsenal of complimentary screening methods.

But if you do have dense breasts and/or are seeking to manage your radiation exposure, speak with your functional or integrative doctor about alternatives like MRI, ultrasound, and yes, thermography.

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Thermography is the breast cancer screening method no one told you about