As we begin 2013, we want to call your attention to a new grading system available to American College of Clinical Thermology (ACCT) thermographers for evaluating breast health that was introduced in the summer of 2012. It is called the Thermography Breast Imaging-Reporting and Data System, also known as T BI-RADS and utilized only by our interpreting physicians at Electronic Medical Interpretation (EMI). In addition, we want to be sure you know what elements comprise your breast health score, what your T BI RADS score means and how to use this grading system to your advantage in monitoring breast health.
Historically, the Breast Imaging Reporting and Data System (BI-RADS) was developed by the American College of Radiology in 1993. This system provides a standardized classification for mammographic studies and demonstrates the likelihood of breast malignancy. The BI-RADS system can inform family physicians about key findings, identify appropriate follow-up and management and encourage educational and emotional support to patients. The BI RADS system was developed to standardize mammographic reporting, to improve communication, to reduce confusion, to aid research, and to facilitate outcomes monitoring.
Similarly, the T BI-RADS system was designed to help the referring doctor integrate the thermography results into a familiar reporting system.
Considerations Made in Your Breast Score
Your T BI RADS score is assigned from all available information including: history and symptoms, the interpreting physician’s clinical impressions from your thermograms and the proprietary software utilized by the EMI doctor.
The TBIRADS Scoring System: What Your Breast Health Score Means
To help you understand your breast health score, we can liken the T BI RADS system to the standard grading system that we use in education: A, B, C, D, and F.
Within normal Limits/Normal: Grade A
This indicates a normal thermal profile with no thermal findings consistent with risk for disease or other developing pathology.
At Low Risk/Non Suspicious: Grade B
This indicates thermal activity which may be associated with benign changes such as glandular hyperplasia, fibrocystic tissue and the development of cysts and fibroadenomas. This does not rule out existing non-active or encapsulated tumors. (This point will be discussed further in the February Newsletter).
At Some risk/Equivocal: Grade C
These findings indicate thermal activity likely to represent benign changes such as inflammation, acute cysts or fibroadenoma, or infection.
At Increased Risk/Abnormal: Grade D
This represents a significant risk for existing or developing malignant breast disease. Clinical correlation is justified and additional testing is indicated, including a 3-month follow-up thermogram.
At High Risk/Suspicious: Grade F
This represents a high risk of malignant breast disease; urgent clinical correlation is indicated with a comprehensive panel of testing and evaluation, including a 3-month follow-up thermogram.
How to Use the Scoring System to Your Advantage
For the clients who have achieved an “A ” on their breast health score, fantastic! Your lifestyle choices that you’ve implemented are contributing to optimal breast health. Keep up the good work!
If a client has a known history of fibrocystic changes and/or breast cysts and receives a breast health score of a “B, ” we would first encourage you to work with your health practitioner to reverse glandular hyperplasia, fibrocystic changes and the development of cysts and/or fibroadenomas through diet and address any hormonal imbalances. You may also want to rule out estrogen dominance and measure estrogen metabolites. Ultimately, it is possible and advisable to work with your practitioner to optimize your score.
If you have a grade of a “C ” as your breast health score, it is time to take more proactive measures at reversing the inflammation associated with this process. Estrogen dominance and estrogen metabolism needs to be evaluated as soon as possible. Other contributing factors to this breast health score may include: hormonal imbalances, lymph congestion, inadequate thyroid support, inflammatory diet, overwhelming or poorly-managed stress just to name a few. Ultimately, it gives you an opportunity to discover what pieces of your health you’ve been neglecting or denying.
Thermography does not diagnose cancer. This can only be achieved through breast biopsy. If you receive a score of a “D ” or an “F, ” certainly additional imaging (mammography, MRI and ultrasound) is mandatory. If a positive diagnosis is made, you may want to continue to utilize thermography to monitor for healing after surgery as well as recurrence of cancer. Understand, a grade of “D ” or “F ” is NOT a positive diagnosis and requires additional information to rule-out or rule-in developing pathology.
In summary, thermal imaging is utilized as a tool to watch for changes over time. With continued breast health, the thermograms remain identical to the initial study. Changes may be identified that may represent physiological differences that warrant further investigation.
The T BI-RADS gives women an opportunity to improve breast health or maintain their optimal breast health. The T BI RADS System for scoring breast health is only utilized by ACCT thermographers like us at Proactive Health Solutions.