1. In The Waiting Room

"In the examination waiting room, allow the patient to adjust to room temperature and settle their heart rate."

In the examination waiting room, we wish you to acclimate to the room temperature from outdoor extremes and calm your heart rate. During this time, you will be asked to complete a medical questionnaire relative to risks and symptoms of breast disease. Some of these questions are asked in order to develop useful statistics of the many risks for breast cancer and you will be asked for permission to include your data in scientific evaluations of Infrared Mammography. Please be assured that your personal confidentiality will be assured in all of these scientific evaluations.

2. In The Imaging Room

Once you have had sufficient time to relax in the waiting room, you will be escorted into the imaging room. There, the technologist will review pertinent features of your medical history and symptoms. The technologist will then explain the imaging procedure to you and answer any questions you may have. Then you will be asked to disrobe to the waist and acclimate to the room's cooler temperature (about 68°F) for ten to fifteen minutes, varying based upon certain environmental parameters specific to the imaging location.

Once the acclimation period has started, you must not touch any part of your upper body until all imaging is complete. Any touching can leave misleading artifacts. The Infrared Mammogram is a functional (physiologic) study and there are factors that can adversely affect the studies' accuracy. Your technologist is trained to prevent the factors that would compromise your study. Our goal is to help you to be as comfortable as possible during the entire study.

3. Capture First Image Set

"Patient is directed to the imaging area, the camera is configured and the first set of images is captured."

Once the acclimation period is complete, the technologist will ask you to stand several feet from the front of the Infrared camera, raise your arms and carefully get in position to view the side of one of your breasts and the underarm. Next, the technologist will adjust the camera's height, focus and display parameters to ensure optimal clarity of the image as viewed on a computer monitor.

Once the camera and image display have been appropriately adjusted, the technologist will record the first set of images.

	For the first image, you will be asked to stand with both arms raised, fingers interlocked behind your neck thereby exposing your underarm area and turned approximately 60 degrees of to your left. This image will include the tops of your shoulders, bottom curve of your right breast and underarm area.
	The second image is the exact reverse (mirror image) of the first. You will be asked to turn right about 60 degrees with both hands still interlocked behind your neck.
	The third image is made with both hands still interlocked behind your neck and now turned to face directly into the Infrared camera. Because symmetry is important, the technologist will assure that you are facing directly into the camera and not turned even a little to the side. The top of the image should be your shoulders; the bottom should be the bottom curve of both of your breasts and the sides of the images should include the side (lateral) margins of your breasts (or chest) (See figure below for sample pose and framing Illustration).

4. A Functional Challenge

"Perform the cold challenge by having the patient place their hands in a shallow pool of cold water."

Immediately after the frontal image is recorded, you will be asked to place both hands wrist deep in a basin of cool (approximately 53° F (11° C) ) water for exactly one minute as timed by the technologist.

5. Capture Second Image Set

"Quickly, as the vaso-constrictive effect of the functional challenge is temporary, the second set of images is recorded."

	The fourth image is made with both hands still interlocked behind your neck and you will be asked to face directly into the Infrared camera. Because symmetry is important, the technologist will assure that you are facing directly into the camera and not turned even a little to the side. Your shoulders should be at the top of the image, the very bottom curve of your breast should be the bottom of the image and the sides of the image should include the side (lateral) margins of your breasts or chest. (See figure below for sample pose and framing Illustration).
	The fifth image is made while standing. You will be asked to turned about 60 degrees to the left with both hands still interlocked behind your neck. This fifth image will include the tops of your shoulders; the bottom curve of your breasts; the right underarm area and the lateral (outside) of your right breast and the medial (inside) area of your left breast to include the nipple area (See figure below for sample pose and framing Illustration).
	The sixth and last image is made after the technologist asks you to turn about 60 degrees to your right from the camera and with both hands still interlocked behind your neck. The image will include the tops of your shoulders; the bottom curve of your breasts; the left underarm area and the lateral (outside) of your left breast and the medial (inside) area of your right breast to include the nipple area (See figure below for sample pose and framing Illustration).

6. Submit Your Study For Analysis And Reporting

"Save the image array and patient history to one easy to manage file, then send it to the lab for analysis."

Once the imaging process has been completed, the technologist will save your complete study, which includes all captured images and your medical history into a single electronic folder that will assure proper identification of your data. Once saved, the study will be submitted to IMS Interpretation Laboratory via a secured internet connection. The successful transfer of your study will be acknowledged immediately by an automated e-mail.