Thermography and Breast Cancer Screening

Thermography, also known as digital infrared thermal imaging (DITI), is an imaging test that uses an infrared camera to detect temperature differences and blood flow on or near the surface of the breast skin. The idea behind using this test to screen for breast cancer is that it could identify “hot spots”' in the breast, which, the thinking goes, could indicate cancer or other abnormalities.

A number of online influencers, a handful of doctors, and some spas and health clinics around the U.S. are recommending or offering thermography as a tool for detecting breast cancer. Some of them are marketing it as an alternative to mammograms.

But experts caution that thermography should only be used — if at all — in combination with mammograms, not in place of them. This is because there’s no research to support its effectiveness and reliability as a method for detecting breast cancer. 

Unlike a mammogram, which compresses the breast at different angles to get X-ray images of breast tissue, thermography uses an infrared camera and no equipment touches your body during the test.

When you get a thermography test, you undress from the waist up and stand or sit about 6 to 8 feet away from the infrared camera. A technician takes several images of your breasts from the front and the side. These digital images (called thermograms) are usually sent to a doctor for analysis.

Some people like the idea of getting a thermography scan because, unlike a mammogram, it’s painless. Also, there’s no radiation exposure when you get a thermography scan, while a mammogram exposes you to a very small dose of radiation.

Thermography isn’t typically covered by insurance and can cost around $200 or more out-of-pocket.

While thermography is an FDA-approved test, it’s only authorized for use as an “adjunctive” screening method. This means it should be used in addition to a primary breast cancer screening test, like mammography.

The FDA says that “thermography has not been shown to be effective as a standalone test for breast cancer screening and detecting early-stage breast cancer.”

Also, while facilities that offer mammograms must follow FDA-required quality standards, there are no such standards for thermography.

Leading medical organizations in the U.S., such as the American Cancer Society, the American College of Radiology, and the Society of Breast Imaging, don’t recommend thermography for breast cancer screening and diagnosis. Many experts say that people who get thermography are putting themselves at greater risk of getting an inaccurate result (either a false-positive or a false-negative) than they do with mammograms.

“I would strongly advise against thermography instead of mammography. Mammography has been clearly proven, with the strongest of evidence including randomized controlled trials and decades of clinical use, to be effective in screening for breast cancer. Thermography cannot make that claim,” says Debra L. Monticciolo, MD, FACR, FSBI, a breast radiologist who is the past president of both the Society of Breast Imaging (SBI) and the American College of Radiology (ACR).

If you’re considering a thermography scan, it’s important to know that there is no evidence supporting its effectiveness in detecting breast cancer.

It’s always a good idea to talk with your doctor about creating a personalized breast cancer screening plan that includes annual mammograms and other tests. Monticciolo notes that if you’re interested in having other screening tests in addition to mammograms, it’s best to use proven options like MRI and ultrasound.

Discuss any concerns about the very small amount of radiation exposure or the discomfort caused by mammograms with your healthcare team. They can tell you about the benefits and risks, and may have strategies for making the test more comfortable for you.