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New imaging tool more accurate than mammogram?

March 6, 2012 12:00:00 AM PST
There's a new non-invasive tool targeted to spot breast cancer that other tests don't always detect. Experts say it may be especially helpful for women who have dense breast tissue because that type of tissue doesn't always show up clearly.

For thousands of women, mammograms may not be able to distinguish dense breast tissue from tumors.

"It's really hard to look for a small tumor that's also going to be white, which is what dense breast tissue appears," said radiologist Dr. Jamie Surratt, Baptist Medical Center.

Baptist Medical Center is taking a new approach to detect cancer in these cases. It's called molecular breast imaging (MBI).

"I think the breakthrough is that it's so different than all of our other tools," said Surratt.

The patient is injected with a radioactive isotope that super-concentrates in areas where there's cellular energy associated with cancer. The tumor appears as an easy-to-see dark spot.

"It's able to help us differentiate things that we might otherwise have to biopsy," said Surratt.

The determination can bring peace of mind on a molecular level.

Only a few centers around the United States are using the new molecular breast imaging approach because it's limited to research. MBI for both breasts takes about 45 minutes, but it exposes the patient to slightly more radiation than a mammogram. Researchers are now trying to figure out how to reduce that exposure.

BACKGROUND: About one in every eight women in the United States will experience breast cancer in their lifetime. Each year approximately 200,000 women will be diagnosed with breast cancer and around 40,000 women will die from it.

SELF-EXAMINATION: Nearly 70 percent of all breast cancers are found through self-exams, and with early detection the five-year survival rate is 98 percent. Researchers believe that taking a few minutes every month to perform a self-examination can make a lifetime of difference. Breast self-exams can be performed lying down, in the mirror, or in the shower, to make sure you are doing it correctly. Women should start performing self-exams as early as the age 20. If a lump is found, then you should call the doctor for an appointment, eight out of 10 lumps are not cancerous.

THE NEXT STEP: Starting at the ages between 20 and 39, women are strongly suggested to get clinical breast exams every three years. By the age of 40 they should be getting baseline mammograms annually, especially if breast cancer runs in their family.

Mammograms: A mammogram is an X-ray picture of the breast. They can be used to check for breast cancer in women who have no signs or symptoms, usually referred to as screening mammograms. The machine can detect tumors that cannot be felt during a self-exam and deposits of calcium that shows the presence of breast cancer. The machine can also be used to look more closely at an already detected lump, called diagnostic mammogram. Signs of cancer include pain, skin thickening, nipple discharge, or a change in breast size or shape. Mammograms are also associated with potential harms, including false-negative results, false-positive results, the diagnosis and treatment of cancers and ductal carcinoma in situ lesions that would not have caused symptoms or threatened a woman's life (over diagnosis and overtreatment), and radiation exposure Also, sometimes it is difficult to get a clear x-ray because of special circumstances like breast implants or women with dense breast tissue. Often it cannot tell the difference between a tumor and dense breast tissue because they both appear white.

Molecular Breast Imaging: Molecular Breast Imaging is a new technique used to detect cancerous tumors that are not always visible in a mammogram. A woman is injected with a radioactive isotope. It accumulates in tumor cells more than it does in normal cells and the tumor then appears dark in a radiation detecting camera and is easy to see. The procedure takes about 45 minutes for both breasts and does expose the patient to more radiation than mammography does. However, a Mayo Clinic study found that MBI detected three times as many cancers in women with dense breast tissue and an increased risk of breast cancer than a mammogram did. It also demonstrated fewer false positives, meaning the results appear abnormal but are noncancerous.

WARNING: Only a few centers in the U.S. are using the MBI approach because it is limited to research. Researchers are working toward reducing the amount of radiation the patient is exposed too. Only one MBI does not put off much, but if it is going to be used annually, then radiation needs to be reduced.