Research Archive

In order to further promote research and help people research their own conditions, we have put together a research archive – a collection of freely available research papers and articles on breast-health and scientific studies of breast cancer related issues.

We have provided an abstract of each and a link to the source. In some cases the full article is only accessible to academics or members – we leave it up to you to apply for the full article through the channels provided at the source.

Please click on the title below

+ Angiogenesis - evidence that tumors are angiogenesis dependent

Abstract
More than 30 years ago, Judah Folkman found a revolutionary new way to think about cancer. He postulated that in order to survive and grow, tumors require blood vessels, and that by cutting off that blood supply, a cancer could be starved into remission. What began as a revolutionary approach to cancer has evolved into one of the most exciting areas of scientific inquiry today. Over the years, Folkman and a growing team of researchers have isolated the proteins and unraveled the processes that regulate angiogenesis. Meanwhile, a new generation of angiogenesis research has emerged as well, widening the field into new areas of human disease and deepening it to examine the underlying biological processes responsible for those diseases.

Link to full article: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2268723/

+ Breast cancer and radiofrequency exposure

Abstract

Besides some epidemiological studies, such as one showing a significant increase in breast cancer for female radio operators, there is evidence that breast cancer tumors absorb significantly more EMR than other cancers, or healthy tissue. To quote from one study, conducted at Duke University, North Carolina, USA, in 1993.

“In general, at all frequencies tested [50 to 900 MHz], both conductivity and relative permittivity were greater in malignant tissue than in normal tissue of the same type. For tissues of the same type, the differences in electrical properties from normal to malignant were least for kidney (about 6% and 4% average differences over the frequency range in permittivity and conductivity, respectively), and these differences were the greatest for mammary gland (about 233% and 577% average differences in permittivity and conductivity, respectively) “(27)

Link to full article: http://www.emfacts.com/2005/11/breast-cancer-and-microwaves/

+ Biopsy - Accuracy of digital infrared imaging for breast cancer detection in women undergoing breast biopsy

Abstract
BACKGROUND:
Mammography has a lower sensitivity for breast cancer detection in younger women and those with dense breasts. Recent improvements in digital infrared breast imaging suggest there may be a role for this technology and we have studied its performance in 100 women prior to breast needle core biopsy (CB).
METHODS:
All patients were imaged using a digital infrared breast (DIB) scan (Sentinel BreastScan) prior to breast biopsy. Analysis of the infrared scans was performed, blinded to biopsy results, in four different ways: Sentinel screening report, Sentinel artificial intelligence (neural network), expert manual review and NoTouch BreastScan a novel artificial intelligence programme.
RESULTS:
Of 106 biopsies performed in 100 women, 65 were malignant and 41 were benign. Sensitivity of Sentinel screening (53%) and Sentinel neural network (48%) was low but analysis with NoTouch software (70%) was much closer to expert manual review (78%). Sensitivity (78%) and specificity (75%) using NoTouch BreastScan were higher in women under 50 and the combination of mammography and DIB, with NoTouch interpretation, in this age group resulted in a sensitivity of 89%.
CONCLUSION:
DIB using NoTouch is an effective adjunctive test for breast cancer detection in women under 70 and appears to be particularly effective in women under 50 where maximal sensitivity (78%) and specificity (75%) were observed. The combined sensitivity of NoTouch BreastScan and mammography in women under 50 was encouraging at 89%, suggesting a potential way forward for a dual imaging approach in this younger age group.

Source: http://www.ncbi.nlm.nih.gov/pubmed/?term=20452740

+ Cancer - Natural Killer Cells: From Biological Functions to Clinical Applications

Abstract
Natural killer (NK) cells are central components of the innate immunity. In murine models, it has been shown that NK cells can control both local tumour growth and metastasis due to their ability to exert direct cellular cytotoxicity without prior sensitization and to secrete immunostimulatory cytokines like IFN-γ. The latter participates in cancer elimination by inhibiting cellular proliferation and angiogenesis, promoting apoptosis, and stimulating the adaptive immune system, and it is instrumental for enhancing Ag processing and presentation. Nevertheless, NK cells display impaired functionality and capability to infiltrate tumours in cancer patients. Also, NK cells are feasible targets of stimulation to participate in immunotherapeutic approaches like antibody-based strategies and adoptive cell transfer. Thus, multiple attempts currently aim to manipulate NK for utilization in the immunotherapy of cancer.

Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3085499

+ Cancer Research uk - How many stages of cancer are there?

Abstract
It depends on which cancer you are talking about and which staging system the doctor is using. Some types of cancer have more than one type of staging system.

Most types of cancer have 4 stages, numbered from 1 to 4. Often doctors write the stage down in roman numerals. So you may see stage 4 written down as stage IV.

Link to full article: http://www.cancerresearchuk.org/about-cancer/cancers-in-general/cancer-questions/how-many-stages-of-cancer-are-there

+ Chemotherapy - contribution of cytotoxic chemotherapy to 5-year survival in adult malignancies

Aims:
The debate on the funding and availability of cytotoxic drugs raises questions about the contribution of curative or adjuvant cytotoxic chemotherapy to survival in adult cancer patients.

