Novel method could revolutionize breast cancer detection

According to a study published on 9th February 2024, in Radiology: Imaging Cancer, a journal of the Radiological Society of North America (RSNA), an innovative breast imaging technique boasts high sensitivity in cancer detection while significantly reducing false positives.

Mammography effectively detects early breast cancer but loses sensitivity in dense breast tissue due to the masking effect of dense fibro-glandular tissue. As nearly half of screening candidates have dense breasts, many necessitate further imaging, typically MRI, post-mammography.

Low-dose positron emission mammography (PEM), a type of mammography, offers enhanced diagnostic accuracy with radiation levels. With its high sensitivity and minimal false positives, PEM could lower healthcare expenses by reducing unnecessary follow-ups compared to MR. Moreover, it offers radiation levels similar to mammography, eliminating the discomfort of breast compression for patients.

For the study, 25 women (median age: 52) diagnosed with breast cancer underwent low-dose PEM with the radiotracer 18F-FDG. PEM images taken at one- and four-hours post-injection were reviewed by breast radiologists, correlating findings with lab results. PEM demonstrated similar performance to MRI, detecting 24 of 25 invasive cancers (96%) with a low false positive rate of only 16%, compared to MRI's 62%.

“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,” said study lead author Vivianne Freitas, M.D., M.Sc., assistant professor at the University of Toronto. “As such, it holds the promise of transforming breast cancer diagnostics and screening, complementing or even improving current imaging methods, marking a significant step forward in breast cancer care.”

The technology could also play a crucial role in interpreting uncertain mammogram results, evaluating the response to chemotherapy and ascertaining the extent of disease in newly diagnosed breast cancer, including involvement of the other breast.

“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.”

Reference: “Breast Cancer Detection Using a Low-Dose Positron Emission Digital Mammography System.” Collaborating with Dr. Freitas were Xuan Li, Ph.D., Anabel Scaranelo, Ph.D., Frederick Au, M.D., Supriya Kulkarni, M.D., Sandeep Ghai, M.D., Samira Taeb, M.Sc., Oleksandr Bubon, Ph.D., Brandon Baldassi, M.Sc., Borys Komarov, M.Sc., Shayna Parker, M.Sc., Craig A. Macsemchuk, B.Sc., Michael Waterston, M.Sc., M.A., Kenneth O. Olsen, B.Sc., M.B.A., and Alla Reznik, Ph.D.