Breast Cancer: Some Statistics
Every year, over 1.1 million women worldwide receive the unwelcome diagnosis of breast cancer, a figure which has virtually doubled since 1975 and appears to be likely to increase in the foreseeable future. In the Unites States, breast cancer is the second most common form of cancer (preceded only by skin cancer), affecting 250,000 women annually. It is the second most common cause of cancer death, accounting for 40,170 deaths each year - only deaths from lung cancer are more common in the US population. It undoubtedly constitutes a most pressing public health priority and, with epidemiological data like this, many have argued that universal breast cancer screening for all women at least annually should be the norm. However, on closer inspection, this may not be the best or the safest means of preventing the disease.
The Disadvantages of Mammograms
This may seem like a rather callous assertion, and anyone who has received successful treatment for cancer after a mammogram-detected tissue abnormality is likely to think it bizarre, but the fact of the matter is that mammograms themselves are neither wholly reliable nor risk free, and may be especially risky for women who have a higher risk of developing the disease due to genetic factors. Frequently, an ambiguous result emerges suggesting a 'probably benign' lesion, an outcome which places both physician and patient in a real quandary. Such patients are often referred for repeat mammographies. Mammograms also are prone to produce both false positives (causing unnecessary distress and alarm) and false negatives (with an even worse predicament for the patient who believes that they are healthy when, indeed, they may not be).
Mammograms use ionizing radiation to detect tissue changes in the breast which physical examination alone would not be able to find; that is their strength and also their weakness. For example, one study has suggested that some women with a genetic predisposition for breast cancer who are subjected to quite low doses of ionizing radiation during mammogram screening may be significantly more at risk of developing cancer as a result. Young women aged between 25 and 29 who carried a variant of the BRCA gene (which mutates its normal function and predisposes the bearers of the gene to breast cancer) were found to receive no benefit from mammography but an increased risk of setting the illness off.
This was a mathematical modeling study but other physicians share the concerns about the indiscriminate use of mammograms as a screening instrument, with one specialist claiming that as many 75% of cases of breast cancer could be prevented by reducing or wholly avoiding mammography and X-rays amongst women vulnerable to the illness. Clearly, if a means could be devised which permitted accurate early diagnosis of breast cancer with none of the harmful effects of ionizing radiation, it would be a most welcome and valuable development in the fight against this dreadful disease.
A Diagnostic Alternative
Thankfully, such a means appears to be on the very brink of being available on a widespread scale. It replaces mammography with a blood test. Specifically, the test seeks traces of certain proteins (tumor antigens) in the blood. These proteins are uniquely correlated with specific types of breast cancer. The new test may well prove to be considerably more reliable than mammography, promising to detect cancerous tissue changes at the very earliest stages, when treatment is most likely to be effective. Any elevation of these blood markers above normal concentrations is likely to be a sign that early changes are underway, and the test appears to be highly sensitive in detecting these alterations in blood biochemistry. Researchers who are developing the test are optimistic that it will detect cellular abnormalities significantly earlier than mammograms, by sensing miniscule shifts in cancer protein marker levels.
The test is known as 'BC-SeraPro' and is already yielding impressive results in clinical trials, showing a 95% success rate. To be precise, it measures the presence of no less than 22 tumor antigens (or 'biomarkers') in serum, providing a reliable differentiation between breast cancer sufferers and healthy patients. Developed and evaluated by Power3 Medical Laboratories, the test appears to be highly accurate, safe and non-invasive. By contrast, women usually find mammograms painful and uncomfortable, as the procedure necessarily involves squeezing and flattening the breast in order to obtain a clear image; more body conscious individuals also find exposing the breast an awkward and embarrassing ritual. The blood test clearly dispenses with these problems and totally protects women from exposure to potentially harmful ionizing radiation. It is expected that the U.S. Food and Drug Administration will approve the test for use during the early part of 2010, after which it should quickly become available to the general public.
A closely allied test, developed by Provista Life Sciences, is already available and is known as the Biomarker Translation Test (or BT Test for short). Similar to Power3's BC-SeraPro, it detects multiple serum-based biomarkers for breast cancer in blood samples. Used in conjunction with a medical profile of the patient, the individual test result is analyzed by a proprietary data analysis procedure which produces a score (known as the BT Score) which accurately indicates the presence or absence of breast cancer. Presently, the results suggest that the test is somewhere in the vicinity of 80% accurate, and efforts to improve this accuracy rate are currently ongoing.
Is This a Significant Step Forward in the Fight Against Breast Cancer?
Designed originally simply to be another 'tool in the physician's box' to complement prevailing imaging techniques, the test is promising to become a major new diagnostic asset. It may be a little too early to say at this point - the BT Test is available in 41 States, in 27 of which the test can be sent directly to consumers without physician prescription - but these new blood tests for breast cancer may prove to be a substantial asset in the ongoing battle to beat this terrible, distressing and all-too-often tragic illness.
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