Next Generation of Breast Imaging on Horizon

[November 29, 2006] New imaging technology has the promise of equaling or surpassing mammography in detecting breast cancer.

And, unlike traditional mammograms, it does it without squeezing the breast in a vice.

But the device is not thoroughly proven, and experts are urging caution in interpreting the findings.

"I'm enthusiastic. This sounds like something that's very helpful, but there have been a large number of technologies that each promise to take over mammography, but each time that proves not to be the case," says Dr. Joshua Kalowitz, chief of breast imaging at Maimonides Cancer Center in New York City.

It is important to remember that a lump or other changes in the breast, or an abnormal area on a mammogram, may be caused by cancer or by other less serious problems.

Early Detection is Best

The technology featured in this study, the Cone Beam Breast Computed Tomography (CBBCT) scanner, has primarily been tested only in healthy women and may not be able to pick up tiny abnormalities because of the resolution, Dr. Kalowitz adds.

Preliminary results from a pilot study of the technique were presented this week at the Radiological Society of North America's annual meeting, in Chicago.

Regular or film mammography is currently the gold standard for breast cancer detection. The challenge has been to find ways to detect malignancies at ever earlier stages, when they have a better chance of being cured.

The problem with mammography is that breasts, particularly in younger women, tend to be very dense, with much of that density captured in a mammogram. "A mammogram is limited because the density of the tissue above and below the area we're interested in may block our view," Dr. Kalowitz explains. "If something is smack in the middle of dense tissue, we may not be able to see it."

Multiple Images Create Big Picture

The CBBCT scanner takes a number of pictures of the breast from various angles then merges them into one 3-dimensional image.

This pilot study used the CBBCT scanner to image 20 volunteers who had normal mammograms, as well as a group of women who had abnormalities detected during a physical exam or who had suspicious mammograms. The goal of the study was simply to see how well the CBBCT could image the breast

The CBBCT proved itself at least as good as conventional mammography in imaging the breast, the authors conclude.

Comfort is King

The system also has the advantage of being more comfortable. The woman lies on her stomach on a cushioned exam table with a cutout in the middle. She suspends her breasts one at a time through the cutout while the CBBCT takes 300 images in the space of about 10 seconds.

The radiation dose is comparable to that of mammography. Unlike conventional mammography, the CBBCT system clearly displays tissue around the ribs and outer breast near the armpits, where 50 percent of cancers are found. This is one reason the breasts currently have to be pulled and flattened during a mammogram.

The pilot study, being conducted at the University of Rochester in Rochester, New York,  will continue until 60 participants have been imaged. A larger trial is planned for next year.

Always consult your physician for more information.