Article – Patient X – Case Study

davjul170311A2BOLWe are delighted and very grateful to the patient who allowed us to display her thermograms and full report below. Please read it carefully and if you have any questions our team will be very happy to answer them. Please don’t hesitate to call us at: 0333 8003003

This is not the patient’s first thermogram (or base scan) – we have chosen this point in the patient’s care carefully, as it explains a little of her history and refers to an on-going condition which can be seen on the thermograms.

Please note that there is a full KEY at the bottom of the document, including protocols and procedures.

Patient: xxxx xxxx
Date of Birth: 22/05/1972
Scan Date: 8/23/2014
Report Type: Upper Body + Breast
Thermographer: Rosa Hughes
Reported By: John Ward MD

All protocols were observed

HISTORY AND SUBJECTIVE COMPLAINTS:

BREAST
Patient has returned for her 4 month breast recall to monitor her breast health in light of previous “some risk” impression in left breast. Since her last imaging patient experienced some changes in the left breast. After laying over night on her left breast the following day the breast was extremely sore & painful to touch. Patient took homeopathic arnica & symptoms disappeared after 24 hours. Patient went to see her GP who referred her to the breast clinic for an ultrasound scan. On examination Breast Consultant said that lump was smooth, mobile 2cm x 3cm & would suggest a fibro adenoma in the left breast. He also felt a cyst in the right breast. The ultrasound showed flecks of calcium in the left lump & described it as hard & ill defined at 1.2cm x 0.7cm. The cyst in the right breast could not be found with ultrasound. Patient was referred for biopsy & a mammogram but refused due to dangers of mammography & biopsy. She will reassess her options once she has her thermography results & when her abdominal problems have improved.

ABDOMEN
From April 2014 onwards patient has experienced severe food sensitivity with bloating & distention & violent belching. Recently she has taken to her bed due to the exhaustion from her symptoms. Patient has previously suffered with constipation but in the last few years she has been passing normal stools. Patients diet has changed over the last few years & her lifestyle has also improved. Patient was previously lactose intolerant but this has developed into many foods causing sensitivity. She has just started the GAPS diet to mend her leaky gut. She has stopped all supplements & is now taking digestive enzymes, probiotics & saccharomyces boulardi.

THERMOGRAPHIC INTERPRETATION:

HEAD AND NECK:
There is increased hyperthermia over the frontalis and temporalis musculature bilaterally, which may represent myofascial dysfunction. There is increased hyperthermia over the frontal, ethmoidal, sphenoidal and maxillary sinuses bilaterally, which suggests inflammation. There is increased hyperthermia over the anterior mandible, with associated bilateral submandibular lymphatic drainage patterns, and over the anterior maxilla. These findings may represent dental/periodontal pathology. There is persistent hyperthermia over the thyroid gland region, which raises the question of a glandular dysfunction.

There is persistent hyperthermia over the carotid bases, R>L, which may relate to inflammation and elevated CRP levels, or to vascular pathology. Further evaluation may be warranted. There is persistent hyperthermia over the supraclavicular fossae, which may be compatible with brachial plexus involvement (i.e., increased physiologic activity). There is persistent hyperthermia over the posterolateral cervical neck regions bilaterally, which suggests myofascial dysfunction. There are no thermal findings to indicate TMJ dysfunction.

CHEST:
There are persistent areas of hyperthermia over the upper chest, specifically the pectoralis and deltoid musculature bilaterally, and both shoulder regions. These findings may represent myofascial dysfunction and/or joint inflammation. There are no thermal findings to suggest cardiac dysfunction.

BREAST:
There are some thermal changes seen in this four-month follow-up study compared to the study dated 09/02/2014. Both breasts, R>L, continue to exhibit a cool pattern. In the right breast, thermal patterns and temperature differentials have remained very stable. In the left breast, there has been a moderate increase in the intensity of the reticulate pattern of hyperthermia present in the upper quadrants. While there is no specific indication of neovascularity, early angiogenesis cannot be excluded. This study is suitable to be archived for future comparative analysis. However, a stable baseline has not been established. The hyperthermia present in both axillary regions, L>R, may represent lymphatic congestion.

