Reducing unnecessary breast biopsies

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One out of eight women will be diagnosed with breast cancer at some point in her life. Early detection is the best tool to increase survival rates.

Now, researchers are looking at a new way to confirm cancer faster during a mammogram while reducing the need for additional testing.

It's a terrifying moment for any woman. A doctor says they have found something during her mammogram.

"Many women are recalled unnecessarily, which causes anxiety. Do I have cancer or not?" explained University of Chicago professor and research associate Dr. Karen Drukker.

An abnormal finding on the mammogram can lead to a biopsy, which can be invasive.

A majority of the time, the finding turns out to be benign. That's why researchers are studying a new technique called three-compartment breast imaging, or 3CB.

"That is imaging, X-ray imaging that uses X-rays of multiple energies so that you can characterize the tumor and tissue," radiology professor Dr. Maryellen Giger said.

"It can measure the three compartments of breast tissue, which are water, lipid and protein," Drukker said.

By measuring these components and using an artificial intelligence method developed by Giger called mammography radiomics, the team can find different digital characteristics to help distinguish a cancerous tumor from a noncancerous one.

They tested this technique on more than 100 patient mammograms.

"We were able to reduce the number of biopsies by about 30%," Drukker said.

It also increased the ability to predict cancer from 32% to 50% compared to visual interpretation alone.

An added benefit is that this technique is not invasive. The team is able to get all this extra information with only a 10% additional dose of radiation during the mammogram.

Further testing still needs to be done before this technique can be available to patients. The next step for the team is to study this technique on 3D mammograms.

MEDICAL BREAKTHROUGHS
RESEARCH SUMMARY
TOPIC: REDUCING UNNECESSARY BREAST BIOPSIES
REPORT: MB #4615

BACKGROUND: Cancer is always scary news for patients. Diagnosing it at its earliest stages provides the best chance for patients to be cured. There are different ways of detecting cancer. Screening tests can help diagnose cancer early and save lives, but that isn't the same for all cancers. For some, screening tests are only recommended for people that have an increased risk. Other ways doctors will diagnose cancer are physical exams, laboratory tests, imaging test, and biopsy. Tumors are also not always cancerous; some are benign which are not cancerous. Cancerous tumors are known as malignant. (Source: https://www.mayoclinic.org/diseases-conditions/cancer/diagnosis-treatment/drc-20370594)

TREATMENT GOALS: The number one goal of treatment is to find a cure and to improve a patient's quality of life. Surgery completely removes or kills the cancer in a patient's body. Methods like chemotherapy and radiation are forms of primary treatment. Adjuvant treatment is a secondary treatment that removes any cancer cells that may still be left after primary treatment. Chemo, radiation and hormonal therapy can also work as adjuvant treatments. Palliative treatment is the last and this helps relieve side effects from any of the other treatments or even symptoms from the cancer itself. (https://www.mayoclinic.org/diseases-conditions/cancer/diagnosis-treatment/drc-20370594)

NEW STUDY: Maryellen Giger, PhD, Professor of Radiology at the University of Chicago explains a new study called 3CB that uses help from AI. "On the 3CB side, it is a x-ray imaging technique that uses x-rays of multiple energies so that you can characterize the tumor and tissue. And then once you obtain these multiple images you can characterize the lipid, the protein and the water content at each point within the image, and because cancer and non-cancer lesions have different content, you can use that information to help distinguish between cancers and non-cancers." Giger says this could be beneficial for women in the future. "When a woman goes for screening if something suspicious is found she then moves on to additional imaging or perhaps a biopsy. And you want to reduce the number of biopsies because they're traumatic to the woman," said Giger, " The goal here was to keep roughly the cancer detection rate the same but reduce the number of cancers that would be benign lesions, those are non-cancers, that would go to biopsy." (Source: Maryellen Giger, PhD)