Materials and methods:
We undertook a literature search for randomised clinical trials reporting a 5-year survival benefit attributable solely to cytotoxic chemotherapy in adult malignancies. The total number of newly diagnosed cancer patients for 22 major adult malignancies was determined from cancer registry data in Australia and from the Surveillance Epidemiology and End Results data in the USA for 1998. For each malignancy, the absolute number to benefit was the product of (a) the total number of persons with that malignancy; (b) the proportion or subgroup(s) of that malignancy showing a benefit; and (c) the percentage increase in 5-year survival due solely to cytotoxic chemotherapy. The overall contribution was the sum total of the absolute numbers showing a 5-year survival benefit expressed as a percentage of the total number for the 22 malignancies.

Results:
The overall contribution of curative and adjuvant cytotoxic chemotherapy to 5-year survival in adults was estimated to be 2.3% in Australia and 2.1% in the USA.

Conclusion:
As the 5-year relative survival rate for cancer in Australia is now over 60%, it is clear that cytotoxic chemotherapy only makes a minor contribution to cancer survival. To justify the continued funding and availability of drugs used in cytotoxic chemotherapy, a rigorous evaluation of the cost-effectiveness and impact on quality of life is urgently required.

Source: http://www.ncbi.nlm.nih.gov/pubmed/15630849

+ DCIS - Rethinking the Standard for DCIS Treatment

The original goal of mammographic screening was to identify invasive cancers at the earliest stage, because of the superior prognosis of stage I cancers. Prior to the advent of screening, ductal carcinoma in situ (DCIS) made up approximately 3% of breast cancers detected. As we pushed to find smaller and smaller cancers, and targeted calcifications instead of just masses, we began to identify DCIS more frequently. Now DCIS accounts for approximately 20% to 25% of screen-detected breast cancers. The cells that make up DCIS look like invasive cancer both pathologically and molecularly, and therefore the presumption was made that these lesions were the precursors of cancer and that early removal and treatment would reduce cancer incidence and mortality. However, long-term epidemiology studies have demonstrated that the removal of 50 000 to 60 000 DCIS lesions annually has not been accompanied by a reduction in the incidence of invasive breast cancers. This is in contrast to the experience with removal of colonic polyps and intraepithelial neoplasia lesions of the cervix, in which the removal of precursor lesions has led to a decrease in the incidence of colon and cervical cancer, respectively. We now know that breast cancer encompasses a range of behaviors, from aggressive to indolent; the latter are more likely to surface with screening. The analysis of Narod et al fuels a growing concern that we should rethink our strategy for the detection and treatment of DCIS.

Full article: http://oncology.jamanetwork.com/article.aspx?articleID=2427488

+ HCG Urine Immunoassay - accurate screening test for Cancer

Abstract
Developed in the late 1950s, by the renowned oncologist, the late Dr. Manuel D. Navarro, the test detects the presence of cancer cells even before signs or symptoms develop. Dr. Navarro found HCG to be present in all types of cancers. The test is based on a theory proposed by Howard Beard and other researchers who contend that cancer is related to a misplaced trophoblastic cell that become malignant in a manner similar to pregnancy in that they both secrete HCG. As a consequence, a measure of the amount of HCG found in the blood or urine is also a measure of the degree of malignancy. The higher the number, the greater is the severity of cancer.

Link to full article: http://navarromedicalclinic.com/

+ Ionising Radiation - used by Mammography

Ionizing radiation is any form of radiation with enough energy to break off electrons from atoms (that is, to ionize the atoms). This radiation can break the chemical bonds in molecules, including DNA molecules, thereby disturbing their normal functioning. X-rays and gamma rays are the only common forms of radiation with sufficient energy to penetrate and damage body tissue below the surface of the skin.

Source: www.breastcancerfund.org – Continue reading

+ Lymph node surgery for breast cancer has no benefit

Abstract
A recent study with lasting affect on the guardians of the status quo in breast cancer care and treatment has found that lymph node surgery for women provides no benefit. In women who had early breast cancer which had spread to their lymph nodes, removing them does not improve their survival rate or prevent the further spreading of cancer. Unfortunately, this painful and lucrative procedure of removing lymph nodes has long been routine for breast cancer patients.

Link to full article: http://alignlife.com/articles/womenshealth/lymph-node-surgery-breast-cancer-benefit

+ Mammography - Twenty five year follow-up for breast cancer incidence and mortality

Abstract
Objective To compare breast cancer incidence and mortality up to 25 years in women aged 40-59 who did or did not undergo mammography screening.

Design
Follow-up of randomised screening trial by centre coordinators, the study’s central office, and linkage to cancer registries and vital statistics databases.

Setting
15 screening centres in six Canadian provinces,1980-85 (Nova Scotia, Quebec, Ontario, Manitoba, Alberta, and British Columbia).

Participants
89 835 women, aged 40-59, randomly assigned to mammography (five annual mammography screens) or control (no mammography).

Interventions
Women aged 40-49 in the mammography arm and all women aged 50-59 in both arms received annual physical breast examinations. Women aged 40-49 in the control arm received a single examination followed by usual care in the community.

