New avenues for age-old problem
In fact, a group of Parisian researchers have found that an interim 18F-FDG PET/CT exam after two cycles of neoadjuvant chemotherapy was predictive of pathologic response and disease-free survival in patients with triple-negative breast cancer, which is an aggressive subtype of breast cancer.
Triple-negative breast cancer represents 15 percent of invasive breast tumors. In the study that appeared Jan. 12 in the Journal of Nuclear Medicine, Groheux et al found that a less than 42 percent decrease in 18F-FDG uptake at two cycles means residual tumor at the end of neoadjuvant chemotherapy and a high risk of early relapse.
Another study provided the first molecular evidence of an increase in low- or ultra-low-risk cancers in tumors when detected by screening mammography. And it provides a basis for integrating molecular profiling at the time of diagnosis to help avoid overtreatment.
The study, which appeared in the December 2011 issue of Breast Cancer Research and Treatment, showed that for women over age 50, a substantial number of cancers detected by mammograms have good prognoses.
The University of California, San Francisco researchers learned that for women under age 40, who are not routinely screened, the likelihood of good or poor prognosis did not differ between the era before widespread screening and the present time with routine screening. Overall, young women are much more likely to have poor prognosis tumors than older women. However, for tumors in patients aged 49 to 60, when comparing the two time periods, there was a substantial increase in good prognosis tumors for women diagnosed more recently.
The study “provides information that will allow us to improve screening,’’ the authors concluded. “Not only can this help us to guide the use of risk stratifying tools to avoid overtreatment, but it should also enable us to reset thresholds for biopsy for very low-risk mammographic lesions.’’
And new, exciting research rolls on. At Johns Hopkins In-Vivo Cellular and Molecular Imaging Center in Baltimore, Dmitri Artemov, PhD, and Peter C.M. van Zijl, PhD, are investigating MRI techniques for breast cancer analysis. Experiments are conducted with laser imaging by Kristine Glunde, PhD, and Xingde Li, PhD, to analyze collagen fibers in breast cancer tumors.
Please let us know what your facility finds most appealing in future molecular breast imaging analyses.