New breast cancer screening technique more accurate and cost-effective

By James Gamble via SWNS

A ground-breaking new imaging technique could soon offer more accurate and less invasive breast cancer diagnoses.

The innovative screening technique called a low-dose positron emission mammography (PEM), returned far fewer false-positive results than MRI scans and is thought to be less uncomfortable than mammogram screening.

Mammograms also often fail to deliver accurate diagnoses in women with high breast density - a problem that doesn't occur for PEM scans.

And in returning fewer false-positive results, PEMs could save health services like the NHS millions by reducing unnecessary operations and treatments.

The Canadian researchers behind the study, published in the journal Radiology: Imaging Cancer, believe the scans could offer more reliable breast cancer screening for a broader range of patients in the near future.

Mammography, though an effective screening tool for early detection of breast cancer, is reduced in accuracy when applied to patients with dense breast tissue.

Dense breast tissue has relatively high amounts of glandular tissue and fibrous connective tissue and relatively low amounts of fatty breast tissue, which make it more difficult to detect cancer.

People with dense breasts also have a higher chance of developing cancer, though scientists still aren't sure why.

However, since nearly half of the screening population have dense breasts, many of these patients require additional breast imaging, often with MRI scans, after mammography.

PEM is a novel molecular imaging technique that provides improved diagnostic performance at a radiation dose comparable to that of mammography.

In the study, conducted by researchers at the University of Toronto, 25 women with an average age of 52 who had recently been diagnosed with breast cancer underwent low-dose PEM after being injected with the radiotracer fluorine 18-labeled fluorodeoxyglucose (18F-FDG).

Two breast radiologists then reviewed the PEM images taken one and four hours after the 18F-FDG injection and correlated the findings with lab results.

The researchers found that PEM displayed a comparable performance to MRI scans in identifying 24 of the 25 invasive cancers (96%).

Moreover, its false positive rate was only 16 percent - compared with 62 percent in MRIs.

Along with its strong sensitivity and higher accuracy, the researchers say PEM could also potentially reduce healthcare costs, as it may prevent further unnecessary work-up in comparison with more inaccurate MRIs.

The technology could also prove less uncomfortable than mammograms, as it's designed to deliver a radiation dose comparable to that of traditional mammography without the need for breast compression.

Dr. Vivianne Freitas, an assistant professor at the University of Toronto and lead author of the study, said the innovative new method could signal a leap forward in breast cancer detection.

"The integration of these features - high sensitivity, lower false-positive rates, cost-efficiency, acceptable radiation levels without compression, and independence from breast density - positions this emerging imaging modality as a potential groundbreaking advancement in the early detection of breast cancer.

"As such, it holds the promise of transforming breast cancer diagnostics and screening in the near future, complementing or even improving current imaging methods, marking a significant step forward in breast cancer care.

“For screening, its ability to perform effectively regardless of breast density potentially addresses a significant shortcoming of mammography, particularly in detecting cancers in dense breasts where lesions may be obscured.

“It also presents a viable option for patients at high risk who are claustrophobic or have contraindications for MRI.”

PEM could additionally play a role in interpreting uncertain results from mammograms; evaluating the response to chemotherapy and understanding the extent of disease in newly diagnosed breast cancer cases, including involvement of the other breast.

Dr. Freitas is currently researching PEM's ability to reduce the high rates of false positives typically associated with MRI scans, whilst further studies are also needed to determine low-dose PEM’s exact role and efficacy in the clinical setting.

If successful, PEMs could significantly lessen the emotional distress and anxiety associated with false positives and lead to a drop in unnecessary biopsies and treatments.

“While the full integration of this imaging method into clinical practice is yet to be confirmed, the preliminary findings of this research are promising, particularly in demonstrating the capability of detecting invasive breast cancer with low doses of fluorine-18-labeled FDG,” Dr. Freitas said.

“This marks a critical first step in its potential future implementation in clinical practice."