Main outcome measure
Deaths from breast cancer.

Results
During the five year screening period, 666 invasive breast cancers were diagnosed in the mammography arm (n=44 925 participants) and 524 in the controls (n=44 910), and of these, 180 women in the mammography arm and 171 women in the control arm died of breast cancer during the 25 year follow-up period. The overall hazard ratio for death from breast cancer diagnosed during the screening period associated with mammography was 1.05 (95% confidence interval 0.85 to 1.30). The findings for women aged 40-49 and 50-59 were almost identical. During the entire study period, 3250 women in the mammography arm and 3133 in the control arm had a diagnosis of breast cancer, and 500 and 505, respectively, died of breast cancer. Thus the cumulative mortality from breast cancer was similar between women in the mammography arm and in the control arm (hazard ratio 0.99, 95% confidence interval 0.88 to 1.12). After 15 years of follow-up a residual excess of 106 cancers was observed in the mammography arm, attributable to over-diagnosis.
Conclusion Annual mammography in women aged 40-59 does not reduce mortality from breast cancer beyond that of physical examination or usual care when adjuvant therapy for breast cancer is freely available. Overall, 22% (106/484) of screen detected invasive breast cancers were over-diagnosed, representing one over-diagnosed breast cancer for every 424 women who received mammography screening in the trial.

Source: http://www.bmj.com/content/348/bmj.g366

+ Mammography - Effect of 3 Decades of Mammography on Breast-Cancer Incidence

BACKGROUND
To reduce mortality, screening must detect life-threatening disease at an earlier, more curable stage. Effective cancer-screening programs therefore both increase the incidence of cancer detected at an early stage and decrease the incidence of cancer presenting at a late stage.

METHODS
We used Surveillance, Epidemiology, and End Results data to examine trends from 1976 through 2008 in the incidence of early-stage breast cancer (ductal carcinoma in situ and localized disease) and late-stage breast cancer (regional and distant disease) among women 40 years of age or older.

RESULTS
The introduction of screening mammography in the United States has been associated with a doubling in the number of cases of early-stage breast cancer that are detected each year, from 112 to 234 cases per 100,000 women — an absolute increase of 122 cases per 100,000 women. Concomitantly, the rate at which women present with late-stage cancer has decreased by 8%, from 102 to 94 cases per 100,000 women — an absolute decrease of 8 cases per 100,000 women. With the assumption of a constant underlying disease burden, only 8 of the 122 additional early-stage cancers diagnosed were expected to progress to advanced disease. After excluding the transient excess incidence associated with hormone-replacement therapy and adjusting for trends in the incidence of breast cancer among women younger than 40 years of age, we estimated that breast cancer was overdiagnosed (i.e., tumors were detected on screening that would never have led to clinical symptoms) in 1.3 million U.S. women in the past 30 years. We estimated that in 2008, breast cancer was overdiagnosed in more than 70,000 women; this accounted for 31% of all breast cancers diagnosed.

CONCLUSIONS
Despite substantial increases in the number of cases of early-stage breast cancer detected, screening mammography has only marginally reduced the rate at which women present with advanced cancer. Although it is not certain which women have been affected, the imbalance suggests that there is substantial overdiagnosis, accounting for nearly a third of all newly diagnosed breast cancers, and that screening is having, at best, only a small effect on the rate of death from breast cancer.

Source: http://www.nejm.org/doi/full/10.1056/NEJMoa1206809

+ Screening - Benefits and harms of screening for cancer with a focus on breast screening

Abstract
The balance between benefits and harms is delicate for cancer screening programs. By attending screening with mammography some women will avoid dying from breast cancer or receive less aggressive treatment. But many more women will be overdiagnosed, receive needless treatment, have a false-positive result, or live more years as a patient with breast cancer. Systematic reviews of the randomized trials have shown that for every 2000 women invited for mammography screening throughout 10 years, only 1 will have her life prolonged. In addition, 10 healthy women will be overdiagnosed with breast cancer and will be treated unnecessarily. Furthermore, more than 200 women will experience substantial psychosocial distress for months because of false-positive findings. Regular breast self-examination does not reduce breast cancer mortality, but doubles the number of biopsies, and it therefore cannot be recommended. The effects of routine clinical breast examination are unknown, but considering the results of the breast self-examination trials, it is likely that it is harmful. The effects of screening for breast cancer with thermography, ultrasound or magnetic resonance imaging are unknown. It is not clear whether screening with mammography does more good than harm. Women invited to screening should be informed according to the best available evidence, data should be reported in absolute numbers, and benefits and harms should be reported using the same denominator so that they can be readily compared.

