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Posts Tagged ‘Breast cancer’

MRI is a practicable approach for chemotherapy response monitoring for breast cancer; know it a bit more!

 

Magnetic resonance imaging is an imaging approach, where strong magnetic fields/radio-waves are utilized for cross-sectional images of internal structures and organs of the body.

The technology is practicable for a variety of medical conditions – tumors, cysts, irregularities of the brain/spinal cord, joint injuries, uterine abnormalities etc.

We know already about mammography, for early detection of breast cancers in women, where x-ray is used to identify and locate the tumors, and for irregularities in the female breast.

And, magnetic resonance imaging of the breast, is one of its kind; the technology does not involve ionizing radiation, and is safe for women; it is often used for determination of ruptured silicone breast implants.

An MRI of the breast is feasible for various conditions that other imaging modalities are unable for, though it is an auxiliary tool, and not a substitute for ultrasound imaging or mammography.

For women that have family history of breast cancer, MRI can be an appropriate diagnostic approach; by looking at the family history that any patient has, doctors can determine whether the MRI approach is relevant for them.

For women with a history of lobular carcinoma in situ, a recent study substantiated the effectiveness of breast MRI, as the technology enhanced cancer detection rate in them.

When a patient is newly diagnosed with breast cancer, the extent of cancer and its effect on underlying muscles can be determined with an MRI; for other cancers in the same and opposite breast are even possible through it; cancer spread can be ascertained through irregular lymph node in the underarm.

Irregularities shown on other imaging modalities, when cannot be sufficiently assessed, singly, an MRI facilitates for to surely establish the results for biopsies and related.

In most of the cases with chemotherapy for breast cancer, an MRI is often utilized for to assess effectiveness of the therapy to ascertain presence of tumor, after the process.

For more about various imaging modalities, new medical innovations, technology vendors and related – stay connected with MedicExchange!

Serial PET scans, through peculiar estrogen-containing isotope found viable for relative effectiveness of estrogen-blocking/depleting therapy in metastatic breast cancer cases, substantiates Seattle Cancer Care Alliance.

 

The study was contributed by: Hannah Linden, M.D.; David Mankoff, M.D.; Jeanne Link, M.D., and Kenneth Krohn, M.D., at the SCCA, and UW; and Brenda Kurland (Statistician, Fred Hutchinson Cancer Research Center).

PET scans – prior, on and after hormonal therapy affirmed the potency of estrogen-receptor-blocking drugs over estrogen-depleting therapies to withhold estrogen receptor in cancer cells; tamoxifen has even been substantiated over fulvestrant in to block estrogen.

Researchers (Linden & the team) evaluated territorial estrogen-receptor blocking/binding through PET scans with 18F-Fluoroestradiol (FES), before, and on discourse with aromatase inhibitors, fulvestrant, and tamoxifen in about 30 patients with breast cancer (vide: oncology) spread to the bones.

Tumor FES uptake waned in patients that took estrogen-receptor blockers, in comparison to others that had taken estrogen-depleting aromatase inhibitors; of both the studies, the rate of all over tumor blockade was highest sticking to use of fulvestrant, in contrast to tamoxifen.

Results suggest FES PET for effective visualization of in vivo activity of endocrine therapy; the technology can be utilized in drug development to gauge effectiveness at purposeful therapeutic targets, and to improve dosing/selection for agents. Moreover, pharmacodynamic imaging is feasible for therapeutic selection, and to evaluate/predict response to estrogen-receptor directed therapy.

(Courtesy: Journal of American Association for Cancer Research)

Mammography is feasible incidentally for breast irregularities associated to extramammary disease, than its regulars in breast cancer.

 

Submitted over as an education exhibit at 2009 RSNA annual meeting, contributions in this segment are being made by Mailan M. Cao, MD; Anne C. Hoyt, MD and Lawrence W. Bassett, MD from the Iris Cantor Center for Breast Imaging, Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, CA.

The article is available in the online journal of Radiological Society of North America.

Even though mammography is principally utilized for to recognize breast cancer, it is feasible incidentally for breast irregularities associated to extramammary disease.

Cardiovascular disorders, viz. central venous obstruction and congestive heart failure may show as breast edema and venous engorgement (congestion), at mammography.

Morbid arterial calcifications observed at mammography can show out to basal risk factor for hastened atherosclerosis, viz. chronic renal failure.

