UW joins breast cancer diagnosis study

Diagnosing some suspicious breast tumors could become simpler and more reliable through a new magnetic resonance imaging (MRI) approach being tested at UW Hospital and Clinics as part of an international study announced October 22.

The approach developed by Professor Hadassa Degani of Israel’s Weizmann Institute of Science uses existing technology in a novel way, according to Dr. Frederick Kelcz, a UW Hospital breast imaging specialist who will direct the study locally. Kelcz helped with preliminary tests of the approach.

Under the study plan, women with suspicious breast tumors requiring biopsy – where breast tissue is removed and examined for signs of cancer – will first have MRI breast scans using Degani’s technique. MRI interpretations and biopsy results then will be compared. The study is expected to involve 250 women, including 50 locally.

Kelcz agreed to conduct clinical tests of Degani’s approach after being “favorably impressed by the excellent results” the scientist and her team achieved in a preliminary test using only MRI data for 30 UW Hospital patients. Degani correctly predicted the diagnoses for 80 percent of the 30 patients, even though the data was collected using another technique.

Degani, a basic scientist, and Kelcz, a clinical researcher and UW Medical School associate professor of radiology, both seek ways to achieve definitive MRI results when images from conventional mammography or ultrasound are ambiguous. A new, reliable MRI approach could prevent unnecessary biopsies and aid in detecting cancers early, Kelcz said.

“Too often, women with ambiguous scans are told to come back in six months to be rechecked. Yet this decision can result in delayed diagnosis and treatment of breast cancer,” Kelcz said. “A woman deserves a reliable answer in a timely fashion.”

As a result of pilot studies by Kelcz and others, UW Hospital in 1995 began using a form of MRI to aid in diagnosing some breast problems. MRI is usually performed after diagnostic mammography and ultrasound have failed to resolve a difficult breast problem.

Degani’s approach, which has been tested primarily in the laboratory, may also help establish the prognosis of cancer and monitor the effectiveness of therapy for breast and other cancers, Kelcz said. Like UW’s own method, Degani’s approach relies not on the image’s appearance to the naked eye, but on a computer interpretation of the way suspect tissue absorbs and releases a special dye-like material, Kelcz said. Cancerous growths tend to take up and release dye more quickly, he said.

Because MRI is expensive and cannot identify at least one form of very early cancer that is clearly visible by mammography, Kelcz does not foresee MRI becoming the predominant breast cancer screening system. However, Degani’s method may lead to faster, less expensive breast MRI examination, possibly permitting screening of women at high risk for breast cancer.