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New Screening Quadruples Breast Cancer Detection Rates

By: Dr. S. Rizel

MBI is a promising new technique that may reveal findings missed by regular mammography

Studies from the American Cancer Society have shown that five year breast cancer survival rates plummet from 99% in early stages to 28% in later stages, demonstrating how crucial early detection is. As such, customary guidelines mandate periodic mammograms as well as breast MRI and ultrasounds. The main problem with these methods is the difficulty in identifying tumors in dense breast tissue, which exists in among 50% of women.


This kind of tissue obscures the image, effectively hiding potentially cancerous masses.  Furthermore, studies show that women with dense breast are at a higher risk for breast cancer occurrence.


Molecular Breast Imaging, commonly called MBI, might be the solution that everyone is looking for. The technology itself has been developed in the Mayo Clinic, that recently published the results of a large scale trial which clearly demonstrated its advantages.


So how does MBI work? The mechanism is similar to that used in PET scans. Before the imaging, a certain radiotracer is injected into the subject’s bloodstream. This substance is absorbed by the tumor, causing it to distinctly standout on the imaging itself. Because the growth is shown based on the radioactive tracer, presence of dense breast tissue is much less likely to obstruct the imaging, allowing for more accurate images and higher diagnosis rates.


The trial showing this feature consisted of screening 1,585 women using both a mammography and MBI. The idea was to identify cases in which a tumor was missed by the mammogram and would have gone unnoticed without MBI. The results exceeded everyone’s expectations; MBI identified 3.6 times the amount of invasive cancers as opposed to mammography alone. In total, 21 women out of the control group were diagnosed with breast cancer. Five of the tumors were identified using mammography alone, while 19 were diagnosed using both mammogram and MBI. While the possibility of an unnecessary biopsy was high with MBI, reaching 4%, this figure was still significantly lower than the 8% associated with MRI and Ultrasound imaging.        


Some concerns have been voiced regarding the level of radiation exposure involved with in the injection and imaging process. However, MBI has evolved remarkably over the past 2 decades. The effective dose of MBI remains slightly higher than that of mammography, although no statistically significant consequences of doses in these ranges have been reported. A patient's risk of breast cancer, however, is real. MBI shows cancers that are not seen on conventional imaging in women with dense breasts and those with high risk, and it has a growing role in assessing response to neoadjuvant therapy (NAC) and as an imaging biomarker of breast cancer risk.


While there are still some concerns that need to be addressed, trial results are very promising, leading many to believe that MBI is indeed the next generation of breast cancer screening.  

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