Connective tissue disorders (rheumatoid arthritis, systemic scleroderma, systemic lupus erythematosus, dermatomyositis-polymyositis) characteristically demonstrate with bilateral axillary lymphadenopathy; stromal calcifications are even visible in ultimate three disease procedures.

Disorders like filariasis and neurofibromatosis type 1 may show up with pathognomonic findings at mammography; but in contrast – amyloidosis, wegener granulomatosis and sarcoidosis show as non-specific breast masses, not easily characterized from breast cancer, and generally call for tissue biopsy for ratification.

Facts about imaging attributes of varied systemic disorders that affect breast will help radiologist in to discriminate systemic disorders from questionable breast lesions, thus ascertain relevant follow-up examination.

Besides, identification of systemic disorders like Cowden syndrome, which is related with an enhanced risk of breast cancer will facilitate the radiologists to suggest proper supervision.

Primary outcomes propose that quantitative diffusion weighted imaging could be used for low grade ductal carcinoma in citu, with high specificity.

 

The medical research study was conducted by Mami Iima, MD; Denis Le Bihan, MD, PhD; Ryosuke Okumura, MD, PhD; Tomohisa Okada, MD, PhD; Koji Fujimoto, MD, PhD; Shotaro Kanao, MD; Shiro Tanaka, PhD; Masakazu Fujimoto, MD; Hiromi Sakashita, MD, PhD and Kaori Togashi, MD, PhD from the Department of Diagnostic Imaging and Nuclear Medicine and Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan; Departments of Radiology and Pathology, Kitano Hospital, Osaka, Japan; Neurospin, CEA-Saclay, Gif-sur-Yvette, France; and Translational Research Center, Kyoto University Hospital, Kyoto, Japan. (Courtesy: RSNA Journal)

The study objective was to assess the possibilities of apparent diffusion coefficients acquired at quantitative diffusion weighted MRI of the breast, as a biological marker of low-grade ductal carcinoma in situ.

About 22 women with mean age of 56.4 years with pure ductal carcinoma in situ/breast cancer (cases were comprised of low, intermediate and high grade cancers), and others with microinvasion (in situ carcinoma) passed through 1.5T breast MRI during year 2008-2010; the examination comprised subsequent: contrast enhanced T1-weighted imaging and diffusion weighted imaging; apparent diffusion coefficients were produced out, and its distributions (region of interest) were equated amongst three grades through with linear mixed models, and the preferential power of the lesion minimum ADC was established with ROC curve analysis.

Of results, the mean ADC for low, intermediate and high grade DCIs and normal breast tissues were collated; mean ADCs for low-grade DCIs were considerably higher than that for the same of high and intermediate grade DCIs; mean ADC for normal tissues was substantially higher than low grade DCIs. The lesion minimum apparent diffusion coefficient for low grade ductal carcinoma in situ was even considerably higher than that for high and intermediate grade DCIs.

Conclusion: primary outcomes propose that quantitative DW-MR imaging could be well utilized for to detect patients with low grade ductal carcinoma in citu, with high specificity; through after confirmation of the results, the approach shows good promise to patients, to keep away from axillary lymph node excision/mastectomy.

As per the study put forward at the Cancer Imaging and Radiation Therapy Symposium in Atlanta:

• Annual mammograms furnish similar consequences post breast conserving therapy for cancer patients, at lower health care cost
• Researchers tried to ascertain the clinical relevance and usefulness of follow up mammogram after Breast Conserving Therapy (BCT), when the patient is treated already with treated with a lumpectomy and radiation for stage breast cancer.

The conference was supported by Radiological Society of North America (RSNA) and the American Society for Radiation Oncology (ASTRO).

Annual mammograms are often carried on after BCT. Some of radiologists urge for interval mammogram (follow-up) after 6 months, after primary post-treatment mammogram, which is about 5 months after the culmination of radiotherapy, on the average, to ascertain constancy, to check out for cancer recurrence (Oncology).

For the trial study, about 88 of 467 BCT patients from Abington Memorial Hospital, Abington, PA had an interval mammogram (IM). This contributed to 4 biopsies that did not generate any recurrent or new cancer cases. The patients proceeded further for their annual mammograms after interval mammogram.

Medical researchers ascertained that ruling out IM would bring down higher healthcare costs, with no vital impact on patient outcomes.

Though an IM after BCT is normal, but physicians are required to reconsider their suggestion for an IM, to relieve patients with lower healthcare costs and unneeded biopsies.

Conclusion: Interval Mammograms after Breast Conserving Therapy is not recommended for patients, to save them money and unneeded biopsies.

