New technique to improve breast cancer diagnosis

Researchers from the University of Michigan College of Pharmacy have come up with a method for diagnosing the disease that is expected to be better at distinguishing between benign and aggressive tumours using a special oral pill. FILE PHOTO | NMG 

By SARAH OOKO

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Summary

• A mammogram test can also miss lumps among women with dense breast tissue, which usually succeeds in hiding existing lumps from the prying eyes of the technology.
• When this happens, affected women end up dying unnecessarily from a treatable disease.
• They are failed by a technology that is still the Gold Standard test for breast cancer screening.
• Aware of these shortcomings, scientists have been trying to come up with newer technologies that can combat the challenges and enhance accuracy of breast cancer screening methods.
• Researchers from the University of Michigan (UM)College of Pharmacy are now closer to achieving this goal.

As a part of her annual medical check-up, Mary Nduku had a mammogram test in 2007, which identified a lump in her breast. It was later found to be cancerous.

She underwent treatment immediately after the diagnosis and has been cancer free for over a decade now.

“I am glad for the medical check-up as it made it possible for the doctors to identify the cancer early enough. And that saved my life!”

For many years, mammogram tests have been instrumental in enhancing early detection and prompt treatment of breast cancer hence reducing deaths associated with the disease.

Nevertheless, the mammogram has its share of limitations since the technology is usually unable to make a distinction between benign (or slow growing) tumours and aggressive (fast growing) lumps that are life threatening.

Indeed, results of a large scale Dutch study published last year in the Internal Medicine Journal revealed that one out of every three women with breast cancer detected by a mammogram is treated unnecessarily.

This is because some of the tumours it detects are slow-growing and harmless. These are lumps that may never grow to a level of causing the disease in the lifetime of a woman.

A mammogram test can also miss lumps among women with dense breast tissue, which usually succeeds in hiding existing lumps from the prying eyes of the technology.

When this happens, affected women end up dying unnecessarily from a treatable disease. They are failed by a technology that is still the Gold Standard test for breast cancer screening.

Aware of these shortcomings, scientists have been trying to come up with newer technologies that can combat the challenges and enhance accuracy of breast cancer screening methods.

Researchers from the University of Michigan (UM)College of Pharmacy are now closer to achieving this goal. They have come up with a new method for diagnosing the diseases that is expected to be more adept at distinguishing between benign and aggressive tumours.

This approach involves the use of a special oral pill that makes tumours light up when exposed to infra-red light. This enables health experts to differentiate between relatively harmless lumps and lethal tumours that require treatment.

So far, this concept has been shown to work in mice. And the scientists are now looking for ways of further improving the technology before it is eventually tested in humans.

“We overspend billions per year on the diagnosis and treatment of cancers that women would never die from,” said Greg Thurber, lead author of the study and assistant professor of chemical and biomedical engineering at the UM College of Pharmacy. “If we go to molecular imaging, we can see which tumours need to be treated.”

According to the researchers, the new technology will also help doctors to detect tumours in dense breast tissue whilst saving women from mammogram tests that can be notoriously uncomfortable to undergo.

The new pill is designed in a manner that enables it to carry a special kind of dye (sensitive to infra-red light) to areas of the breast with lumps or tumours. This causes tumours to light up, while at the same time providing information on the type of molecules present in them.

This knowledge (molecule type) makes it easier for health experts to distinguish between harmless and harmful lumps. Unlike mammograms that may miss hidden lumps in dense breast tissue, the infra-red light is effective in searching and “fishing-out” all existing tumours since it can comfortably penetrate and get to all depths of the breast without causing any harm. Intense exposure to X-ray beams used in mammograms carries the risk of disrupting genes or DNA structures in the breast thus making women vulnerable to life threatening tumours that could have been easily avoided.

Using a dye delivered orally rather than directly into a vein also improves the safety of screening.

This is because the latter approach can cause severe reactions in some patients hence affecting their health adversely.

Dr Asim Shaikh, an oncologist at the Aga Khan University Hospital in Nairobi, noted that despite their limitations, mammograms are still very instrumental in breast cancer diagnosis and should not therefore be shunned.

He said techniques used in mammograms are also improving. For instance, some hospitals now have digital mammography or PET scan guided mammograms that enhance accuracy of generated results.

“The Dutch study and a few others that have highlighted the limitations of this diagnosis approach are still few. So we expect many more studies to be done before a definite decision can be made on whether we should promote or discourage mammograms.”

“Also, these studies have been conducted abroad. So they may not necessarily represent the situation here in Kenya or Africa. We will therefore need to also do our own local research.”

For instance, he noted that the average age for breast cancer diagnosis in African women is between 47 and 48 while women in the West tend to get it between the ages of 55 and 60.

He said mammograms are ideal for women above the age of 40 as they have less dense tissue. Women below that age are often advised to have ultrasound tests which are much more effective in penetrating dense breast tissue and identifying lumps.