Thermograms vs. Mammograms: Why Physicians Recommend Against Thermography

A follow-up to a previous discussion about thermograms and breast cancer screening, because the question keeps coming up. So let me really dig in: what is a thermogram, why doesn't it work for breast cancer screening, and why do physicians who actually treat breast cancer feel so strongly about it?

This one matters. Mammography saves lives. Thermography does not. The fact that thermograms are still being aggressively marketed — often to women who are afraid of mammograms — is a real and ongoing patient safety problem.

• An x-ray of the breast
• Detects masses, calcifications (especially the microcalcifications associated with the very earliest cancers), and structural changes
• The gold standard for breast cancer screening
• Tightly regulated, performed in certified facilities, read by board-certified radiologists who often subspecialize in breast imaging

• An infrared camera image of heat emitted from your body surface
• Originally proposed for breast cancer screening because cancers are highly vascular (lots of blood vessels) and can appear "hot" on infrared imaging
• Theoretically: hot spot = possible cancer

The thermogram theory is actually intuitive. The problem is that the research never panned out.

This is the central issue. There is no research indicating thermograms are a useful tool for finding early breast cancers.

Some thermograms can find larger, later-stage cancers — but that completely defeats the purpose of screening.

The whole point of screening is to find cancers early, when:

• Less surgery is needed (lumpectomy instead of mastectomy)
• Radiation can sometimes be avoided
• Chemotherapy can sometimes be avoided
• Survival rates are dramatically better

A test that only finds late-stage cancers isn't a screening tool — it's a confirmation of a tragedy that's already underway.

Mammograms exist within a very tight regulatory framework:

• They have to be done in certified facilities
• The technicians who perform them go through specific training and certification
• The radiologists reading them are board-certified, often with breast subspecialty training
• The equipment is calibrated and inspected
• There are national standards for image quality and interpretation

Thermograms are mostly none of these things:

• Often performed in chiropractor's offices or naturopath clinics
• Rarely read by board-certified radiologists
• Quality of the device, the imaging conditions, and the interpretation is highly variable

You are essentially paying for an unregulated test, often interpreted by someone with no specific training in breast imaging.

This part is genuinely impractical. If a mammogram finds something concerning, the radiologist can use the same imaging modality to guide a needle biopsy and figure out what it is.

If a thermogram finds something concerning:

• You cannot biopsy based on a thermogram
• You have to then go get a mammogram, ultrasound, or MRI
• That imaging then has to find a corresponding lesion to biopsy
• You've essentially added a step (and a cost) for zero benefit

I want to be specific about this, because it matters: most physicians who treat breast cancer have a real problem with how thermography is sold to patients.

The marketing typically involves three parallel claims, all of which are objectively wrong:

False. This is the most aggressively promoted claim and the most clearly contradicted by research. Thermograms do not find cancers earlier. Period.

This is fearmongering, and it works precisely because mammograms involve radiation — and "radiation" is a scary word.

Let me put this in context:

• A mammogram exposes you to a very low level of radiation
• It's similar to the background radiation every human gets just from living on Earth for about a month
• It's about the same as a single airplane ride from LA to New York
• The benefit of catching breast cancer early massively outweighs this tiny risk

This is the one that genuinely costs lives. Skipping proper breast cancer screening because someone told you a thermogram was a substitute is dangerous.

• Breast cancer deaths have decreased by 15–20% since the introduction of mammography and modern screening programs
• That's an enormous public health win
• Thermography has not contributed to that improvement

I want to be honest, because this is the part that breaks my heart.

I have seen women come into my office with horrific, gigantic, late-stage breast cancers that:

• Were never visible on the thermograms they'd been getting for years
• Were missed because the patient had been told everything was fine
• Were diagnosed only when the tumor became large enough to feel or to cause symptoms
• Required extensive therapy — bilateral mastectomy, chemotherapy, radiation, sometimes hormone therapy on top of that

By the time these women came to me, many of them had lost faith in the chiropractor or naturopath who had been giving them reassuring thermogram results. The cancer had been there the whole time. The thermogram just couldn't see it.

This is completely needless suffering. It's also wildly preventable.

The piece that genuinely makes me angry: patients pay cash for these tests.

• Thermograms are not covered by insurance because they don't meet evidence-based standards
• Patients pay several hundred dollars out of pocket
• That money goes to a practitioner who is lying about what the test does and fearmongering about the test that actually works
• The patient walks away with false reassurance and a lighter wallet

It's a worthless test, often sold with active disinformation about what real screening provides. That's an exploitation pattern, full stop.

For the record: the FDA only authorizes thermography as an adjunctive tool, used alongside mammography — not as a replacement. The FDA explicitly does not approve thermograms as a stand-alone breast cancer screening test.

If you really want to get a thermogram in addition to your annual mammogram, that's your call. I see no value in it, but it's not actively dangerous as long as you're doing the mammogram too.

The danger is when patients substitute thermography for mammography. Don't do that.

Quick reminder for context:

• Mammogram is the foundation
• For women with dense breasts, adding ultrasound catches an additional 2–3 cancers per 1,000 screens
• For very high risk patients (BRCA, strong family history), MRI may be added
• For patients with implants, implant integrity imaging is layered on separately

That's the framework. None of it includes thermography, and none of it should be replaced by thermography.

I've also written about other "screening" trends like Prenuvo and HerScan — many of the same issues apply.

A thermogram is an infrared image of your breast. It does not reliably find early breast cancer. The research has not supported it as a screening tool, and the FDA only authorizes it as an adjunct to mammography — not a replacement.

The reason physicians are so vocal about this isn't turf protection. It's because we've personally seen women die or end up with massive, late-stage cancers because they were sold a thermogram instead of a real screening test.

Mammograms are safe, evidence-based, and have driven a 15–20% reduction in breast cancer deaths. Get your mammogram. If you want to add a thermogram on top, fine. Just please don't skip the test that actually saves lives.