Source: http://www.ncbi.nlm.nih.gov/pubmed/?term=20332715

+ Screening - Breast cancer: new technologies for risk assessment and diagnosis

Abstract
In the US, one in every eight women will develop breast cancer in her lifetime. Despite the advances made in treating breast cancer, the causal mechanisms underlying this disease have yet to be fully elucidated; 85% of breast cancer cases occur sporadically without any known genetic mutation. Too little is known about the pathogenesis of breast cancer for primary prevention to be feasible in the near- to mid-term. Secondary prevention through screening offers an alternative that has been widely adopted. For decades, breast self-examination has been touted as a technique for the early identification of breast cancer. However, it has been recently suggested that this technique is a waste of time and resources for both doctors and patients. Mammography finds breast cancer earlier than breast self-examination, and will reduce the risk of death from breast cancer by approximately 30% in women over 50 years old. Mammography is limited in that cancer, like breast tissue, appears white on the x-ray; therefore lesions may be difficult to detect in women with very dense breasts, and a tumor may not cast a significant shadow until it is quite large. Some cancers are so aggressive that they can spread quickly, before routine screening can detect them. Despite these limitations, mammography is still viewed as the best tool currently available for screening and early diagnosis. Improved methods to detect and diagnose breast cancer early, when it is most curable, are required if a significant impact on morbidity and mortality from breast cancer is to be made. Various new and innovative technologies are being investigated for improving the early detection and diagnosis of breast cancer. About 85% of breast cancers begin in the milk ductal system of the breast. As cancer develops in the breast, abnormalities occur, including atypical hyperplasia, ductal carcinoma in situ, and invasive breast carcinoma. Thus, the early screening of ductal cells can provide a parallel benefit to the ‘Pap’ smear, which is used virtually universally to identify the abnormal cells that can lead to cervical cancer. Two technologies to monitor for atypical ductal epithelial cells are Cytyc Corporation’s FirstCyte Ductal Lavage system and Nastech Pharmaceutical Company’s Mammary Aspiration Cytology Test. Matritech, Inc. is searching for biomarkers linked to breast cancer. Researchers at Matritech have detected the presence of nuclear matrix protein (NMP) in the blood of women at the early stage of breast cancer, which is absent in the blood of healthy women, as well as those with fibroadenoma, a benign breast disease. NMP66 has been selected as a marker for further development and clinical trials of a test for use in the detection and monitoring of women with, or at risk for, breast cancer have been initiated. Technologies developed by the US Department of Defense are under investigation as breast cancer screening. Advanced Image Enhancement, Inc. has licensed naval sonar technology for digital image enhancement of mammograms. New thermography applications are also being investigated in two separate projects sponsored by the US Department of Defense using military thermal surveillance tools adapted for cancer detection. Both are enhancements of older thermal imaging technology based on the principle that heat equates to unwanted activity, in the case of breast cancer, abnormal cell proliferation.

Source: http://www.ncbi.nlm.nih.gov/pubmed/?term=14529321

+ Screening - Combination of thermographic and ultrasound methods for the diagnosis of breast cancer

Abstract
The experiment leads to the formulation of a non-invasive and highly efficient method for the detection of the female breast cancer. The proposed method is a combination of the results of ultrasound and thermography tests of the breast. The study is expected to produce the principles of test results analysis offering a 90% success rate in detecting breast cancer.

Source: http://www.ncbi.nlm.nih.gov/pubmed/?term=8200367

+ Screening - Comparative study of analytical software identifying different stages of breast cancer using temperature data.

Abstract
Breast cancer is the second leading cause of death in women. It occurs when cells in the breast begin to grow out of control and invade nearby tissues or spread throughout the body. The limitations of mammography as a screening modality, especially in young women with denser breasts, necessitated the development of novel and more effective screening strategies with acceptable sensitivity and specificity. The aim of this study was to develop a feasible interpretive software system which was able to detect and classify breast cancer patients by employing techniques of different analytical software. The protocol described uses 6,000 pieces of thermal data collected from 16-sensors, eight placed on the surface of each breast. Data was collected every 5 min for the duration of the test period. Placement of sensors was accomplished with the use of a template design from information provided by the national tumor registry to insure that the information was collected in areas of the breast where most breast cancers develop. Data in this study was collected from 90 individuals exhibiting four different breast conditions, namely: normal, benign, cancer and suspected-cancer. The temperature data collected from these 16 sensors placed on the surface of each breast were fed as inputs to the classifiers. Comparisons were made on five different kinds of classifiers: back-propagation algorithm, probabilistic neural network, fuzzy (Sugeno-type), Gaussian mixture modeland support vector machine. These classifiers were able to attain approximately 80% accuracy in classifying the four different diagnoses (normal, benign, cancer and suspected-cancer). Gaussian mixture model was the most sensitive classifier, achieving the highest sensitivity of 94.8%. Support vector machine was considered the best classifier as it was able to produce the most specific and accurate results. Based on these evaluations, this current effort shows the feasibility of applying analytical software techniques together with the real-time functional thermal analysis to develop a potential tool for the detection and classification of breast cancer.

Source: http://www.ncbi.nlm.nih.gov/pubmed/?term=19397099

+ Screening - Progress in screening methods for early breast cancer

Abstract
Ten years have now passed since the American Cancer Society/National Cancer Institute sponsored Breast Cancer Detection Demonstration Projects (BCDDP) started to evaluate the use of mammography, physical examination, thermography, and breast self-examination in screening women for the presence of unsuspected breast cancer. Criteria have been developed to evaluate population screening as an approach to cancer control and breast cancer screening techniques. Combined physical examination and mammography have been particularly successful in detecting early breast cancer. Although the number of screening programs for breast cancer has increased in the past decade, real progress has been surprisingly slow and the issues in breast cancer screening have proved to be subtle and complex.

