Further testing with breast-specific gamma imaging (BSGI) uncovers additional cancer in breast cancer patients and changes surgical management
A study from Beth Israel Medical Center, New York, revealed
that additional breast cancer was found in 9 percent of patients when Breast-Specific
Gamma Imaging (BSGI) was used to complement mammography, substantially impacting
surgical treatment. A total of 82 patients underwent BSGI for newly diagnosed
breast cancer; of these, 18 had an additional abnormality, and 17 were biopsied.
The findings were presented at the American Society of Breast Surgeons 2009 Annual
Meeting in San Diego.
BSGI, a molecular breast imaging technique, is an adjunct
to mammography that can see lesions independent of tissue density and discover
early stage cancers. With BSGI, the patient receives a pharmaceutical tracing
agent that is absorbed by all the cells in the body. Due to their increased rate
of metabolic activity, cancerous cells in the breast absorb a greater amount of
the tracing agent than normal, healthy cells and generally appear as "dark
spots" on the BSGI image.
"We wanted to determine the number of patients with
known breast cancer who were found to have an additional lesion detected by BSGI,
but undetected by mammography," said Dr. Susan K. Boolbol, Chief of Breast
Surgery at Beth Israel Medical Center, New York. "In our study group, 22
percent of patients had a change in surgical management based on BSGI findings.
This is critical information in our desire to diagnose breast cancer early for
successful treatment."
BSGI provides the capability of helping differentiate
cancer from other structures or benign tissue in the breast. Unlike mammography,
BSGI is not affected by tissue density. The test is especially useful for patients
who have dense breasts, scar tissue, implants, or palpable lesions that cannot
be detected using mammography or ultrasound.
Boolbol and her team conducted an IRB-approved review
of all patients who underwent BSGI at Beth Israel Medical Center from 2005 to
2008. A total of 82 patients underwent BSGI for newly diagnosed breast cancer.
There were five cases of invasive ductal carcinoma, two DCIS, one LCIS, two papillomas,
and eight benign biopsies. One patient proceeded directly to mastectomy and an
area of DCIS was found, which corresponded to the BSGI.
"We know that mammography will not detect all breast
cancers. This study proves that BSGI is an additional tool to detect breast cancers
otherwise missed by standard imaging. Therefore, BSGI plays an important role
in the clinical management of patients with known breast cancer," said Dr.
Boolbol.
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