June 9, 2013 by Robert Wascher
Filed under A Cancer Prevention Guide for the Human Race, Benign Breast Disease, Breast Biopsy, Breast Cancer, Breast Cancer Diagnosis, Breast Cancer Screening, Breast Cancer Surgery, Breast Cancer Treatment, Breast-Conserving Surgery, Cancer, DCIS, Diagnosis, Ductal Carcinoma In Situ, MRI, MRI Scan, Mammograms, Mammography, Raman Spectroscopy, Weekly Health Update, cancer screening, health, lumpectomy, surgery, treatment
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.
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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
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