Source: http://www.ncbi.nlm.nih.gov/pubmed/?term=4079432

+ Thermography - Advanced integrated technique in breast cancer thermography

Abstract
Thermography is a passive and non-contact imaging technique used extensively in the medical arena, but in relation to breast care, it has not been accepted as being on a par with mammography. This paper proposes the analysis of thermograms with the use of artificial neural networks (ANN) and bio-statistical methods, including regression and receiver operating characteristics (ROC). It is desired that through these approaches, highly accurate diagnosis using thermography techniques can be achieved. The suggested method is a multi-pronged approach comprising of linear regression, radial basis function network (RBFN) and ROC analysis. It is a novel, integrative and powerful technique that can be used to analyse large amounts of complicated measured data such as temperature values extracted from abnormal and healthy breast thermograms. The use of regression allows the correlation between the variables and the actual health status of the subject, which is decided by other traditional means such as the gold standard of mammography for breast cancer detection. This is important as it helps to select the appropriate variables to be used as inputs for building the neural network. RBFN is next trained to produce the desired outcome that is either positive or negative. When this is done, the RBFN possess the ability to predict the outcome when there are new input variables. The advantages of using RBFN include fast training of superior classification and decision-making abilities as compared to other networks such as backpropagation. Lastly, ROC is applied to evaluate the sensitivity, specificity and accuracy of the outcome for the RBFN test files. The proposed technique has an accuracy rate of 80.95%, with 100% sensitivity and 70.6% specificity in identifying breast cancer. The results are promising as compared to clinical examination by experienced radiologists, which has an accuracy rate of approximately 60-70%. To sum up, technological advances in the field of infrared thermography over the last 20 years warrant a re-evaluation of the use of high-resolution digital thermographic camera systems in the diagnosis and management of breast cancer. Thermography seeks to identify the presence of a tumour by the elevated temperature associated with increase blood flow and cellular activity. Of particular interest would be investigation in younger women and men, for whom mammography is either unsuitable or of limited effectiveness. The paper evaluated the high-definition digital infrared thermographic technology and knowledge base; and supports the development of future diagnostic and therapeutic services in breast cancer imaging. Through the use of integrative ANN and bio-statistical methods, advances are made in thermography application with regard to achieving a higher level of consistency. For breast cancer care, it has become possible to use thermography as a powerful adjunct and biomarker tool, together with mammography for diagnosis purposes.

Source: http://www.ncbi.nlm.nih.gov/pubmed/17852648

+ Thermography - Association of infrared imaging findings of the breast with hormone receptor and human epidermal growth factor receptor 2 status of breast cancer.

Abstract
RATIONALE AND OBJECTIVES:
Evidence on breast infrared (IR) imaging and its association with estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) statuses of breast cancers is limited. The aim of this study was to investigate the association of IR imaging findings and ER, PR, and HER2 status in breast cancers.
MATERIALS AND METHODS:
A total of 163 women with 171 pathologically proven breast cancers underwent IR imaging of the breast before surgery. Five IR signs were used to score the lesions: IR1, the temperature difference (ΔT) of the lesion site from that of the contralateral mirror image site; IR2, ΔT of the lesion site from that of the adjacent normal breast tissue in the same breast; IR3, abnormal vascular morphologic patterns; IR4, focal bulge or edge sign with back heat at the lesion site; and IR5, asymmetric thermographic pattern between the lesion site and the contralateral breast. The association of different IR signs with ER, PR, and HER2 status was evaluated using Fisher’s exact test.
RESULTS:
IR1 was inversely associated with ER (P = .010) and PR status (P = .039). IR2 was inversely related to PR status (P = .020). IR5 was inversely associated with ER (P = .037) and PR (P = .022) status. No IR sign was associated with HER2 status. Triple-negative (ER-negative, PR-negative, and HER2-negative) cancers tended to show higher IR1 scores compared to other types of cancers (P = .029).
CONCLUSION:
Breast IR findings were associated with ER and PR status of breast cancers. Triple-negative cancers more frequently featured higher IR1 scores than other types of cancers.

Source: http://www.ncbi.nlm.nih.gov/pubmed/?term=21126889

+ Thermography - Breast thermography is a noninvasive prognostic procedure that predicts tumour growth rate.