Cancer treatment response can be found with blood test that involves chemically cleaning the blood for DNA fragments shed by dying cells and check if cattle are afflicted by mad cow disease.

Scientists from Chronix Biomedical has discovered that the blood test could identify accurately 90% of the patients with breast and prostate cancer. This result will be showcased at the American Society of Clinical Oncology’s annual meeting in Chicago. According to Howard B. Urnovitz, CEO and co-founder of Chronix, “It’s not a genetic test, It’s really an apoptosis test.”

The results of the test could be deciphered on the rates of cell death or apoptosis. ‘Hot spots” along the genome,that are linked to cancers, in case of breast or prostrate cancers. The excessive presence of DNA fragments from these “hotspots” in the blood identifies cancer in a patient.

Blood samples were compared from about 178 breast cancer and 197 prostate cancer patients for the research.It was revealed that around 92% of all cancers,100% had no false positives.

“If you have a disease whose fundamental basis is that cells die, then this test would be effective,” Urnovitz said. “We can say it works in mad cow, chronic wasting disease, breast and prostate cancer. We predict, and I could be wrong, that it will work on all cancers.”

“It represents a whole area of research underway in many labs around the world to answer this question of finding these small, unique markers for cancer that we can effectively and routinely measure for detection or treatment,” said Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society.

However, the process of implementation of these tests will need to wait for personal diagnoses indefinately. Chronix considers the plans to promote and market the test product to pharmaceutical companies and cancer researchers will be the first step to monitor if these experimental drugs shrink tumors and prevent cancer recurrence in the first place.

Women with higher density on a mammogram has higher risk (four to five times) of developing breast cancer, opined the researchers who presented data regarding this during the Annual Meeting of the American Association for Cancer Research.

The presentation included data from three studies on latest research regarding mammographic density. The following two studies in the presentation indicate that mammographic breast density is an indicator of breast cancer risk.

1. Longitudinal breast density and risk of breast cancer: The study was conducted at the Mayo Clinic, Rochester,  and lead by Celine M. Vachon, Ph.D., associate professor of epidemiology in the College of Medicine and colleagues. They evaluated from data collected for Mayo Mammography Health Study, which included 19,924 women who had a mammogram at the Mayo Clinic between 2003 and 2006; the women were above 35 years and didnt have a history of breast cancer. The researchers evaluated whether change in breast density is associated with breast cancer and found that women who had an increase in breast density over six years has a higher risk (28 percent) of developing breast cancer. And it is likely that women with decreasing density has lower risk.

2. Change in mammographic density with estrogen and progestin therapy: A measure of breast cancer risk in the Women’s Health Initiative : Celia Byrne, Ph.D.and colleagues at the Lombardi Comprehensive Cancer Center at Georgetown University found that Change in mammographic density may be a useful intermediate marker to explain the increased breast cancer risk among postmenopausal women using estrogen and progestin therapy (EPT). The case-control study was conducted within the Women’s Health Initiative (WHI) randomized trial of EPT.

Mammography, which is basically an x-ray of the breast, is the gold standard for breast cancer screening and the American Cancer Society recommends yearly screening mammograms for all women aged above 40yrs of age. The new research has added a new dimension in the advantages of a mammogram, ie not just early breast cancer detection but also identification of potential risk of developing breast cancer later.

A new study finds that women who does not undergo annual mammographic screening have higher rate of detection of breast cancer as palpable breast tumors, which are at an advanced stage when compared to cancers detected by mammography screening.

The study supports the benefits of yearly screening mammographyas well as clinical breast examination (CBE) and breast self-examinationat in early detection of breast cancer. Thus it contradicts the new U.S Preventative Services Task Force (USPSTF) recommendations – biennial mammography screening starting at 50yrs, discouraging teaching breast self examination and that current evidence is insufficient to assess the additional benefits and harms of clinical breast examination (CBE).

“Presentation as a palpable mass was more frequent in those women who had not had a mammogram in the prior 12 months. This finding is even more concerning when you consider the recent recommendations for decreasing the use of mammography because it would result in an even greater proportion of breast cancers being detected by palpation and therefore at more advanced stages.”said Judy Boughey, MD, FACS, assistant professor of surgery, Mayo Clinic, Rochester, MN, and a co-investigator of the study.

The study investigator is Dr. Amy C. Degnim, MD, FACS, associate professor of surgery, Mayo Clinic and the findings of the study are published in the March issue of the Journal of the American College of Surgeons.