ABSTRACT
The utility of thermography in breast cancer screening and detection has been studied since 1955. Despite its initial promise, the imprecise thermal scanners of the 1960s coupled with the lack of thermal equilibration protocols severely hampered thermographic sensitivity to detect malignancy. Later studies employing cooldown protocols showed better sensitivity despite the lack of spatial and thermal resolution inherent in the older scanning systems. A big advance came in 1994 with the declassifying uncooled microbolometer thermal scanners for civilian and medical use. By 2000, thermal imagers based on these advanced, micro-machined chips were delivering thermograms with quality approaching visual photographs. This improved resolution has allowed the separation of venous and lymphatic vessel appearance as well as nipple from areolar temperatures. The Ville Marie” TH” thermographic evaluation scale may need a proposed revision. Many full-color images are presented showing breast anomalies, artifacts, and samples of the five TH classifications from normal to severely abnormal. Anatomic and physiologic mechanisms for these classifications are provided. A breast screening clinic based on thermography, backed up by mammography is proposed. How to prepare, cool down, position, and image a breast screening patient and then measure the important temperatures are fully covered.