Abstract
Our recent retrospective analysis of the clinical records of patients who had breast thermography demonstrated that an abnormal thermogram was associated with an increased risk of breast cancer and a poorer prognosis for the breast cancer patient. This study included 100 normal patients, 100 living cancer patients, and 126 deceased cancer patients. Abnormal thermograms included asymmetric focal hot spots, areolar and periareolar heat, diffuse global heat, vessel discrepancy, or thermographic edge sign. Incidence and prognosis were directly related to thermographic results: only 28% of the noncancer patients had an abnormal thermogram, compared to 65% of living cancer patients and 88% of deceased cancer patients. Further studies were undertaken to determine if thermography is an independent prognostic indicator. Comparison to the components of the TNM classification system showed that only clinical size was significantly larger (p = 0.006) in patients with abnormal thermograms. Age, menopausal status, and location of tumor (left or right breast) were not related to thermographic results. Progesterone and estrogen receptor status was determined by both the cytosol-DCC and immunocytochemical methods, and neither receptor status showed any clear relationship to the thermographic results. Prognostic indicators that are known to be related to tumor growth rate were then compared to thermographic results. The concentration of ferritin in the tumor was significantly higher (p = 0.021) in tumors from patients with abnormal thermograms (1512 +/- 2027, n = 50) compared to tumors from patients with normal thermograms (762 +/- 620, n = 21). Both the proportion of cells in DNA synthesis (S-phase) and proliferating (S-phase plus G2M-phase, proliferative index) were significantly higher in patients with abnormal thermograms. The expression of the proliferation-associated tumor antigen Ki-67 was also associated with an abnormal thermogram. The strong relationships of thermographic results with these three growth rate-related prognostic indicators suggest that breast cancer patients with abnormal thermograms have faster-growing tumors that are more likely to have metastasized and to recur with a shorter disease-free interval.

Source: http://www.ncbi.nlm.nih.gov/pubmed/?term=8279754

+ Thermography - Consistency of thermographic findings in the breast

Abstract
Thermography is a valuable complementary method in breast examination, but is not a suitable screening method. However, the results of control investigations in 200 females who were reexamined after at least two years, showed no change in the thermographic pattern in 87.5% of the women. In 10.5% the change in thermogram was due to pathological changes, whilst no explanation could be found in only 2% of cases.

This high stability rate of the thermograms permits an alternative procedure: If, one year after a basic examination which includes clinical investigation, mammography and thermography, the thermographic pattern is identical with the first, no mammography is necessary. On the occasion of the next control, mammography should be carried out again at the time of the subsequent control examination. This schedule permits a reduction in irradiation without reducing the security of diagnosis.

Source: http://www.ncbi.nlm.nih.gov/pubmed/?term=6636786

+ Thermography - Detecting early breast tumour by finite element thermal analysis.

Abstract
Thermography has been proved to be an effective technique for indicating breast disease abnormalities or risks. However, the abnormalities might not express clearly due to various factors, such as when a small tumour is located in a deep region, or environmental influences that make breast disease difficult to find. This study aims to solve these problems for early detection of breast tumour. A three-dimensional breast model is presented to investigate the relationship between an embedded tumour and the surface temperature distribution. Then a subtraction technique is used to enhance the thermal signature of breast tumour. It was showed that the surface thermal characteristics of a small tumour even in a deep region could be found easily by this method. Furthermore, it was also found that the surface thermal characteristics of tumour obscured due to environmental cooling effect can be clearly displayed. The results are very useful for analysing breast thermograms.

Source: http://www.ncbi.nlm.nih.gov/pubmed/?term=19384702

+ Thermography - Dynamic infrared imaging-based diagnostic process for breast cancer

Abstract
BACKGROUND:
Dynamic infrared (IR) imaging is an emerging functional imaging modality for the detection of breast cancer without evidence of optimal imaging and diagnostic application.
PURPOSE:
To evaluate dynamic IR imaging in breast cancer diagnostics by comparing a stepwise diagnostic scheme to digital mammography and postoperative histopathology.
MATERIAL AND METHODS:
Dynamic IR imaging of breasts was undertaken preoperatively with a long-wave quantum well (QWIP) and two mid-wave photovoltaic (PV) IR cameras in 10 cases (age 34-80 years) with breast cancer size 6-45 mm on mammography. Image stabilization, two-phase frequency analysis, and two image-processing algorithms were applied.
RESULTS:
Combining image processing with frequency analysis proved advantageous in detecting breast cancer. The IR imaging process recognized the cancer area independently of tissue density, cancer size, and cancer appearance on mammography. Compared to histopathology, all cancers yielded abnormal analysis results, including one case of ductal carcinoma in situ. Evidence of lymphatic invasion in postoperative histopathology, imaging with PV camera, and image processing with the Wiener filtering combination correlated with highest confidence between normal and cancer tissue measured by the calculated superiority value.
CONCLUSION:
Dynamic IR imaging with image-processing-guided frequency analysis is a promising modality for breast cancer detection and may not have the tissue-dependent limitations of mammography. Our results encourage further work on medical IR imaging and comparison to established breast-imaging modalities.

Source: http://www.ncbi.nlm.nih.gov/pubmed/?term=19636984

+ Thermography - Effectiveness of a digital infrared thermal imaging system in the detection of breast cancer.

