Overview of functional infrared imaging as part of a multi-imaging strategy for breast cancer detection and therapeutic monitoring

To assess infrared imaging as a first line detection strategy, we retrospectively reviewed the relative ability of our preoperative clinical exam, mammography, and infrared imaging to detect 100 new cases of ductal carcinoma in situ, Stage I and II breast cancer. While the false-negative rate of infrared imaging was 17%, at least one abnormal infrared sign was detected in the remaining 83 cases, including 10 of the 15 patients, a slightly younger cohort, who had nonspecific mammograms. The 85% sensitivity rate of mammography alone thus increased to 95% when combining both imaging modalities. Access to infrared information was also pertinent when confronted with the relatively frequent contributory but equivocal clinical exam (34%) and mammography (19%). The average size of those tumors undetected by mammography or infrared imaging was 1.66 cm and 1.28 cm, respectively, while the false-positive rate of infrared imaging in a concurrent series of 100 successive benign open breast biopsies was 19%. Our initial experience would suggest that, when done concomitantly with clinical exam and mammography, high-resolution digital infrared imaging can provide additional safe, practical, first-line and objective information. To assess infrared imaging as a therapeutic monitoring tool, 20 successive patients who received preoperative chemohormonotherapy (PCT) for locally advanced breast cancer underwent high resolution digital infrared imaging (IR) both before and after PTC and prior to surgery. The images were graded using a new scale. Initial pre-PCT IR imaging revealed obvious and often dramatic angiogenesis-related findings in all our patients. Following PCT, there was a significant decrease in both the IR score and in the clinical size of those with measurable disease. Four of the six patients with complete pathological response also saw their IR revert to normal. In nine patients, the elevated pre-PCT IR score lingered longer than the clinical findings. IR provides a very safe and convenient alternative functional imaging modality to monitor PCT. Further study and follow-up is required to assess whether the IR changes that reflect the effect of PCT on tumor vascularity also provide an additional valuable prognostic indicator for this subset of patients with aggressive tumors.