This blog shares a document provided to us from Dr. Robert Kane, the physician who works with COEM to interpret Thermography scans. He discusses in this document how to understand and interpret the different rating levels he provides on each report. It gives a really thorough explaination of each rating that is very easy to understand.
Those of you who have not scheduled a Breast Thermography are encouraged to call us to schedule one as soon as you are available. Thermographies are painless, safe, and very quick. We offer a coupon through the office of $100 off for new and repeat Thermography appointments.
Please enjoy the information below from Dr. Kane.
Understanding Your Thermal Breast Imaging Report
© Robert L. Kane, DC, DABCT, All Rights Reserved
Introduction:
Thermal imaging is a tool that is used to help assess risk for breast cancer. Unlike
screening examinations or diagnostic examinations, the findings can suggest risk for
currently having breast cancer or for developing it in the future. This information can be
used to help determine when additional testing or intervention designed to lower risk is
necessary. By watching for changes from examination to examination, Thermal Imaging
can also help monitor the effects of interventions to see if they are effective. This includes
things such as modifying one’s diet or lifestyle, and improving nutrition among others. It
does not directly detect or diagnose cancer but can help reach those goals. Thermal
imaging does not replace mammography or any other diagnostic or screening examination.
TH 1: Lowest Risk
Based upon temperature analysis, this rating suggests the lowest risk that breast cancer is
currently present or that it may develop in the future. This rating cannot guarantee that
the breasts are cancer free and should not delay any other breast examination
recommended by your doctor. When cancer is present, it tends to be growing less quickly
(less active) or has not produced enough inflammation or changes to the blood supply so
that it is visible on thermography.
TH 2: Low Risk
This is also a low risk thermal image. The increase in risk between TH1 and TH2 is
minimal. This rating is not a guarantee that breasts are cancer free and should not delay
any other breast examination recommended by your doctor. When cancer is present, it
tends to be growing less quickly (less active) or has not produced enough inflammation or
changes to the blood supply so that it is visible on thermography.
Follow Up Recommendations for TH 1 and TH 2:
Follow-up imaging for women over 30 years of age should be performed annually and, for
women 20 to 30 years of age, every 3 years. Imaging should be performed along with your
annual breast examination.
TH 3: Medium Risk
This rating suggests a medium risk that breast cancer is currently present or that it may
develop in the future. Follow-up thermal imaging and other breast examinations can help
clarify any significance to this rating. When cancer is present it may be more active and
growing slightly faster than those found in the lower TH risk categories. This rating can
also be caused by conditions such as normal variation in anatomy, some benign tumors,
lymphatic activity or congestion and low grade inflammation or infection. It is important to
determine the cause of the thermal findings and not prematurely conclude that cancer is
present.
Follow Up Recommendations for TH 3:
3-6 month follow-up thermal imaging is recommended depending on your individual
situation. Additional imaging such as mammogram or ultrasound should be performed if it
has not taken place within the last year. Your doctor will recommend the best test for you.
If something is being watched on another examination such as a mammogram, you should
consult with your doctor to determine if any additional testing is necessary at this time.
Interventions intended to reduce risk should be introduced as a preventative measure.
TH 4: High Risk
This rating suggests a high risk that breast cancer is currently present or that it may
develop in the future. Since this rating can also be caused by inflammation, infection and
some fast growing benign tumors, it is important to determine the cause of the thermal
findings and not prematurely conclude that cancer is present. Other factors such as
lymphatic congestion and/or hormone imbalance can contribute to these findings and need
to be considered when evaluating their significance. Most women with TH4 ratings do not
have cancer at the time of the thermal imaging examination but do indicate high risk for
developing cancer in the future.
TH 5: Highest Risk
This is also a high risk thermal image. As with TH4, this rating can also be caused by
inflammation, infection and some fast growing benign tumors so it is important to
determine the cause of the thermal findings and not prematurely conclude that cancer is
present. Other factors such as lymphatic congestion and/or hormone imbalance can
contribute to these findings and need to be considered when evaluating their significance.
Most women with TH5 ratings do not have cancer at the time of the thermal imaging
examination but do indicate the highest risk for developing cancer in the future.
Follow up Recommendations for TH 4 and TH 5
It is strongly recommended that you consult with your physician and begin additional
imaging such as mammography, ultrasound, or any other appropriate test promptly to help
clarify the thermal findings. A biopsy may be recommended if this rating occurs in a breast
with a lump or other suspicious finding on another examination. Interventions intended to
reduce risk are strongly recommended as a preventative measure.
Follow-up thermal imaging should be performed at 3-month or at the discretion of the
Thermologist based upon the thermal findings and any intervention being performed.
Modifiers
A plus or minus sign is used to upgrade or downgrade the severity within a particular TH
rating.
