Non-Invasive Cancer Test May Help Identify Breast Tumors

June 22, 2010 -- After getting numbed up, Sherry Gavanditti had to watch while doctors removed what she called a corkscrew-sized piece of tissue from her left breast.

She saw the needle pierce her flesh, and then heard what she said sounded like a staple gun.

A little while after the biopsy was over, the area where the procedure was done was black and blue and tender to the touch.

Doctors told her she needed the test after she discovered a lump in her left breast. And even though it was benign, doctors told her it had to be checked regularly.

"They advised me to come back for a biopsy every year," she said.

She underwent her fourth biopsy after finding a lump under her arm last month, and definitely wishes there were another way.

"I asked for an ultrasound to get a clear idea of the scope of the lump," she said. "The biopsy is painful and scary, and I wonder what damage they may be doing with all the poking."

There may be an alternative coming, according to a study from the University of Connecticut and the University of Connecticut Health Center. They found that the combination of ultrasound and optical tomography identified whether small lesions in the breast were cancerous.

Whether it will one day be able to help people like Gavanditti is a matter of debate among breast cancer experts. A biopsy is the gold standard in determining whether a growth is malignant or not.

The new test is non-invasive, however, and may let doctors shine more light on the nature of breast tumors.

The Connecticut researchers used ultrasound to locate the areas where the lesions were, and then used a hand-held device to shine light of two different wavelengths on each lump. Since there's more blood flowing through cancerous tissue, they were able to tell which lumps were cancerous based on the amount of light they absorbed.

When compared with the results of biopsies, the combination of ultrasound and optical tomography identified nine out of 10 tumors.

No Substitute for Biopsy, Yet

But they're quick to stress that the test is not meant to be a substitute for the biopsy, which is still the only way to be 100 percent certain whether a lesion is cancerous or not.

"It could be used to delay the need for a biopsy," said Quing Zhu, one of the study's co-authors and an associate professor of electrical and computer engineering at the University of Connecticut.

"The technology is good in terms of giving a more accurate diagnosis," said Zhu.

Doctors agree that this technique shows some promise and may help some people avoid the need for an early biopsy.

"This will not replace biopsy, but it may help us with diagnosing breast cancers and potentially help us decide who can delay biopsy and who cannot," said Dr. Ben Ho Park, associate director of the Hematology/Oncology Fellowship Training Program at The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins. Dr. Park was not involved in the research.

Dr. Clifford Hudis, chief of the Breast Cancer Medicine Service at Memorial Sloan-Kettering Cancer Center, agreed, adding that there's some value in this technique because of the potential "avoidance of a procedure when you are on your way to the operating room anyway." Hudis was also not involved with this study.

However, he also wondered if a negative result using this technique would cause people to avoid getting a biopsy.

"The short answer is no, because there is a risk that you can have breast cancer despite a 'benign' result," he said.

Annie Lehmann shares that sentiment.

She had a biopsy a few months ago, and the results indicated that she did have early-stage breast cancer.

She thinks the development of a non-invasive screening test would be great, but not at the expense of a definitive diagnosis.

"If the only way you're going to know 100 percent if you have cancer is to have a biopsy, I'd have the biopsy in a second," she said.

While the optical tomography/ultrasound combination does show some promise, other medical experts say it's too early to tell just how effective a tool it can be.

Test May Offer Non-Invasive Option to Future Generations

"We are not ready to move away from our current approach," said Hudis.

"Nine out of ten is not good enough," said Dr. George Sledge Jr., professor of medicine at the Indiana University Simon Cancer Center. "Remember that nine of ten is what screening mammograms currently pick up."

Despite the criticisms, Sherry Gavanditti is glad that research into non-invasive screening tests is ongoing.

"I fear for my daughters," she said. "If they can find something so they won't have to go through a biopsy, that would be wonderful."

.