New Scan Almost 100% Accurate in Diagnosing Breast Cancer



A new type of scan is almost 100 percent accurate in diagnosing breast cancer.


 

NEW SCAN ALMOST 100% ACCURATE IN IDENTIFYING BREAST CANCER

An estimated 1.4 million women undergo breast biopsies every year in the United States for abnormal findings on their mammograms, and approximately 85 percent of these suspicious mammographic findings will turn out to be benign following biopsy.

At the present time, breast imaging technology has not advanced enough to replace biopsy for most women with suspicious abnormalities noted on mammograms, or for women who develop palpable breast lumps. For example, MRI scans can detect 95 to 98 percent of early breast cancers, but MRI is also associated with a very high “false-positive” rate, in which as many as 25 percent of identified abnormalities turn out, after biopsy, to be benign. In an ideal world, a “perfect” breast scan would accurately identify 100 percent of cancers and 100 percent of benign breast lesions, but such a scan does not exist at this time. However, a new technology for scanning small cores of breast tissue removed during a needle biopsy may bring us closer to that “perfect” breast scan.

A newly published study suggests that a novel imaging technology may be able to accurately distinguish benign from cancerous breast cells within core needle breast biopsy specimens with almost 100 percent accuracy. This study appears in the current issue of the journal Cancer Research.

In this study, a device known as a spectroscope was used to scan core needle breast biopsy tissue specimens from 33 women. Pathologists then evaluated these same biopsy specimens and compared their microscopic diagnoses with the findings of the spectroscopic examination.

Using an analytic method known as the Raman algorithm, spectroscopic evaluation of these needle biopsy breast tissue specimens was shown to be almost as accurate as the pathologists’ diagnoses. Among the biopsy tissue samples that were identified as having cancer by Raman spectroscopy, 100 percent turned out to be cancer. Among the biopsy tissue samples that were identified as being benign (i.e., no cancer) by Raman spectroscopy, 96 percent turned out to be benign, while 4 percent contained cancer, based upon the pathologists’ findings

This new noninvasive imaging technology offers a number of potentially important benefits to patients with abnormal mammogram findings, as well as, potentially, women who are undergoing breast-conserving surgery (i.e., lumpectomy) for confirmed breast cancer.

For women who are undergoing needle biopsy of their breast following an abnormal mammogram, Raman spectroscopy of core needle biopsy specimens may allow the Radiologist performing the biopsy to determine, in real time, the results of such biopsies, rather than waiting for a week or longer for the Pathologist to report a formal diagnosis. Raman spectroscopy may also assist the Radiologist in determining whether or not the core needle biopsy has been accurately and adequately performed, based upon the spectroscopic “signature” of the breast tissue recovered from the needle biopsy.

There is also great interest in using Raman spectroscopy to more accurately determine the adequacy of lumpectomy when performing breast-conserving surgery for confirmed breast cancer. At the present time, 25 to 40 percent of patients with very small breast cancers have to undergo repeat lumpectomy due to the presence of cancer cells at (or close to) the edges of the lumpectomy breast tissue specimen, as seen under the microscope by the Pathologist. There is, at this time, preliminary data suggesting that Raman spectroscopy may be useful, in the operating room, to identify areas (“margins”) on the lumpectomy breast tissue specimen where tumor cells are too close to the surface of the specimen, thus allowing the surgeon to take additional breast tissue in these suspect areas at the time of the original lumpectomy surgery. In the best case, this novel approach to breast-conserving surgery may spare many women with breast cancer the need for a second (or third) breast lumpectomy.

As a cancer surgeon who cares for a large number of breast cancer patients, I find this novel and noninvasive imaging technology to be very exciting, and full of potential promise and benefit to patients with abnormal mammograms, as well as patients who have already been diagnosed with breast cancer.

 

For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my bestselling book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & Noble, Books-A-Million, Vroman’s Bookstore, and other fine bookstores!

Within one week of publication, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books. Within three months of publication, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.com Top 100 New Book Releases in Cancer” list.

 

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Additional Links for Robert A. Wascher, MD, FACS

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Dr. Wascher Discusses the Management of Metastatic Cancer of the Liver on Sharecare

Dr. Wascher Discusses Obesity & Cancer Risk on hopenavigators.com

Dr. Wascher Discusses Hormone Replacement Therapy & Breast Cancer Risk on interactmd.com

Dr. Wascher Discusses Thyroid Cancer on health2fit.com

 

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According to recent Bureau of Labor Statistics, the unemployment rate for veterans who served on active duty between September 2001 and December 2011 is more than 12 percent.  A new website, Veterans in Healthcare, seeks to connect veterans with potential employers.  If you are a veteran who works in the healthcare field, or if you are an employer who is looking for physicians, advanced practice professionals, nurses, corpsmen/medics, or other healthcare professionals, then please take a look at Veterans in Healthcare. As a retired veteran of the U.S. Army, I would also like to personally urge you to hire a veteran whenever possible.


