A new technology developed by Australian researchers may enable women to learn-within minutes and without surgery-if a breast abnormality is benign or malignant and, if they have early breast cancer, whether or not the cancer has spread to the lymph nodes.

"This technology could eliminate a lot of unnecessary surgery in women with breast abnormalities by providing both a diagnosis and a prognosis before surgery," said Cynthia L. Lean, Ph.D., scientific director of the Institute for Magnetic Resonance Research in Sydney, Australia, and a member of the team that developed the technology.

The technique, known as magnetic resonance spectroscopy (MRS), works by analyzing the chemicals present in a small cluster of cells removed with a fine needle from the suspicious area of the breast. If a malignancy is found, a computer program evaluates the likelihood that the tumor has spread to the lymph nodes.

The group has conducted multiple laboratory tests using breast cancer cells that have shown that MRS can identify benign and malignant tumors and the presence or absence of lymph node involvement with a high degree of accuracy. Clinical testing of the technology is set to begin within a year in Australia, Sweden, and the United States.

Currently, women in whom other diagnostic tests are inconclusive may need a surgical biopsy to determine whether a breast abnormality is benign or malignant-and it may take several days to get the biopsy results. "In most cases, the abnormality turns out to be benign, but the woman has had to undergo surgery as well as days of uncertainty to obtain that diagnosis," explained Lean.

In women with early breast cancer, the presence or absence of lymph node involvement is a crucial factor in determining how their disease is treated. However, surgical removal of lymph nodes to determine if they contain cancer can cause lymphedema-swelling in the arms or legs due to excess fluid accumulation, which remains a risk after the procedure, and after breast cancer has been successfully treated.

"We hope that MRS will ultimately eliminate the need for lymph node surgery and the associated risk of lymphedema," Lean said.

SOURCE:
Department of Defense Breast Cancer Research Program meeting, Orlando, Florida, September 26, 2002