A new way to detect breast cancer

Dr. Neb Duric

My name is Neb Duric, Ph.D., and I am the Imaging Program leader in the Department of Oncology and Breast Cancer Biology at the Barbara Ann Karmanos Cancer Institute and Wayne State University School of Medicine (SOM).

I work closely with Peter Littrup, M.D., radiologist and director of the Imaging Core and Radiological Research at Karmanos and WSU SOM. Together we lead a team of Karmanos doctors and scientists who are attempting to provide women with a new alternative to mammography that improves breast cancer survival rates and decreases unnecessary biopsies through the introduction of safe, cost-effective, operator-independent sonography based on the principles of ultrasound tomography (UST).

Together, my colleagues and I are developing a commercial version of the scanner, named SoftVue, which is aimed at delivering MRI-like imaging performance at a fraction of the cost of MRI.

One patient’s story

For 34-year-old breast cancer survivor Pamela Haddox, RN, of Huron Township, this non-invasive screening technology was much easier on her as a patient diagnosed with breast cancer. It also provides comfort to others who are uneasy about screening for the disease.

“I found a lump during my routine self-breast exam last year and scheduled an appointment immediately,” said Pamela, a clinical transformation specialist at Detroit Receiving Hospital. “My mom was diagnosed with breast cancer at 43 so I know how important it is to detect cancer in its early stage. I wanted to do everything I could to beat this disease.”

Pamela came to the Karmanos Cancer Center. Her mammography showed a suspicious mass. Just before her biopsy, she was asked if she wanted to take part in a clinical study related to new breast imaging technology created at Karmanos. She agreed, knowing that it could make a difference for others in the future.

“My first experience with this imaging was just before my biopsy. The exam was quick and there was no discomfort whatsoever,” said Pamela.

The biopsy confirmed that she had Stage II invasive ductal breast cancer.

“I went through several weeks of chemotherapy to shrink the tumor before I could have surgery. As part of the clinical trial, I would go each week to have another ultrasound of my breast with this new technology. Since there was no radiation or compression, it was safe and much easier to monitor how effective the treatment was on shrinking my tumor based on the enhanced images. The tumor mass did shrink and I was able to have surgery in June 2009.”

Pamela finished cancer treatments in March 2010 and continues to see her oncologist regularly for checkups and mammograms. She also continues with her maintenance drugs to prevent return of the cancer.  She added, “From a patient’s perspective, there was no discomfort or added anxiety from the process. It only takes a couple of minutes compared to MRIs, which take 45 minutes, or a mammography which can be painful. And it’s safe. I would love for all women to have access to this new technology.”

SoftVue’s clinical impact

SoftVue has been designed on the basis of strong clinical results from extensive testing of a prototype the group developed at Karmanos. The rationale for their work is that a commercial UST scanner will lead to a practical, low-cost device for breast cancer screening and diagnosis with potential for significant societal impact.

Why are we coming up with a whole new way of detecting breast cancer? Although mammography is the current gold standard for breast cancer screening, its effectiveness has recently become a subject of considerable debate. The limitations of mammography are most evident in the population of women who have dense breast tissue where the false negative rate can be as high as 50 percent.

The clinical impact of this limitation is profound given that women with dense breasts are up to five times more likely to develop breast cancer relative to those with fatty breasts. In addition, mammography continues to yield a high rate of false positives, averaging 80 percent benign biopsies, thereby contributing to an increase in breast cancer incidences and psychological stress.

Finally, mammography can be uncomfortable and uses ionizing radiation. Ionizing radiation forces risk-benefit trade-offs that limit frequency of screening, resulting in interval cancers, also more common in women with dense breast tissue.

A look to the future

While it is evident that magnetic resonance imaging (MRI) can significantly improve on these limitations, it is also impractical because it has long been prohibitively expensive for routine use. Therefore, an alternative breast imaging method is needed that eliminates the constraints of these standard imaging modalities. 

The lack of such an alternative is a barrier to dramatically impacting mortality (about 45,000 women in the U.S. per year) and morbidity from breast cancer because, currently, there is a trade-off between the cost effectiveness of mammography and sonography on the one hand and the imaging accuracy of MRI on the other.

Our team has been able to create a spin-off company to commercialize SoftVue. That new company is called Delphinus Medical Technologies, LLC. We’ve been able to secure sales commitments from several national health organizations and have had some investment from private equity partners. Development continues on this new technology and my colleagues and I are very excited about where we’ll see SoftVue used to help women and the early detection of breast cancer in the future.

For more information about breast cancer screening and treatment services at Karmanos Cancer Center, call -1-800-KARMANOS (800-527-6266) or visit www.karmanos.org. You may also e-mail us at info@karmanos.org.

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