Hormonal Grade
How Do You Determine the Effects of Estrogen on Your Level of Risk: The
Hormonal Grade:
Lifetime exposure to estrogen has been identified as a significant risk factor for the
development of cancer. The hormonal grade is a way to look at the effects of estrogen on
the breasts. When we measure the level of estrogen and progesterone in the blood, urine
or saliva we are looking at the hormonal balance in the whole body. The question remains,
what is the effect of these hormone levels on the breasts. Normal fatty tissue in the
breasts can actually produce estrogen and will be missed on blood testing and can
contribute to risk. Some women have estrogen receptors that are more sensitive or bind
estrogen more easily. They may even have low estrogen levels but their breasts are
actually being over stimulated by the estrogen they have. By looking at the hormonal
grade, we can put all of these factors into perspective.
It is important to recognize some additional factors that can affect the hormonal grade that
may or may not be the result of estrogen stimulation. Systemic inflammation can produce
mottled thermal patterns that can simulate the appearance of estrogen stimulation in the
breasts and should therefore be considered in the case of an elevated hormonal grade.
Altered thyroid function can create mottling and can directly alter the estrogen
progesterone balance. In addition, chronic: pain, stress, hormonal imbalance, allergy,
illness, (low-grade) infection, exposure to foods/chemicals for which one is sensitive can
also affect nervous and/or immune/lymphatic system function creating mottling. When the
hormonal grade is at a 3 or 4, all of these factors should be considered.
Grade 0 – There are no symmetrical blood vessel patterns in the breasts which means
the breasts do not appear to be stimulated by estrogen at all. Your breasts appear to be
handling the estrogen in your body very well and there is really nothing to be done to
restore hormonal balance in the breasts. If you are taking hormone replacement, this
rating is great news since it suggests that the estrogen is probably not contributing to any
risk you may have for developing cancer. This rating is most common in post menopausal
women and is considered to be the healthiest.
Grade 1 – Symmetrical blood vessel patterns are seen in the chest wall and upper most
breast surface only. This suggests a small amount estrogen activity but like Grade 0,
suggests that the estrogen in your body is not contributing to any risk you may have for
developing cancer. This rating is also common in post menopausal women and is
considered to be healthy.
How should you follow up for a Hormonal Grade of 0 or 1:
No follow up or management is necessary. You are doing just fine!
Grade 2 – Symmetrical blood vessel patterns now extend to the upper-inner and/or
upper outer quadrants of the breasts. This suggests a slightly higher activity than Grade 1
suggests and the estrogen in your body is probably not contributing to any risk you might
have for developing cancer or that the contribution is small. This grade is commonly seen
in premenopausal women and is considered to be healthy.
How should you follow up for a Hormonal Grade 2:
This grade does not necessarily require any follow up or management and may be
normal especially for pre-menopausal women. For post menopausal women who are
not on hormones, they may wish to work with a holistic practitioner to try to lower the
estrogen stimulation to the breasts especially if their TH rating is suggesting any
elevation in risk.
Grade 3 – The blood vessel patterns now extend to the level of the nipple line as they do
during pregnancy under the effects of estrogen. This suggests moderate estrogen activity
and may suggest that estrogen stimulation of the breasts may be contributing to risk for
developing cancer. The reason I say ‘may’ is because woman who are pregnant, lactating
will generally have a Hormonal Grade of 3 or 4 due to natural hormonal changes. Also,
women on birth control pills and hormone replacement will also commonly exhibit this
Hormonal Grade as a function of the hormones they are taking. This grade simply says the
level of stimulation is elevated. The TH rating will let you know the level of risk for
developing cancer. Other possible causes for this rating included large breast size, poor
estrogen-progesterone balance and poor estrogen metabolism.
Grade 4 – The symmetrical blood vessel patterns now are seen extending below the
nipple line. The significance is the same as Grade 3. The level of stimulation is just greater.
How should you follow up for a Hormonal Grade 3 or 4:
The first thing to do with a Hormonal Grade 3 or 4 is to check the TH ratings to see the
level of risk. We will show you how to put together the two rating systems in the next
section. The next step is to investigate what might be causing the elevation.
If you are pregnant or lactating there is nothing to do. This is completely normal for
you and should not generate any concern. If you are taking hormones or birth control
pills, this is likely the cause and reducing the activity may not be possible as long as
you continue on these medications. Use the TH rating to determine if there is an
elevated level of risk for the breasts. If there is a TH rating of 3 or higher, addressing
the estrogen may be a way to lower your risk. If discontinuing treatment is not an
option or not desired, watch the TH ratings to see if any increase in risk can be
detected and use that with your health care provider to determine if changes to your
hormone intake are warranted.
If there are no obvious sources of estrogen that could explain the grade it is time to
look at environmental and dietary estrogen, estrogen-progesterone balance and
estrogen metabolism. Tips on how to do this may be available from the center where
you were imaged or a consultation with a holistic health care provider can be
considered.
How do I understand the significance of a particular TH rating with a particular hormonal grade?
The easiest way to think about this is to remember that the TH rating looks at the effect of all risk factors on the breast tissue while the Hormonal Grade looks at only the effects of estrogen. In other words, you can have a high hormonal grade suggesting lots of estrogen stimulation but a low TH rating. This means that although the estrogen stimulation is high, it is not causing a measurable increase in your level of risk. It is also possible to have a high TH rating and a low Hormonal Grade. This means that the level of risk for the high rated breast is elevated but that estrogen does appear to be a contributing factor.