International Health
Feasibility of New-generation Infrared Imaging Screening for Breast Cancer in Rural Communities
Francisco Gutierrez-Delgado, MD, PhD, FACP1 and José Guadalupe Vázquez-Luna, PhD2
1. Director, Center for the Study and Prevention of Cancer (CEPREC), Juchitan, and Professor of Oncology and Medicine, Medical Sciences PhD Program, National Autonomous University of Mexico; 2. Professor, Department of Physics and Mathematics, Autonomous University of Puebla
Abstract
Breast cancer is a major public health problem worldwide. Important advances have improved survival, but early detection remains the main clinical challenge in reducing mortality. Currently, mammography is the ‘gold standard’ tool for breast cancer screening. However, the search for an early breast cancer detection method is the subject of extensive research. Although infrared imaging or breast thermography for early breast cancer detection has been evaluated since the late 1950s, the negative results reported in 1979 by the Breast Cancer Detection and Demonstration Project decreased interest in this imaging modality. Advances in infrared imaging and reduced equipment costs have, however, renewed interest in breast thermography. Breast cancer in developing countries requires new strategies to increase early detection and access to care. In this article, we highlight the principles and advances of infrared imaging technology and describe our experience with new-generation infrared imaging for early breast cancer detection in rural communities in southern Mexico.
Keywords
Infrared imaging, breast thermography, breast cancer, breast cancer screening, thermography, thermal infrared imaging, medical infrared imaging
Disclosure: The authors have no conflicts of interest to declare. Acknowledgement: This study was supported by a grant (2004-CO1-021) from the Council for Science and Technology (CONACYT)-MEXICO. Received: September 3, 2009 Accepted: October 13, 2009 Citation: US Radiology, 2010;2(1):92–6 Correspondence: Francisco Gutierrez-Delgado, MD, PhD, FACP, Centro de Estudios y Prevencion del Cancer (CEPREC), Juchitan, Oaxaca, Mexico Guancastles y Colorines s/n Fracc. Reforma, Juchitan, Oaxaca, 70020, Mexico. E:
fgutierrez@ceprec.org
Breast cancer, the most common cancer and the second leading cause of death among women worldwide, remains an important public health problem. More than one million women are newly diagnosed with breast cancer each year, and approximately 500,000 women die annually from this malignancy. Advances in breast cancer therapy have led to improved survival in the last 10 years. However, early breast cancer detection continues to be a clinical challenge.1
Although
mammography was approved by the US Food and Drug Administration (FDA) as the ‘gold standard’ tool for breast cancer screening, the limitations of this screening procedure are well known.2
Moreover, the
World Health Organization (WHO) has recognized that mammography is not a viable option for many countries because it is an expensive screening tool that requires a large infrastructure and trained healthcare professionals.3
The search for a detection tool for
early-stage breast cancer is the subject of extensive research. Efforts to develop an early breast cancer detection method have included digital mammography, computer-aided detection, ultrasound, magnetic resonance imaging (MRI), positron emission tomography (PET), electrical impedance imaging, and infrared (IR) imaging, alternately named thermography or breast thermography. Despite these imaging technologies receiving FDA approval as diagnostic adjuncts to mammography, currently there is no diagnostic tool capable of significantly reducing breast cancer mortality that benefits women at all
92
ages, is non-invasive, has high quality assurance, has high sensitivity and specificity, is inexpensive, and is easily trainable. Moreover, most imaging modalities, although promising, are too expensive for routine use. Advances in IR imaging and reduced equipment costs show promise as a feasible technology that could meet ideal characteristics for an early breast cancer detection tool. The incorporation of cameras with high-resolution digital imaging, high-speed image capture, image manipulation software, high-speed computers, and computer-aided detection are new technologies suitable for breast cancer screening. Diakides and Bronzino have provided a comprehensive review of recent advances in IR imaging.4
Low- and middle-income countries require new
strategies to increase early breast cancer detection and access to care. In this article we review the role and feasibility of IR imaging for early breast cancer detection in rural communities in southern Mexico.
Definition of Infrared Imaging
Clinical thermography is a non-invasive, non-contact, and non- ionizing radiation imaging technique that detects, records, and forms an image of the temperature distribution on the surface of the body. IR imaging is not related to morphology; it is a functional imaging technology. The physics rationale is that all objects with a temperature above absolute zero (-273°K) emit IR radiation from their surface. Because the emissivity of human skin is high, it can be
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