Abstract
BACKGROUND:
Digital infrared thermal imaging (DITI) has resurfaced in this era of modernized computer technology. Its role in the detection of breast cancer is evaluated.
METHODS:
In this prospective clinical trial, 92 patients for whom a breast biopsy was recommended based on prior mammogram or ultrasound underwent DITI. Three scores were generated: an overall risk score in the screening mode, a clinical score based on patient information, and a third assessment by artificial neural network.
RESULTS:
Sixty of 94 biopsies were malignant and 34 were benign. DITI identified 58 of 60 malignancies, with 97% sensitivity, 44% specificity, and 82% negative predictive value depending on the mode used. Compared to an overall risk score of 0, a score of 3 or greater was significantly more likely to be associated with malignancy (30% vs 90%, P < .03).
CONCLUSION:
DITI is a valuable adjunct to mammography and ultrasound, especially in women with dense breast parenchyma.

Source: http://www.ncbi.nlm.nih.gov/pubmed/?term=18809055

+ Thermography - Feasible method for screening breast cancer?

Abstract
Potential use of thermography for more effective detection of breast carcinoma was evaluated on 26 patients scheduled for breast carcinoma surgery. Ultrasonographic scan, mammography and thermography were performed at the University Hospital for Tumors. Thermographic imaging was performed using a new generation of digital thermal cameras with high sensitivity and resolution (ThermoTracer TH7102WL, NEC). Five images for each patient were recorded: front, right semi-oblique, right oblique, left- semi oblique and left oblique. While mammography detected 31 changes in 26 patients, thermography was more sensitive and detected 6 more changes in the same patients. All 37 changes were subjected to the cytological analysis and it was found that 16 of samples were malignant, 8 were suspected malignant and 11 were benign with atypia or proliferation while only 2 samples had benign findings.

Source: http://www.ncbi.nlm.nih.gov/pubmed/23941007

+ Thermography - Impact of human epidermal growth factor receptor-2 status of invasive breast tumors on thermography findings.

Abstract

OBJECTIVE:

To analyze the impact of prognostic human epidermal growth factor receptor-2 (HER-2) in invasive breast cancers on the findings of thermography tests.

METHODS:

The study was carried out at the Department of Surgical Oncology and the Department of Pathology, University Clinical Hospital Center, Sisters of Mercy, Zagreb, Croatia, in collaboration with licensed infrared (IR) thermography experts. The study involved 75 female patients diagnosed with invasive breast cancer from May to July 2011. Thermography findings were compared between different immune-histochemical (IHC) findings (HER-2 status: positive or negative).

RESULTS:

Significantly higher temperatures were recorded in invasive cancer breasts than in healthy breasts. The cancer sites and the entire cancer breasts were significantly warmer (p less than 0.001) than the healthy breasts and opposite tumors mirror sites. Considering the HER-2 status, HER-2 positive invasive cancers were significantly warmer in comparison with the HER-2 negative cancers (p=0.035).

CONCLUSION:

The trend of increased temperature in HER-2+ tumors was noted. The findings clearly indicate that HER-2+ status has a higher impact on the increased thermographic temperature findings.

Source: http://www.ncbi.nlm.nih.gov/pubmed/?term=23047218

+ Thermography - Importance of the thermographic study method in oncology

Abstract
Results of the study give reason to consider distant thermography a method for detection of a tumor and differential diagnosis of tumorous and inflammatory pathology. Registering changes of temperature in tumorous lesion, that is assessment of functional condition of pathological focus, may be helpful in solving diagnostic problems and provides possibility for monitoring of the process in the course of radiation therapy.

Source: http://www.ncbi.nlm.nih.gov/pubmed/?term=8209469

+ Thermography - Improvement in the early detection of breast cancer by thermography

In the last few years thermography lost some of its value in the diagnosis of breast cancer because of the changeover to x-ray mammography and ultrasound mammography. Nevertheless, it is still a very useful additional method, especially if the doctor can only perform a clinical examination. Combination of thermography and clinical examination produces better results. In case of pathological vascularisation, clinically occult carcinomas can be detected.

Source: http://www.ncbi.nlm.nih.gov/pubmed/?term=3715334

+ Thermography - Influence of hormonal status on thermography findings

Abstract
The aim of this study was to investigate the association of infrared imaging findings and hormone receptor (estrogen and progesterone) status in breast cancers. The study was carried out at Department of Surgical Oncology and Department of Pathology, Sestre milosrdnice University Hospital Center, in collaboration with licensed infrared thermography experts. The study involved 75 female patients with invasive breast tumors. Thermography findings were compared with different immunohistochemical findings (hormone status positive or negative). Seventy-five female patients aged 36 to 86 years, mean age 64 +/- 11.36 years, were examined.

Source: http://www.ncbi.nlm.nih.gov/pubmed/?term=23837271

+ Thermography - Novel functional infrared imaging system coupled with multi-parametric computerised analysis for risk assessment of breast cancer.

Abstract

OBJECTIVE:

We evaluated a functional three-dimensional (3D) infrared imaging system (3DIRI) coupled with multiparametric computer analysis for risk assessment of breast cancer. The technique provides objective risk assessment for the presence of a malignant tumour based on automated parameters derived from a clinically known training set.

METHODS:

Following institutional review board approval, we recruited 434 women for this prospective multicentre trial, including 256 healthy woman undergoing routine screening mammography with BI-RADS-1 results and 178 women with newly diagnosed breast cancer. This was a two-phase study: an initial training and calibration phase, followed by a two-armed blinded evaluation phase (52 healthy and 66 with breast cancer). 3DIRI data sets were acquired using a non-contact, no radiation system.

