If you are seeing more pink than usual this month, October is Breast Cancer Awareness Month. While every month is special in some way, October gets extra emphasis from me because I am also a breast cancer survivor. This post shares just a few recent advances that have been made in breast cancer detection technology and treatment that is assisting medical professionals and clinicians in diagnosing tumors, and reducing the time required for treatment and the pain from more invasive surgery.
Three-D Technology: When tomosynthesis or 3-D technology was approved for mammography screening in 2011 by the Food and Drug Administration, many heralded it as a break-through technology. Four years later, the technology has it champions as well as skeptics. What women and members of the public need to understand is that there is no perfect technology for breast cancer screening.
Here’s the thing: each technology has pros and cons, and one may be more advantageous than the other under different circumstances. Three-D (3-D) mammograms are more costly not only due to the equipment’s expense, but also because radiologists have to look at more images. There may be out-of-pocket costs for patients choosing a 3-D mammography, while the cost of 2-D mammography is covered in most health insurance wellness plans. [Ref 1]
Researchers also hope tomosynthesis will benefit specific groups of women, such as those with dense breast tissue — about half of all women — and younger women. “Three D has revolutionized the mammogram in the sense it does a better job,” according to Dr. Kara Carlson, medical director of the Evergreen Health Breast Center. The advantage of 3-D is that it prevents images of breast tissue from overlapping each other, hiding cancers that can spread, she said. “It’s a more effective tool than your standard 2-D mammogram.”
Here’s another thing to remember: just as it took years for radiologist and technicians to learn and understand 2-D technology, there is definitely going to be a learning curve for the 3-D technology.
Image-Guided Autonomous Robot (IGAR): Medical professionals are now applying robot capabilities derived from the International Space Station (ISS) for life-saving surgical techniques in combating breast cancer. A team of researchers with the Centre for Surgical Invention and Innovation (CSii) in Canada began a round of clinical trials using a robot that has technology similar to one designed for ISS. [Ref 2] Researchers created IGAR to provide increased access, precision and dexterity, resulting in highly accurate and minimally invasive procedures.
“The IGAR platform moves the use of robotics in surgery to a new dimension, allowing the robot to act in an automated fashion after programming by a physician,” said Dr. Mehran Anvari, chief executive officer and scientific director at CSii. “This technology has been practiced in manufacturing and in space, but is new to medicine.” IGAR is designed to work in combination with an MRI scanner, which is highly sensitive to early detection of suspicious breast lesions before they possibly turn into a much larger problem.
“Our automated robot is capable of placing the biopsy and ablation tools within 1 mm (about three-tenths of an inch) of the lesion in question with a high degree of targeting accuracy, improving sampling, reducing the morbidity and pain of the procedure, reducing time in the MRI suite and saving significant dollars as a consequence,” said Anvari. “It also will allow all radiologists to perform this procedure equally well, regardless of the number of cases per year and move the site of treatment from operation room to radiology suite for a significant number of patients.”
This robotic technology is not limited only to biopsies. “I think IGAR is paving the way for the minimally-invasive excision and treatment of small tumors that are often found incidentally during pre-op MRI,” said Dr. Nathalie Duchesne, co-investigator on this clinical study. “The trend toward breast preservation has brought on the importance of lumpectomies. For tumors that may require this procedure because they are invisible to ultrasound and X-ray mammography, researchers are currently developing the ability for IGAR to deploy a radioactive seed — smaller than a grain of rice — near the area of interest. During surgery, the seed can be located with a detector, allowing the doctor to identify the lesion and remove it with increased accuracy and patient comfort. It’s expected that follow-up surgeries also will be greatly reduced.
From ISS to the ground, robotic arms lend a hand, whether it be to grab an arriving resupply vehicle or to help save more lives.
Microscopic Magnets May Minimize Invasive Treatment: Interventional radiologists are currently investigating a new technique in which magnets are used to pull chemotherapy drugs into tumors. Microscopic magnetic particles are attached to the cancer-killing drugs and infused through a catheter into the blood vessel that feeds the tumor. A rare earth magnet is positioned over the patient’s body directly above the site of the tumor. The magnet pulls the drug-carrying particles out of the blood vessel so that they lodge in the tumor. Although the technique is still experimental, early research is promising. [Ref 3] Physicians are hopeful that it will bolster the effects of chemotherapy while avoiding some of the drugs’ side effects, such as hair loss and nausea.
Gel-form of Tamoxifen: Meanwhile, researchers at Northwestern University are using a gel form of a drug to treat breast cancer and prevent side effects. [Ref 4] Tamoxifen is a drug frequently prescribed to prevent breast cancer in women at increased risk, but many women avoid the treatment due to intense side effects. Women with dual carcinoma in situ (DCIS) or a strong family history of the cancer sometimes forgo tamoxifen to avoid the hot flashes, blood clots and other symptoms associated with the pill.
A new study led by Seema Khan, MD, professor of surgery and Bluhm Family Professor of Cancer Research at Northwestern University Feinberg School of Medicine, showed tamoxifen in gel form, when applied to the skin, could decrease abnormal cell growth without any increase in the blood markers associated with the negative side effects. The topical gel treatment, which could potentially improve preventive breast cancer treatment in women at risk, may also represent the opportunity for similar discoveries with other drugs.
Using one of the slogans from the American Cancer Society, these experimental technologies and treatment enhance the phrase: making strides against breast cancer.
- 3-D technology finds some hidden cancers but can cost more, by Sharon Salyer, The Herald of Everett, Washington, October 4, 2015, http://www.heraldnet.com/article/20151004/NEWS01/151009695
- Robots from Space Lead to One-Stop Breast Cancer Diagnosis Treatment, by Jessica Eagan, International Space Station Program Science Office, NASA’s Marshall Space Flight Center, October 31, 2013, http://www.nasa.gov/station/research/news/igar/#.ViKALvlViko
- Minimally Invasive Treatments for Breast Cancer, The Society of interventional radiology, http://www.sirweb.org/patients/breast-cancer/
- Gel Form Offers Prevention Without Side Effects, Northwestern University Feinberg School of Medicine, http://www.nmbreakthroughs.org/medical-advances/a-new-way-to-fight-breast-cancer