BACK:
There are persistent areas of hyperthermia over the posterior deltoid, trapezius, rhomboid, supraspinatus, infraspinatus and latissimus dorsi musculature bilaterally, R>L, which suggest myofascial dysfunction. There is persistent hyperthermia involving the thoracic and lumbar spines, with associated hyperthermia over the paraspinal musculature and both lumbar triangles, R>L. These findings may relate to joint inflammation and myofascial dysfunction, respectively. There are no thermal findings to suggest cardiac or pulmonary dysfunction.

ABDOMEN:
There is increased hyperthermia over the distal sternum and epigastrium, which may represent gastroesophageal dysfunction. Note that costochondritis cannot be excluded. There are persistent areas of hyperthermia over the ascending, transverse and descending colons, which suggest inflammation and raise the question of irritable bowel syndrome (IBS). The above findings may relate to the reported symptoms. There is persistent hyperthermia over both anterior iliac crests, which may represent myofascial dysfunction and/or hip joint inflammation.

UPPER EXTREMITIES:
There are persistent areas of hyperthermia over the deltoid musculature bilaterally, which suggest myofascial dysfunction and/or shoulder joint inflammation. There is persistent hypothermia in both hands, which raises the question of an autonomic dysfunction (possible Raynaud’s phenomenon).

DISCUSSION:

The thermal findings relating to right breast physiology remain within normal limits for this patient and are considered at low risk for developing pathology. The thermal findings in the left breast should be considered at increased risk for active or developing pathology until clinical evaluation confirms fibrocystic nature and rules out malignant pathology. Note that all discrete breast masses should warrant clinical evaluation. The thermal findings over the sinuses may represent inflammation. The thermal findings in the oral region suggest dental/periodontal pathology. Dental issues, if left untreated, can possibly develop into smouldering subclinical infections creating a milieu for chronic inflammation. This can lead to a number of chronic diseases, i.e., cardiovascular, fibromyalgia, CFS, thyroid gland issues, gastrointestinal challenges and breast health issues. The thermal findings in the anterior neck may represent thyroid gland dysfunction. If clinical symptoms are present, then consider sensitive and specific thyroid function tests: TSH, Free T3, Free T4, Thyroglobulin Antibodies and Thyroid Peroxidase Antibodies. The thermal findings over the carotid arteries may relate to inflammation and elevated CRP levels. Further investigation may be warranted. The thermal findings over the distal sternum and epigastrium raise the question of gastroesophageal dysfunction.

The thermal findings over the abdomen suggest stomach and colon dysfunction. The thermal findings in the forehead, neck, back, chest, shoulders and pelvis suggest myofascial dysfunction. The thermal findings over the thoracolumbar spine may represent joint inflammation. The glove-like hypothermia may represent an autonomic dysfunction. The circumoral hyperthermia, along with the hyperthermia over the sinuses, may also represent a neurogenic flare, which can be seen in fibromyalgia-like syndromes. The latter two patterns indicating a possible autonomic dysfunction would suggest the individual’s immune system is chronically activated. Contributing factors could include food allergies, pro-inflammatory diet, dental pathology, hormonal imbalances/deficiencies, hypoadrenia/chronic stress, heavy metal toxicity, low-grade chronic infection and systemic illness.

FOLLOW-UP:

Suggest clinical correlation of thermal findings with patient’s history and symptoms. Recommend timely clinical evaluation of the thermal findings in the left breast. Consider thermographic breast imaging in three months to monitor stability. Clinical Impression with Thermography Breast Imaging-Reporting and Data System (T BI-RADS)

Left Breast: At Increased Risk
Right Breast: At Low Risk 

—————————————————————

CLASSIFICATION KEY:

Within normal Limits (Normal)
This indicates a normal thermal profile with no thermal findings consistent with risk for disease or other developing pathology. Normal thermal contours, statistical analysis and differentials are recorded. Annual comparative follow-up is recommended after a stable baseline has been established.

