No More Compression With Breast Imaging?

In the fast-paced world of breast imaging comes a new optical imaging technology that could give doctors new ways to both identify breast cancer and to monitor the responses of individual patients to initial treatments of the disease. Tufts Medical Center in Boston is now undertaking a five-year clinical study of the procedure through a $3.5 million grant from the National Institutes of Health.

This noninvasive technology uses near-infrared (NIR) light to scan breast tissue, and results are interpreted through a specific standard algorithm. Structures in the breast, such as water, fat, and oxygen-rich and oxygen-poor tissue, can then be identified through differences in light absorption.¹ Unlike other breast-imaging methods, it also offers the advantage of obtaining functional real-time images of metabolic changes, such as levels of hemoglobin concentration and oxygenation.²

Sergio Fantini, PhD, Professor of Biomedical Engineering at Tufts, is leading the research effort with members of the Tufts Medical School. “This suggests that NIR imaging can be valuable not only in diagnosing breast cancer but in monitoring individual response to therapies without requiring repeated x-rays. For example, it could help determine if a patient is responding to neoadjuvant chemotherapy administered to shrink a tumor before surgery.” ¹ Currently MRI is used for this purpose with modest success.

Additionally, optical mammography is more comfortable than traditional mammograms. The technique lightly compresses the patient's breasts between two horizontal glass panels and illuminates them with NIR light.³ Real-time images of the breasts are displayed by a specialized software program as the optical system scans back and forth.² What patient hasn’t asked when compression (a known barrier to annual screening) will stop being used in breast imaging?

The NIH-funded study will investigate healthy women, women with breast cancer, and women with benign breast lesions. The effort will seek to examine the effectiveness of optical mammography in detecting breast cancer and in distinguishing between malignant and benign tumors. Also, the study will characterize the power of optical mammography to determine patient response at the beginning of therapeutic treatment by looking at breast cancer patients who are undergoing chemotherapy.⁴

While it is far from coming to market as a screening or diagnostic tool, we should all be satisfied to know that research in breast imaging continues to question the status quo and look for better ways in early detection and the progress made during treatment.

References:

1. Fantini S, Sassaroli A Near-infrared optical mammography for breast cancer detection with intrinsic contrast. Ann Biomed Eng. 2012 Feb;40(2):398-407.
2. Chung SH, Yu H, Su MY, Cerussi AE, Tromberg BJ. Molecular imaging of water binding state and diffusion in breast cancer using diffuse optical spectroscopy and diffusion weighted MRI. J Biomed Opt. 2012 Jul;17(7):071304.
3. Taruttis A, Ntziachristos V. Translational optical imaging. AJR Am J Roentgenol. 2012 Aug; 199(2):263-71.
4. Ueda S, Roblyer D, Cerussi A, Durkin A, Leproux A, Santoro Y, Xu S, O'Sullivan TD, Hsiang D, Mehta R, Butler J, Tromberg BJ. Baseline tumor oxygen saturation correlates with a pathologic complete response in breast cancer patients undergoing neoadjuvant chemotherapy. Cancer Res. 2012 Sep 1;72(17):4318-28.