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


 

I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  Over the past 12 months, 3.2 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious readers.  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 


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Axillary Lymph Node Dissection for Breast Cancer May Not Be Necessary

Welcome to Weekly Health Update


“A critical weekly review of important new research findings for health-conscious readers”



AXILLARY LYMPH NODE DISSECTION FOR BREAST CANCER MAY NOT BE NECESSARY

The management of breast cancer has undergone many advances since the radical mastectomy that first came into popularity in the United States in the late 19th century.  At that time, even early cancers of the breast were managed by surgically removing the entire breast, the underlying chest wall muscles, and all of the lymph nodes under the armpit (axilla).  It wasn’t until the 1970s that surgeons began to abandon radical mastectomy, in favor of the less disfiguring modified radical mastectomy, based upon emerging research data at the time.  By the 1980s, additional research data had confirmed that women who underwent lumpectomy plus radiation therapy experienced equivalent survival when compared to women who underwent mastectomy.  In the late 1990s, another major paradigm shift in the surgical management of breast cancer occurred with the rapid adoption of sentinel lymph node (SLN) biopsy, which had previously also revolutionized the surgical management of melanoma.  Following the successful application of SLN biopsy to breast cancer, the 60 to 70 percent of women with breast cancer who have normal axillary SLNs (i.e., no evidence of spread of breast cancer cells to the lymph nodes in the axilla) could now avoid undergoing complete axillary lymph node dissection (ALND), wherein about two-thirds of the armpit lymph nodes are surgically removed.  As the risk of arm swelling (lymphedema), numbness, and other long-term side effects associated with ALND are only one-tenth as common following SLN biopsy, the majority of women undergoing breast cancer surgery over the past decade have been able to avoid many of the chronic complications and side effects associated with the more radical surgical approaches used in the past.  However, between one-fourth and one-third of women diagnosed with breast cancer will still be found to have tumor cell in their SLNs, and most of these women have routinely been advised to undergo ALND to remove additional armpit lymph nodes.

Now, a newly published clinical research study from the American College of Surgeons Oncology Group has, once again, dramatically shifted the paradigm of breast cancer management.  This clinical research study, which I was privileged to participate in when I was a Surgical Oncology Fellow at the John Wayne Cancer Institute, enrolled 891 women newly diagnosed with breast cancer, and with early metastatic cancer involving one or more of their axillary SLNs.  These women were evenly randomized into two groups.  One group underwent the standard therapy of ALND, while the other half of these patient volunteers were observed, without further surgery, following SLN biopsy.  The results of this pioneering breast cancer research study appear in the current issue of the Journal of the American Medical Association.

After an average duration of patient follow-up of more than 6 years, this pivotal clinical study has confirmed what many of us oncologists have long suspected.  In women with evidence of microscopic spread of breast cancer to one or more axillary SLNs, there was no difference in overall survival whether or not they went on to undergo ALND, as long as they underwent otherwise standard therapy for lymph-node-positive breast cancer (including lumpectomy, radiation therapy to the breast, and chemotherapy).

I cannot overstate the potential impact of the findings of this important clinical study.  However, while some have heralded the findings of this study as breaking important new ground, in fact that ground was broken by the very same pioneering prospective clinical research study (the National Surgical Adjuvant Breast and Bowel Project’s NSABP B-04 study, which began in 1971) that originally led surgeons to abandon radical mastectomy.  Within this older large prospective clinical study was an important subgroup of 586 women with palpably enlarged axillary lymph nodes (and which actually indicated a more advanced stage of lymph node involvement than the women who participated in the more modern American College of Surgeons Oncology Group study).  Like all of the women who participated in the NSABP B-04 study, these 586 breast cancer patients with enlarged armpit lymph nodes were randomized to undergo radical mastectomy with radical ALND versus mastectomy alone (and no lymph node surgery at all ) combined with radiation therapy.  After an average follow-up of 25 years, there wasabsolutely no difference in survival between the women who underwent radical lymph node surgery combined with radical mastectomy versus those women who underwent simple mastectomy alone (and no lymph node surgery) followed by radiation therapy.

Thus, the newly reported findings of this pivotal American College of Surgeons Oncology Group clinical study only further validates the findings of the nearly 40 year-old NSABP B-04 study, and should put to rest, once and for all, the decades-old debate about the role of surgery in the management of the axillary lymph nodes in patients with newly diagnosed breast cancer.  At a minimum, surgeons should now advise their breast cancer patients that there is now 40 years worth of high-level clinical research data showing that the surgical removal of most or all of the armpit lymph nodes (ALND) does not improve survival in women who otherwise undergo standard breast cancer treatment that includes lumpectomy (or mastectomy), chemotherapy, and radiation therapy.

I predict that the findings of these two landmark breast cancer surgical studies will, together, once again revolutionize the surgical management of breast cancer, and will further reduce the adverse impact of surgery on hundreds of thousands of women around the world each year.  Indeed, this latest revolution in the management of breast cancer has already started at major cancer centers in the United States, where women are already being advised that the finding of early spread of breast cancer cells to their axillary SLNs no longer mandates “completion ALND,” as long as these patients undergo standard chemotherapy and radiation therapy following lumpectomy and SLN biopsy.


For a complete discussion of evidence-based approaches to cancer risk and cancer prevention, order your copy of my new book, A Cancer Prevention Guide for the Human Race.  For the price of a cheeseburger, fries, and a shake, you can purchase this landmark new book, in both paperback and e-book formats, and begin living an evidence-based cancer prevention lifestyle today!


For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my new book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & NobleBooks-A-MillionVroman’s Bookstore, and other fine bookstores!


On Thanksgiving Day, 2010, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books! On Christmas Day, 2010, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.comTop 100 New Book Releases in Cancer” list!



Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity




Dr. Wascher is an oncologic surgeon, a professor of surgery, a cancer researcher, an oncology consultant, and a widely published author




For a different perspective on Dr. Wascher, please click on the following YouTube link: Texas Blues Jam



I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people, from around the world, who visit this premier global health information website every month. (More than 1.2 million health-conscious people visited Weekly Health Update in 2010!) As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.







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