Thermography: The Magic 8 Ball of Breast Cancer Screening
Of all the healthcare scams, fake cancer screening infuriates me the most because those who suffer the greatest harm are also shamed and silenced due to their willing participation, so patients and their family members are less likely to speak out or to seek retribution, even in the face of intentional and catastrophic medical malpractice. Meanwhile, since the majority of people never receive a cancer diagnosis, they will not suffer any bodily harm and will remain outspoken advocates.
Thermography is an infrared scan that detects variations in temperature. It was once hypothesized as a screening modality for breast cancer because, intuitively, it would seem that this scan would detect increased metabolic activity, much like a PET scan. However, multiple studies consistently showed that it performed no better than chance at detecting breast cancer, and mammography remains the Gold Standard for breast cancer screening. Despite a total lack of evidence, charlatans, typically of the chiropractic persuasion, continue to convince women to forgo mammography and instead pay hundreds of dollars for thermography to screen for breast cancer. Although these women would be better off using a Magic 8 Ball, I would estimate that due to cognitive biases, such as confirmation bias and authority bias, over 90% of them will remain in the dark and feel pleased with their choice of thermography for breast cancer screening.
Let’s consider all of the possibilities for women who choose thermography. 13% of women will be diagnosed with breast cancer during their lifetime, which means that 87% will never have breast cancer and will be happy with any breast cancer screening. The first group of women are those who never have breast cancer and always have normal thermography. These women are confident in the accuracy of thermography and pleased to remain cancer-free. The second group of women are those who never actually have breast cancer but had abnormal thermography and are convinced that they do, in fact, have breast cancer. Even if they see a legitimate physician without any evidence of breast cancer on mammogram, ultrasound, breast MRI or PET scan, their chiropractor will likely convince them that thermography is a more sensitive screening test for breast cancer, which can detect it earlier than mammography. These patients will then be convinced to spend hundreds or even thousands of dollars on unproven supplements, infusions, and other treatments for the cure or prevention of breast cancer, which will appear to be effective since these women will never officially be diagnosed with breast cancer. These will be the most zealous advocates for thermography because they will feel so grateful for the early detection and treatment of their breast cancer and avoidance of mastectomy, chemotherapy and radiation. Despite the fact that these women are victims of financial and emotional harm, they will never be convinced that they are not, in fact, breast cancer survivors, and they will strongly believe in the accuracy of thermography.
Of the 13% of women with breast cancer, some of them will randomly have abnormal thermography. Most of these women will likely receive confirmation of their breast cancer diagnosis by a legitimate physician following mammogram and biopsy, and most will probably receive legitimate treatment for their breast cancer. The women who survive will be grateful to their chiropractors for discovering their breast cancer, and they will be loud and passionate advocates for thermography. The women who do not survive, either due to delayed diagnosis or to unproven chiropractic cancer treatments, are more likely to blame cancer, or themselves, than they are to blame their chiropractors. Likewise, the women who die from breast cancer following a lifetime of normal thermography are also unlikely to blame their chiropractors for failure to diagnose their breast cancer. Even though thermography will fail the majority of women with breast cancer, their voices will be drowned out by thermography proponents.
Thank you for this article Dr O’Rourke. These stats are important tools to use when discussing breast imaging with patients. This is super helpful!
what a well written article on thermography. I enjoyed and learned from it.
Ahhhh, M.D.s use mammography and chiropractors use mumbo-jumbo thermography and make extravagant claims. It figures. I will suffice it to say that years ago I flipped a car on the back road and luckily since I was strapped in, just lightly bopped my head on the windshield. Neck hurt. After x-rays didn’t show anything “bad”, my osteopathic partner did a manipulation and boy did that provide relief. This was 9 months after the accident and I still was suffering.
Years later, my low back was bugging me and my osteopathic partner long since retired. I had x-rays from my primary care that just showed a little age-related DJD that I took to a local chiropractor and he did a manipulation and I felt better. He told me if I still have problems, make an appointment and comeback. Didn’t sign me up for a zillion treatments. Years later at age 69, I’m still doing o.k. and didn’t need a chiropractic followup after one treatment. My back and neck are still doing well. My neck is fine and my low back is extremely tolerable without serious pain whatsoever. Some will say the back thing was a placebo effect but I say after the manipulation I got relief and stayed in decent condition since.