Developing Technologies for Early Detection of Breast Cancer A Public Workshop Summary (2000) / Chapter Skim
Currently Skimming:
Workshop Summary
Workshop Summary
Pages 1-15
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 1... ...
The breast cancer detection technologies discussed at the workshop may have the potential to enhance breast cancer detection. Right now, these emerging technologies show promise primarily as adjuncts to existing standard detection techniques, but with further development, some technologies may perhaps eventually replace current early detection modalities.
|
From page 2... ...
, digital mammography can be used for computer-aided diagnosis, using algorithms similar to those available for reading film screen mammography. A potential advantage of softcopy display over conventional fiIm-screen mammography is that it permits adjustment of magnification, brightness, and contrast after the mammography examination, thus enabling a more detailed examination of questionable areas without necessarily requiring additional imaging.
|
From page 3... ...
. Preliminary results based on 4,945 screening exams show that digital mammography performs no better than standard film screen mammography in detecting malignant lesions, but has so far led to fewer recalls than conventional mammography in a screening population.
|
From page 4... ...
He noted that technologies are unlikely to be attractive to insurers unless they can improve upon existing technology, demonstrate cost-effectiveness, save lives, or show improvements in important clinical endpoints. Thus, if digital mammography cannot show superior performance in early detection by improving the sensitivity and specificity, insurers won't find it attractive in replacing conventional film screen mammography.
|
From page 5... ...
MRI Screening in High-Risk Women * Contrast-enhanced magnetic resonance imaging is currently under active investigation for several applications, notably for imaging dense breast tissue in younger women; surveillance of high-risk women; presurgical planning and surgical guidance; evaluation of recurrence and drugtherapy monitoring; and for imaging elastography.
|
From page 6... ...
For example, the sensitivity and specificity of MR spectroscopy need to be improved for small lesions. At present, the International Consortium on Breast Magnetic Resonance Imaging, the National Cancer Institute, and National Institutes of Health are supporting research aimed at standardizing lesion characterization.
|
From page 7... ...
Ultrasound has also been shown, in limited studies, to hold promise as a method for early detection of cancers in women with dense breast tissue, which is often problematic with conventional fiIm-screen mammography. Based on a presentation by Christopher Merntt, M.D.
|
From page 8... ...
In the breast, 3-D imaging deserves evaluation for early breast cancer detection as in serial studies, according to Merrift. Coupled with contrast agents, 3-D Doppler imaging may provide more detailed assessment of tumor vascularity than is currently possible.
|
From page 9... ...
Scintimammography uses radioactive tracers that are taken up more readily by breast tumors compared to normal breast tissues to produce an image of a tumor. This is a relatively new technology that some clinicians may use as an adjunct to standard x-ray mammography to help localize tumors, to distinguish malignant and benign lesions, and to identify lymph node metastases.
|
From page 10... ...
However, much more bench research and clinical trials are necessary to prove efficacy and effectiveness before this technology enters the clinic. Imaging Gene Expression by MRT Another emerging imaging technique uses "smart" magnetic resonance contrast agents to reveal biochemical and physiological information, such as gene expression and other physiological processes in the form of a 3D-MR image.
|
From page 11... ...
Optical scanning uses non-ionizing radiation and a variety of contrast agents to produce an image of the breast. Potential advantages of the technology include speed, comfort, noninvasiveness, and easy access to the breast.
|
From page 12... ...
Both apoptosis and proliferation are under hormonal regulation in normal breast Apnea cells. Preliminary studies suggest that average rates of growth are higher and apoptosis is lower in premalignant cells compared to normal cells, which may be important in the development and progression of premalignant disease.
|
From page 13... ...
One impediment to moving ahead in our understanding of early breast cancer is that researchers have been largely restricted to working with small archival tissue samples from premalignant breast tissue, which means that scientists have been limited to doing correlative studies. Such studies do not provide information on mechanisms, and there is a lack of animal models or cell lines to address these mechanistic questions.
|
From page 14... ...
Nipple aspiration uses breast massage and a modified breast pump to aspirate fluid and cells for determining a cytological diagnosis. It can also facilitate measurement of protein markers such as growth factors and tumor-specific antigens, which are likely to be more concentrated in the breast fluid than in serum.
|
From page 15... ...
Using time-lapse digital movies of the live cells taken from tumors, it is possible to capture living cell movements and cell-to-cell interactions. So far, the time-lapse live cell videos have revealed markedly different behavior and cell-to-cell interaction in tumor cells compared with normal cells, according to Latimer.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.