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These images of a 50-year old woman's breast were taken at the Mayo Clinic and showcase the new method. The leftmost image is a traditional X-Ray and misses the tumor, showing no abnormalities. The expensive MRI in the center detects the tumor. However, the molecular breast image, using radioactive dye (right) also detects the tumor at a fraction of the cost.  (Source: AP)
New methods promise to save lives by detecting breast cancer more quickly, eliminate false positives

With approximately one-third of Americans experiencing cancer in their lifetime, it is imperative to develop better cancer detection and treatment.  For women and some men, one of the deadliest cancers is breast cancer.  Traditionally, women are checked for cancer by mammograms, typically consisting of an X-ray of the breast.  However, the tests are somewhat inaccurate at spotting cancer.

On the other side of the spectrum is the MRI test used to generate a more detailed view inside the breast.  This expensive test is typically only reserved for high-risk patients.  The result -- some cancers that could be detected are going undetected due to the cost and effort required.

Now scientists at the Mayo Clinic are experimenting with a new, cheaper method that may allow the accuracy of MRI at a fraction of a cost.  New imaging methods are also being developed, which create an image that the radiologist views in three dimensions using special glasses, similar in basic concept to a 3D movie.

The new technology is still being assessed for viability, but many physicians see it as critical.  In women with dense breast tissue, it is virtually impossible to detect cancer using X-rays.  The new methods may help with this group of women.  It is estimated that half of women younger than 50 and a third of women over 50 have dense breasts.  Worst of all, dense breasts have been shown to have a higher cancer risk, so the most at risk group is the hardest to detect, a dangerous mix.

For women today with dense breasts (which a doctor can determine in a mammogram check), this news may be rather startling.  With current available methods there's little that can be done either.

American Cancer Society screening specialist Robert Smith stated, "It's a major issue in the field now, more and more, how to address the imaging needs of women with significant breast density.  We and women and everyone else is kind of left wondering what would be best under what circumstances.”

Dr. Mary S. Newell, assistant breast-imaging chief at Emory University in Atlanta added that "we can do better than we're doing."  She's helping test one of the 3D approaches.

Traditional mammograms work by X-raying breast tissue.  Shadows indicate denser spots, which could be tumors.  Regular mammograms for women over 40 are very beneficial as they can catch cancer earlier, in a more treatable stage.  Dense breasts however show up as one big shadowy mass.

Currently there are two alternatives.  Some women have elected to go for ultrasound scans of their dense breasts.  There have been a handful of studies supporting this approach, but it remains controversial and many physicians remain skeptical.  Others go for MRIs, which can spot unusual blood flow, indicating a tumor.  However, the MRI carries a $1,000 plus price tag.  Furthermore, both methods frequently have false positives, creating hassle and unnecessary fear for the patient.

One of the new methods is "stereo mammograms".  These mammograms help standard 2D mammogram images taken by literally smushing the woman's breast into mammogram unit, as usual to flatten the breast.  The image is only a little different than standard ones, but by using special glasses that utilize stereoscopic effects in the differences in angles between the two eyes, a pseudo-3D image is created.  This image can help doctors spot unseen spots under soft tissue.

In a new soon-to-be-published study in which Emory radiologists gave both the classic and the new stereo scan mammograms to patients, the new method improved detection by 23 percent and lowered false positives by 46 percent.

The second method, being developed by the Mayo Clinic, is named molecular breast imaging, or MBI.  It detects tumor not by a visual, but by how it acts.  Doctors inject a radioactive tracer, typically used in heart tests.  It has been found that the tracer collects in breast tumors and when exposed to a small gamma ray camera it lights up for easy viewing and detection of tumors.

Unlike MRIs, which require a separate visit and massive expensive equipment, the new scan can be done on the same visit and in the same room as the X-ray machine said Mayo radiology fellow Carrie Beth Hruska.

The MBI method in a recent test proved almost as accurate as the MRI, a proven technology.  It detected 51 tumors in 30 patients, while the MRI found 53 cancers in 31 patients.  Dr. Hruska presented these results at a Defense Department breast cancer conference last week.

The Mayo clinic will soon release the full results of their study, which tested 2,000 women with the new method.  In the fall, additional government funding is expected to bring the method to more hospitals, as it is tested more carefully.

While everyone wants to cure cancer, detection is equally important.  These new methods promise to save lives.





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