At Low Risk (Non Suspicious)
This indicates low grade thermal activity which is not suspicious for serious pathology. Thermal findings may be associated with benign changes such as glandular hyperplasia, fibrocystic tissue and the development of cysts and fibroadenomas. Annual comparative follow-up is recommended after a stable baseline has been established but more frequent follow-up may be clinically indicated. This does not rule out existing non-active or encapsulated tumours.

At Some risk (Equivocal)
These findings indicate thermal activity likely to represent benign changes such as inflammation, acute cysts or fibroadenoma, infection, or even normal personal variant. Clinical correlation is indicated with any associated history or symptoms. Other objective means of evaluating the breasts may be justified.

 At Increased Risk (Abnormal)
This represents a significant risk for existing or developing malignant breast disease. Benign pathology or personal variant cannot be ruled out but is less likely. Clinical correlation is justified and objective evaluation and additional testing is indicated. A follow-up thermal study in 3 months should be part of a comprehensive testing panel.

At high Risk (Suspicious)
This represents a high risk of confirming malignant breast disease. Benign processes or personal variant are very unlikely. Urgent clinical correlation is indicated with a comprehensive panel of testing and evaluation with all possible alacrity. A follow-up thermal study in 3 months should be a part of this evaluation.

Previously Confirmed Malignancy
This represents a current diagnosis of malignant pathology in the patients history. Thermography will not show any cancers from a structural or pathological perspective. It will show positive physiological findings in 83% of malignancy (specificity), leaving 17% of cancers that present as thermographically silent due to the type of pathology, long term cancer which the body has accommodated or encapsulation and age of patient. The utility for including thermography as an adjunctive screening test in previously confirmed malignancy is for the establishment of a baseline and detection of any physiological change over time, correlation with other tests and the monitoring of response to treatment. Breast thermography screening is an adjunctive test to mammography, ultrasound and MRI and is a specialised physiological test designed to detect angiogenesis, hyperthermia from nitric oxide, oestrogen dominance, lymph abnormality and inflammatory processes including inflammatory breast disease, all of which cannot be detected with structural tests. Follow-up and interval screening of less than 12 months should be determined by patients healthcare professional as considered appropriate.

PROCEDURE:
This patient was examined with digital infrared thermal imaging to identify thermal findings which may suggest abnormal physiology. Thermography is a physiologic test, which demonstrates thermal patterns in skin temperature that may be normal or which may indicate disease or other abnormality. If abnormal heat patterns are identified relating to a specific region of interest or function, clinical correlation and further investigation may be necessary to assist your health care provider in diagnosis and treatment. Thermal imaging is an adjunctive test, which contributes to the process of differential diagnosis, and is not independently diagnostic of pathology. Breast thermography is a way of monitoring breast health over time. Every woman has a unique thermal pattern that should not change over time, like a fingerprint. The purpose of the two initial breast studies (usually obtained three months apart) is to establish the baseline pattern for each patient to which all future thermograms are compared to monitor stability. With continued breast health, the thermograms remain identical to the initial study. Changes may be identified on follow up studies that could represent physiological differences within the breast that warrant further investigation. The ability to interpret the first breast study is limited since there are no previous images for comparison. This exam is an adjunctive diagnostic procedure and all interpretive findings must be clinically correlated. DITI is not a substitute for mammography.

PROTOCOLS:
The thermographer certifies that this exam was conducted under standard and clinically acceptable protocols.

PATIENT HISTORY:
The interpretation represents objective descriptions of thermal patterns. Clinical significance of such patterns is interpreted in relation to and limited by the patient data and history provided.

REPORTING:
Results are reported by certified thermologists. Results are determined by studying the varying patterns and temperature differentials as recorded in the thermal images.

NORMAL FINDINGS:
Normal findings are diffuse thermal patterns with good symmetry between similar regions on both sides of the body. Comparative imaging may identify specific asymmetries that have remained stable and unchanged over time and therefore regarded as normal.

ABNORMAL FINDINGS:
Abnormal findings may be localised areas of hyperthermia or hypothermia, or thermal asymmetry between similar regions on both sides of the body with temperature differentials of more than 1° C. There may be vascular patterns that suggest pathology. Comparative imaging may identify specific changes or new asymmetries that warrant further investigation.