3D Mammograms and Breath Test Represent Advances in Breast Cancer Detection Technology

Doctors and researchers around the world are looking to improve the prevention, detection, and treatment of breast cancer. In recent years, the advancements in technology, specifically in detection methods, have demonstrated significant improvement in how early patients are diagnosed and treated.

Mammograms are the most common and well-known breast cancer detection method; however, they are often an uncomfortable process and are not always completely accurate. According to the American Cancer Society, false-negative results—when the mammogram looks normal although breast cancer is present—are fairly common, as screening mammograms do not find about 1 in 5 breast cancers. False-positive results—when a mammogram looks abnormal though there is no cancer present—are also common and require additional testing, at additional costs.

In recent years, many researchers have been using and testing the efficacy of 3-dimensional (3D) mammogram and its potential screening benefits. In a study, reported by AARP, nearly 7300 women from ages 48 to 71 received both a standard mammogram and a combination of standard plus 3D imaging. A total of 59 breast cancers were detected; however, 39 were found by both standard mammogram alone and the standard plus 3D, while the combination mammography was able to find an additional 20 cancers.

In September 2017, the Tomosynthesis Mammographic Imaging Screening Trial (TMIST) opened and began looking to enroll healthy women in order to compare tomosynthesis (known as the 3D mammogram) and the conventional (2-dimensional [2D]) mammogram.

“We need to determine if 3D mammography is better than 2D at finding the sort of breast cancers that are most likely to spread and kill women,” ECOG-ACRIN study chair Etta D. Pisano, MD, vice chair of research in the Department of Radiology at Beth Israel Deaconess Medical Center and professor in residence of radiology at Harvard Medical School, said in a statement. “If a newer screening technology does not reduce the numbers of advanced, life-threatening cancers, then are we really improving screening for breast cancer?”

Additionally, a 2016 study published by the Annals of Internal Medicine found that false-positive mammography results and additional imaging are common, especially among young women. A detection device that could potentially decrease the rates of this occurring is the breath test from Menssana Research, Inc. The breathalyzer test is able to identify biomarkers of diseases, including breast cancer.

“We developed the world’s most sensitive breathalyzer in our lab. It is a billion times more sensitive than the kinds of breathalyzer that police use for alcohol. So when we have anyone that gives a sample with our breathalyzer we can analyze it,” Michael Phillips, MD, FACP, FRCP, founder and CEO of Menssana, told The American Journal of Managed Care®. “We find many different compounds, 100 to 200 or more compounds in the breast and we find that many of these are biomarkers of various diseases—including breast cancer.”

Phillips emphasized that the breath test is not yet approved by the FDA and is still in the feasibility stage, and therefore is not affecting the standard of care. While the breath test will not replace these mammograms or biopsies, it could instead potentially work with them.

“The real concern here is that a tremendous amount of mammograms and a tremendous amount of biopsies are being done unnecessarily—meaning that a lot of women are having discomfort,” added Phillips. “It’s quite possible that we could safely reduce the number of these investigations.”

As biopsies remain the standard of care in breast cancer detection, the breath test research is intended to reveal which women are at a low-risk and which are at a high-risk for breast cancer. This risk information, as Phillips explained, will hopefully be able to decrease the number of women who have to undergo mammograms and biopsies.

By decreasing the number of mammograms and biopsies, the breath test could lower the discomfort women feel when they undergo these tests, but also the eliminate extra costs. Therefore, patients could rule out the potential of breast cancer while saving their time and money.

A breath test study is currently being funded by the National Institute of Health and the National Cancer Institute and being conducted in 4 sites across the United States. In 2018 the researchers are expecting to look at the data and hope to have accumulated a significant number of patient diagnoses that match their predictions from the breath test. If the results are strong, they are looking to submit them to the FDA for approval.

“We are not going to replace mammograms, and we are not going to replace biopsies, but we might be able to safely reduce the number of them being performed,” Phillips concluded.