From Our Experts  |  February 20, 2018  |  Eithne Burke, MD

Mammography vs. Thermography: Which is better at detecting breast cancer?

Every couple of years, we receive an increased number of questions about and interest in breast thermography. As co-director of Wake Radiology’s Breast Imaging team, I want to share important information, scientific data and our practice’s position on thermography.

What is thermography?  

Breast thermography, also known as infrared imaging of the breast, is a pictorial representation of the infrared energy or heat emission of the breasts. It is based on the observation that patients have an elevated breast skin temperature over breast cancer. Some women want thermography because it is painless and doesn’t require exposure to radiation.

Can thermography detect breast cancer?

Leading medical organizations do not recommend thermography as a reliable way to detect breast cancer and they do not recognize it as an approved or appropriate alternative.[i] Even with modern equipment, the ability of a thermogram to accurately and consistently detect breast cancer remains extremely low.[ii]

  • The American Cancer Society states that no study has ever shown that it is an effective tool for detecting breast cancer.[iii]
  • Both the American College of Radiology and the Society of Breast Imaging (SBI) do not endorse thermography for detecting clinically occult breast cancer. The SBI does not currently support the use of thermography as a screening tool for breast cancer detection or as an adjunctive diagnostic tool. Going further, the SBI says there are no current studies supporting the use of thermography alone or as an adjunct to mammography that show clear benefits of the technique.[iv]
  • The US Food and Drug Administration (FDA) views thermography as an “adjunctive” tool, meaning only for use alongside a primary screening mammography. The FDA cautions that patients who only have a thermography test should not feel confident in those results alone because the device has not been cleared for use unless with another testing method like mammography.[v]
  • Some organizations do claim that thermography can find breast cancer years before it would be detected through other methods. The FDA doesn’t have any evidence that supports these claims. It also doesn’t have proof that thermography improves cancer detection in dense breasts.
  • In addition, most major insurance companies, like United Healthcare and Medicare, do not cover thermography and have concluded that there is insufficient, limited and weak evidence that it has a beneficial impact on health outcomes.[vi]

How do patients know what’s true?

The FDA has taken regulatory action, including issuing warning letters, against healthcare providers and thermography manufacturers who try to mislead patients into believing that thermography can take the place of mammography. To protect the public health, the FDA’s regulatory action can include scheduling a regulatory meeting, sending a warning letter or other correspondence, an establishment inspection, and judicial actions.

 What is Wake Radiology’s position on thermography?

At Wake Radiology, we do not endorse thermography as a reliable or accurate breast cancer screening tool. This position is based on evidence, literature and statements by reputable medical organizations, as outlined above.

When a woman is worried about how a mammogram feels or potential radiation, we encourage that patient to talk with our breast imaging team or their primary healthcare provider about what to expect. We understand that a mammogram can occasionally be uncomfortable because the exam requires brief compression of the breast. This only lasts for a few seconds and is essential to increase the clarity of the x-ray image. Learn more about conventional and 3D mammograms.

Some women express concern about the radiation associated with mammograms. Mammograms do expose the breasts to small amounts of radiation. We believe that the benefits of mammography far outweigh any possible harm from the radiation exposure.[vii] Mammograms have a radiation dose in the order of 0.5 to 1.0 millisieverts (mSv is a measure of radiation dose). To put the dose into perspective, the amount of radiation used for a screening mammogram of both breasts is about the same amount of radiation a woman would get from her natural surroundings over about seven weeks. Learn more about mammogram radiation.

What is the best way to detect breast cancer?

Mammography remains the gold standard for early breast cancer detection.

Physicians at Wake Radiology agree with the American College of Radiology, American Cancer Society, and U.S. Preventive Services Task Force that annual mammography beginning at age 40 saves the most lives.[viii]

We are proud to be the Triangle’s leader in 3D mammography and to offer this service at multiple locations throughout the area making it easy for women to access this life-saving procedure. 3D mammograms:

  • Detect breast cancer at its earliest possible stage
  • Offer greater detail and clarity of breast tissue regardless of age or breast density
  • Expose small, invasive cancers earlier than ever before
  • Provide peace of mind for patients

Wake Radiology is a Breast Imaging Center of Excellence (BICOE) by the American College of Radiology. This ensures that qualified female personnel who are registered in mammography will perform your exam, that board certified radiologists will interpret your scans, and that dedicated mammography equipment is being used to obtain the highest quality images with the lowest possible radiation dosage.

Most major insurance providers, including Medicare, pay for annual screening mammograms. A woman does not need a doctor’s order to have an annual screening mammogram if they have been seen by a physician within the past 18 months. Wake Radiology offers evening, Saturday and same-day mammogram appointments.

We are happy to answer any questions that patients have about mammography. We are committed to helping women understand the importance of their breast health and how mammography is an essential part in that as well as in early breast cancer detection.

You’re invited to know more about 3D mammography. To schedule your mammogram, call our scheduling team at 919-232-4700 or make an appointment request online.


[i] American Journal of Roentgenology, Tailored Supplemental Screening for Breast Cancer: What Now and What Next?

[ii] Radiologic Clinical North America, Alternatives to Breast-Imaging Approaches

[iii] American Journal of Roentgenology, Harmonizing Breast Cancer Screening Recommendations: Metrics and Accountability

[iv] Society of Breast Imaging, Position Statement on Thermography

[v] Food & Drug Administration, Breast Cancer Screening: Thermogram No Substitute for Mammogram

[vi] UnitedHealthcare Commercial Medical Policy, 2017.

[vii] American Cancer Society, X-rays, Gamma Rays and Cancer Risk

[viii] American Cancer Society, Mammogram Basics

About Our Expert

Eithne Burke, MD — Breast Imaging Radiologist Medical School University of Galway Medical School, Galway, Ireland Ireland: Internship/Residency – Internal Medicine University College Hospital, Galway, Ireland United States: Clinical Fellowship – Geriatric Medicine Boston University School of Medicine, Boston, Massachusetts Residency – Diagnostic Radiology University of North Carolina, Chapel Hill, North Carolina Fellowship – Breast Imaging University of North […] Learn More...

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