Wednesday, August 4

More detailed MRI to detect early breast cancer begins UK trials | Breast cancer

A new and more convenient way of detecting breast cancer, which could allow the identification of tumors at an earlier stage, has entered trials in the UK.

About one in eight British women will be diagnosed with breast cancer at some point in their lives. Although an X-ray test called a mammogram can detect tiny cancers in the postmenopausal breasts, they are less effective in younger women whose breasts contain denser fibrous tissue and less fat, because cancers and fibrous tissue appear as solid white areas on X-rays. .

Mammograms can also miss cancers in postmenopausal women with relatively dense breast tissue, who are also at increased risk of developing breast cancer in the first place.

Here, women with a suspicious lump can be offered an ultrasound or biopsy and, if the diagnosis is still uncertain, they can be referred for so-called dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), which identifies the growth of new blood vessels that supply tumors. However, these may not be visible in women with early stage cancers, which means they receive a false reassurance.

The new technique, called multiparametric MRI, was originally developed to assess liver disease without the need for a painful biopsy, and is already widely used in Europe and the US.

Like conventional MRI, it uses strong magnetic fields and radio waves to excite particles called protons in tissue, using differences in the amount of time it takes for them to settle to create a “map” of the various tissues in the breast. However, by combining images created by different pulses and MRI sequences, multiparametric MRI makes it possible to create an even more detailed map.

A healthy breast scan, scanned using multiparametric MRI.
A healthy breast scan, scanned using multiparametric MRI. Photography: looking for diagnoses

“We believe that if you differentiate the tissue, instead of looking at the blood vessels around the tumor, we should be able to detect not only tumors in dense breasts, but also tumors potentially not seen on mammograms,” said Professor Sally Collins. Consultant obstetrician and women’s health medical leader at Oxford-based Perspectum Diagnostics, who recently underwent treatment for breast cancer.

“We are also trying to improve the patient experience when being scanned. Mammograms are horrible – they basically smash your chest on this plate, which is unworthy and uncomfortable, and MRIs are even worse because you have to lie on your stomach with your breasts hanging on this coil and your arms above your head like superman , and stay like that for centuries, ”Collins said.

“We are trying to fix it so that the woman can dress, be dignified and comfortable while the scan is being performed, all of which is very important to the patient’s journey through the diagnosis of cancer.”

Perspectum has the ethical approval to recruit 1,030 women for the trial, including 10 with confirmed breast cancer and 30 to 40 healthy women who are currently being scanned, to test whether the technique can accurately map their breast tissue while lying on their backs. above. The trial is expected to take about two years to complete.

“It will never replace routine mammography for postmenopausal women, but we hope it will improve the diagnostic pathway for women with dense breasts or premenopausal women who are at very high risk of breast cancer, eliminating the need for multiple tests, which is what they’re going through right now, ”Collins said.

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