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Clinical trial provides second look for breast cancer

Community Hospital first in state to participate

Mammograms are a highly effective tool for early detection of breast cancer, but women with dense rather than fatty breast tissue have harder mammograms to read. The dense tissue can mask an abnormality, making diagnosis difficult.

"Women who have pure fat in their breasts don't like being told that," says Dr. Susan Roux, medical director of Community Hospital's Breast Care Center, "but it's actually good news. Fat creates a dark background to a white cancer, so it's like looking at a star in a dark sky as opposed to trying to see a star in a cloudy sky. In women with dense breast tissue, the white cancer hides in the white tissue; it's the ‘white bird in the snowstorm' analogy."

"We're pleased that women from our community
are able to take part in the study and that we will
be contributing to the knowledge that comes from it."

Dr. Roux, Medical Director, Breast Care Center

Dr. Susan Roux, Breast Care Center medical
director

Roux hopes to improve screening results for women with dense breasts by performing a 3-D automated breast ultrasound in tandem with a routine screening mammogram. The two-step approach is part of a national U.S. Food and Drug Administration-approved clinical trial sponsored by U-Systems, Inc., maker of the ultrasound system used in the study. In October, the Breast Care Center was the first site in California to launch the trial and is one of only 10 centers in the United States taking part.

The study is designed to help determine the effectiveness of pairing ultrasound with a routine mammogram in the early detection of breast cancer.

"We have already done studies where a breast-specialist radiologist does a handheld ultrasound and scans two-inch-wide sections of the breast, in rows across the breast, watching the screen to see if it picks up anything that looks suspicious," Roux says. "In patients with dense tissue, that kind of scanning combined with mammogram has detected double the number of cancers found with mammogram alone. However, this was not a practical solution because there is a shortage of radiologists who are able to do it and it takes an immense time commitment."

Now, an automated system can perform an ultrasound that covers a much larger portion of the breast. A trained technician submits the information into a computer, then the ultrasound and the mammogram are read together by the breast radiologist. This automated form of scanning the breast in 14-inch rows results in much more tissue scanned at once, enabling images to be gathered quickly.

Participants in the clinical trial, who must meet specific criteria, receive the ultrasound at no additional cost when they have their regular mammogram.

"It is a very easy procedure, involves no radiation, and the patient spends no more than 10 to 20 minutes having the test done," Roux says.

An estimated 20,000 women will participate in the trial nationally.

"We're pleased that women from our community are able to take part in the study," Roux says, "and that we will be contributing to the knowledge that comes from it."