Early infrared camera technology of the 1950's was primitive and produced poor quality images. It wasn't until the late 1970's that the thermobiology of the breast was sufficiently understood to permit the emergence of a credible, accurate and objective method for interpreting the thermal patterns of the breast. And, until 1983, there were there no published environmental controls or formalized patient pre-examination protocol. Thus, from breast thermography's earliest years until the early-1980's, breast thermograms were haphazardly acquired and subjectively interpreted by individuals with little or no understanding of the procedure.
When breast thermography was introduced in the early 1950's, several physicians and manufacturers touted it as the ultimate screening process. The legacy of their eagerness to proceed without adequate expertise, equipment or environmental controls still haunts the science. The low quality images were subjectively interpreted resulting in an abundance of incorrect diagnoses, followed by unnecessary surgical procedures. When it was realized that thermography was not measuring up to the exaggerated claims of practitioners and vendors alike, the technology was dismissed as non-specific and unreliable.
In 1972, the American Cancer Society and National Cancer Institute sponsored the "Breast Cancer Detection and Demonstration Project" (BCDDP), in which women were screened using a combination of medical history, physical examination, mammography, and thermography. Untrained radiologists with no knowledge of breast thermography performed the thermographic examinations and the subsequent subjective interpretation of the images. The resultant high error rate and low sensitivity quickly resulted in the discontinuance of thermography as a routine element of the BCDDP.
These two chapters in breast thermography's history illustrate that subjective interpretation of breast thermograms leads to unusually high and unacceptable error rates.
The mid-1970's to the early 1980's appeared to promise the dawn of a new and promising era for breast thermography:
The arrival of low cost contact thermography was also the harbinger of increased opposition to breast thermography by the radiology community.
Radiologists who were still influenced by the BCDDP experience were not a viable market for contact thermography devices, so device manufacturers directed their marketing efforts to gynecologists. This proved to be a marketing error. When the radiology community realized that gynecologists were being sold image acquisition equipment, it predicted results similar to the BCDDP, i.e., subjective interpretations of images by novices delivering erroneous results. The radiology community responded vehemently against the use of breast thermography by gynecologists.
The contact thermography equipment provided the gynecologists with easy access to reasonably good quality images, but left the question of image assessment unanswered. The computer system was costly, so a thermogram reading service using the early TAS program was established. Physicians mailed images to the reading service for an assessment of the images, which were supplied by return mail. Unfortunately, the physicians ultimately chose to not use the service, because the time and overhead involved in mailing the images along with the wait to receive reports proved burdensome. Worse, the gynecologists made a decision antithetical to conventional wisdom and began to [subjectively] interpret the images themselves. The resulting barrage of appropriate criticism from the medical community forced breast thermography to be put on hold by most practitioners.
Notwithstanding efforts by the radiology community to impede the use of breast thermography, thermology stalwarts continued their efforts to demonstrate the efficacy of the technology. More than 800 case and clinical studies comprising 300,000+ patients, some tracked for twelve years, have been reported in the literature since 1980, all with results favorable to breast thermography use. These include:
While breast thermography advocates achieved demonstrable proof of the technology's efficacy, studies of mammography screening were reporting mammography's lack of efficacy and health risk. Although mainstream medicine became somewhat aware of mammography's drawbacks, the industry largely ignored or argued against the clinical studies, and continues to this day to promote mammography as though it is efficacious and free of health risk and continues its attempts to distract from breast thermography.
In 1982 the US Food and Drug Administration approved breast thermography for breast cancer risk assessment, but left the technology unregulated and not limited in use by medical doctors. Chiropractors were using thermography to produce evidence in personal-injury lawsuits and Workers' Compensation claims. By the mid-1980's the campaign to thwart the gynecologists use of breast thermography had succeeded, the courts stopped accepting thermography as evidence, and the alternative medicine practitioners migrated their thermography practices to breast thermography.
Today, the vast majority of breast thermography screening examinations in the U.S. are performed by alternative medicine practitioners, primarily chiropractors.