RESULTS:

The sensitivity and specificity of functional infrared imaging in providing the correct risk for the presence of breast cancer were 90.9 % and 72.5 %, respectively. The area under the ROC curve was 86 %. Forty-two of the 60 (70 %) cancers in women correctly classified by the system as suspicious were smaller than 20 mm in size.

CONCLUSION:

The preliminary blinded results of this novel technology show sufficient performance of functional infrared imaging in providing risk assessment for breast cancer to warrant further clinical studies.

KEY POINTS:

• 3D functional infrared imaging (3DIRI) provides new metabolic signatures from breast lesions. • 3DIRI offers high sensitivity for risk assessment of breast cancer. • It also has reasonable specificity. • This initial experience warrants further evaluation in larger clinical trials.

Source: http://www.ncbi.nlm.nih.gov/pubmed/?term=23223805

+ Thermography - Procedure to estimate thermophysical and geometrical parameters of embedded cancerous lesions using thermography.

Abstract

Based on the fact that malignant cancerous lesions (neoplasms) develop high metabolism and use more blood supply than normal tissue, infrared thermography (IR) has become a reliable clinical technique used to indicate noninvasively the presence of cancerous diseases, e.g., skin and breast cancer. However, to diagnose cancerous diseases by IR, the technique requires procedures that explore the relationship between the neoplasm characteristics (size, blood perfusion rate and heat generated) and the resulting temperature distribution on the skin surface. In this research work the dual reciprocity boundary element method (DRBEM) has been coupled with the simulated annealing technique (SA) in a new inverse procedure, which coupled to the IR technique, is capable of estimating simultaneously geometrical and thermophysical parameters of the neoplasm. The method is of an evolutionary type, requiring random initial values for the unknown parameters and no calculations of sensitivities or search directions. In addition, the DRBEM does not require any re-meshing at each proposed solution to solve the bioheat model. The inverse procedure has been tested considering input data for simulated neoplasms of different sizes and positions in relation to the skin surface. The successful estimation of unknown neoplasm parameters validates the idea of using the SA technique and the DRBEM in the estimation of parameters. Other estimation techniques, based on genetic algorithms or sensitivity coefficients, have not been capable of obtaining a solution because the skin surface temperature difference is very small.

Source: http://www.ncbi.nlm.nih.gov/pubmed/?term=22482688

+ Thermography - Reappraisal of the use of infrared thermal image analysis in medicine

Abstract

Infrared thermal imaging of the skin has been used for several decades to monitor the temperature distribution of human skin. Abnormalities such as malignancies, inflammation, and infection cause localized increases in temperature which show as hot spots or as asymmetrical patterns in an infrared thermogram. Even though it is nonspecific, infrared thermology is a powerful detector of problems that affect a patient’s physiology. While the use of infrared imaging is increasing in many industrial and security applications, it has declined in medicine probably because of the continued reliance on first generation cameras. The transfer of military technology for medical use has prompted this reappraisal of infrared thermology in medicine. Digital infrared cameras have much improved spatial and thermal resolutions, and libraries of image processing routines are available to analyze images captured both statically and dynamically. If thermographs are captured under controlled conditions, they may be interpreted readily to diagnose certain conditions and to monitor the reaction of a patient’s physiology to thermal and other stresses. Some of the major areas where infrared thermography is being used successfully are neurology, vascular disorders, rheumatic diseases, tissue viability, oncology (especially breast cancer), dermatological disorders, neonatal, ophthalmology, and surgery.

Source: http://www.ncbi.nlm.nih.gov/pubmed/?term=10048859

+ Thermography - Thermal analysis of cancerous breast model.

Abstract

Breast cancer is one of the most common and dangerous cancers. Subsurface breast cancer lesions generate more heat and have increased blood supply when compared to healthy tissue, and this temperature rise is mirrored in the skin surface temperature. The rise in temperature on the skin surface, caused by the cancerous lesion, can be measured noninvasively using infrared thermography, which can be used as a diagnostic tool to detect the presence of a lesion. However, its diagnostic ability is limited when image interpretation relies on qualitative principles. In this study, we present a quantitative thermal analysis of breast cancer using a 3D computational model of the breast. The COMSOL FEM software was used to carry out the analysis. The effect of various parameters (tumor size, location, metabolic heat generation and blood perfusion rate) on the surface temperature distribution (which can be measured with infrared thermography) has been analyzed. Key defining features of the surface temperature profile have been identified, which can be used to estimate the size and location of the tumor based on (measured) surface temperature data. In addition, we employed a dynamic cooling process, to analyze surface temperature distributions during cooling and thermal recovery as a function of time. In this study, the effect of the cooling temperature on the enhancement of the temperature differences between normal tissue and cancerous lesions is evaluated. This study demonstrates that a quantification of temperature distributions by computational modeling, combined with thermographic imaging and dynamic cooling can be an important tool in the early detection of breast cancer.

Source: http://www.ncbi.nlm.nih.gov/pubmed/?term=25328914

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