Liquid crystal thermography for breast cancer detection: principles, current evidence, limitations, and future directions.

Abstract

Breast cancer remains a leading cause of cancer-related mortality in women worldwide, making early and accurate detection a global clinical priority. Conventional screening modalities, including mammography, ultrasonography, and Magnetic Resonance Imaging (MRI), each have well-established strengths and limitations; in particular, mammographic sensitivity is reduced in women with heterogeneously or extremely dense breast tissue, where it may fall to approximately 50%. Liquid Crystal Thermography (LCT) is a contact-based, non-invasive, radiation-free technique that uses thermochromic liquid crystal (TLC) foils to map surface thermal patterns on the breast and has been investigated as a potential adjunct to standard breast screening. This narrative review summarises the physical and physiological basis of LCT, describes the Braster-based contact thermography workflow, evaluates published diagnostic performance data, and provides a structured analysis of current limitations, confounding factors, and evidence gaps in comparison with established screening modalities. Available studies suggest that LCT may have a role as an investigational adjunctive or triage tool, particularly in settings with limited access to standard imaging; however, the evidence base is heterogeneous, predominantly small in sample size, and methodologically variable, and is insufficient at this stage to establish LCT as a standalone substitute for mammography. The U.S. Food and Drug Administration (FDA) has explicitly stated that thermography should not be used in place of mammography for breast cancer screening or diagnosis. Any potential advantage of LCT in dense breast tissue remains unconfirmed, as no published comparative study has yet provided head-to-head false-negative and false-positive counts across modalities within this subgroup. Preliminary observational data from an ongoing Malaysian case series are included only to illustrate the clinical workflow; these findings are exploratory, unpublished, and not peer-reviewed, and should not be interpreted as confirmatory evidence of diagnostic performance. Future research priorities include large-scale prospective validation, standardised acquisition and interpretation protocols, and rigorous comparative reporting of sensitivity, specificity, and misclassification rates.