New lower-radiation CT scan superior to mammograms at detecting breast cancer

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WASHINGTON (Reuters) - A new breast scan using a souped-up kind of X-ray called a CT scan may be more accurate than a standard mammogram -- and much less uncomfortable, U.S. researchers reported on Monday.

The new scan produces three-dimensional pictures, which are better at showing whether a spot on the X-ray is a benign lesion or a tumor, the researchers at the University of Rochester in New York said.

It can also provide pictures of tissue around the ribs and outer breast toward the armpit, where 50 percent of cancers are found, the researchers told a Radiological Society of North America meeting in Chicago.
The Cone Beam Breast Computed Tomography scanner takes 360-degree views of breast anatomy, with no need to compress the breast between cold glass plates.

"We have one case in which a cancer shows up phenomenally well using this new imaging system, whereas when you look at the same lesion on a mammogram it is hard to detect," said Dr. Avice O'Connell, director of women's imaging at the university's Medical Center, who led the study.

O'Connell's team is still doing trials of the system and will not have a full study until 60 women have undergone the imaging.

But the results so far suggest the CT scan can detect more of a tumor than a mammogram can, O'Connell said. So far the Cone Beam scanner has detected every tumor seen on a mammogram, she said.

"The mammogram is not 100 percent. It never was," O'Connell said in a telephone interview. "Mammograms in the best hands in the world will miss 15 percent of tumors." Continued...

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They are difficult to read because the mammogram X-ray reduces a three-dimensional structure -- the breast -- to two dimensions.

WHITE ON WHITE

"You have the white thing -- the tumor -- superimposed on this other white stuff -- that's the healthy tissue," O'Connell said.

Women with "dense" breasts were always difficult to image, she said. A mammogram that does not show a tumor does not mean a woman with dense breasts is cancer-free. "All it means is that we can't see anything. It doesn't mean there is nothing there."
And mammograms can often show only part of a tumor -- what looks like a speck on a mammogram is often at the core of a much larger tumor.

O'Connell believes the Cone Beam system will be popular if it is ever approved. It would be far more comfortable than getting a mammogram.

"You lie there. You hold still. It takes 10 seconds," said O'Connell, who was subject number 3 in the trial.

"You are lying on the table with the breast dependent," she said -- the breast is allowed to hang through a hole in the table. The scanner takes 300 shots from every angle.

"The computer does its magic and reconstructs what looks like a breast," O'Connell said. Continued...

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While CT scans can deliver a hefty dose of radiation, this scanner does not, said O'Connell.

"This gives approximately the same dose as a mammogram," she said.

She believes the first target patients should be women at high risk of breast cancer, who can justify having a pricier screening.

"The insurance is not going to want to pay for a CT," O'Connell said. The average cost of a mammogram is $80, she said -- a CT can cost several hundred.
Breast cancer is the biggest cancer killer of women, after lung cancer, with 1.2 million cases globally -- 270,000 in the United States alone.

It kills 500,000 men and women every year globally -- 40,000 in the United States.

The university has licensed the technology to a Rochester, New York start-up company, Koning Corporation, to make, use and sell Cone Beam scanners.