Advances in Screening and Diagnosis
A trio of important presentations at the recent annual meeting of the American Roentgen Ray Society may have significant implications for improving breast cancer screening and diagnosis in the coming years.
In the keynote address to the convention, Dr. Carol Lee of the Yale University School of Medicine predicted that the use of MRI for breast cancer screening and diagnosis would expand dramatically in the coming years.
"I think that MRI screening of high-risk women is a reality that is just around the corner," she told attendees, although she cautioned that mammography remains the primary tool for breast cancer screening.
Lee noted that MRI is currently used for evaluating breast implants, although its potential range of applications is significantly broader. For example, she said, MRIs may soon be regularly used to look for distant metastases as well as for guiding more accurate breast biopsies. Lee also cited two ongoing studies in which MRI was found to be superior to traditional mammograms in detecting cancerous tumors.
In a breakout session, Dr. Supriya Kulkarni of Mount Sinai Hospital in Toronto, Canada, told attendees that some breast cysts are difficult for radiologists to evaluate because of their small size or location. However, a new technique called linear transducer harmonic imaging appears to provide better contrast and "reduced artifacts," which can hinder a precise evaluation.
Kulkarni and a team of colleagues evaluated 177 breast cysts in 30 patients; all of the cysts were considered "indeterminate" with conventional ultrasound. The researchers then simultaneously imaged the cysts with standard sonography and with the new harmonic sonography technique.
The harmonic images, Kulkarni reported, were superior to conventional ultrasound in 80 percent of the cases. In particular, the new technique was better in evaluating small cysts and those situated in the posterior third of the breast, Kulkarni said.
In another presentation, Dr. Nathalie Duchesne of Hopital du Saint-Sacrement in Sillery, Quebec, Canada reported on the use of the ultrasound-guided Hand Held Mammotome for conducting minimally invasive breast biopsies.
The mammotome, also known as vacuum-assisted biopsy, uses suction to draw in suspicious tissue. This method usually removes about twice as much tissue as core biopsies.
Duchesne and her colleagues used the mammotome for 111 biopsies; the sizes of the lesions ranged from 4 mm to 50 mm. The researchers found that they were able to completely excise the lesion in more than half of the cases.
Duchesne noted that the procedure takes more time and is more costly than standard core biopsy techniques. But it has an advantage in that it allows for the complete excision of the lesion. A new multicenter clinical trial is now underway to further investigate its effectiveness.
SOURCES:
101st Annual Meeting of the American Roentgen Ray Society, May 1-3, 2001, Seattle, Washington
The American Cancer Society (http://www3.cancer.org)
[Table of Contents] [Archived Issues / Search] [The Breast Center]