Catching cancer with pap smear for the breast

  • 2

LONGWOOD, Fla. (Ivanhoe Newswire) – What if you could detect the beginnings of breast cancer years before it showed up on a mammogram? That’s what a new screening test is doing. The noninvasive test has the potential to cut breast cancer rates, just like pap smears have cut rates of cervical cancer.

Daily exercise is a must for Susan Burkett. “It just gets rid of all the stress in my life,” Burkett told Ivanhoe.

A top stressor for her is breast cancer. Burkett’s breast density increases her risk and makes it harder for mammograms to spot potentially dangerous growths.

“You can have a mammogram that’s negative for nothing suspicious and by the time you go back for your next one there could be something there,” Burkett said.

Debra Dube, MD, Internal Medicine, Internal Medicine Connection, says a new test known as ForeCYTE could help Burkett and millions like her.

“It’s absolutely huge. To me, this is a new frontier,” Dr. Dube told Ivanhoe.

Much like a pap smear, the test detects pre-cancerous cells up to eight years before cancer arises. “Enabling us to treat much earlier, at the very beginning of a tumor formation,” Dr. Dube said.

Unlike a mammogram, the test is virtually painless. Dr. Dube uses a device similar to a breast pump to collect cells that line the milk ducts, and the cells are then sent to a lab for analysis. The results help women like Burkett make an informed decision about her future.

“I think it’s more than anything peace of mind,” Burkett explained.

Dr. Dube says women over 40 should take the test every year and get an annual mammogram. Women between 18 and 39 can also take the ForeCYTE test and the screening is covered by Medicare and private insurance.

Debra Dube, MD, practices Internal Medicine at the Internal Medicine Connection, in Longwood, Florida. She talks about a new test for breast cancer.

Breast cancer will affect 1 in 8 women.  Can you talk about the need for testing?  

Dr. Dube: I think it is critical that we do testing.  We are finding breast cancer at earlier ages.  The baseline for a mammogram is age 35 and at 40 doing yearly mammograms.  Unfortunately, with the mammogram, or even with self-breast exam, which should be done monthly, there is a problem with the size of the mass as being enlarged; so we are not really doing preventive medicine at that time.  We are doing reactive medicine related to breast cancer.  Monthly breast exams are important and that should start at an early age.  By the time a female is 18, she should start learning how to do breast exams and do them on a monthly basis. If there are any changes then let their physician make them aware of it.  

Can you talk about the new test? 

Dr. Dube: In Susan’s case, there is a lot of anxiety related to being retested every six months with a mammogram and an ultrasound; she has been doing that for the last two years.  With the Forecyte testing, all you need is a few cells out of the ductal system that can be analyzed to see if there is hyperplasia or abnormalities related to those cells so that we can treat much earlier; at the very beginning of a tumor formation.

Can you sort of go through how the process works with us?

Dr. Dube: What we do is we heat the breast up with a heating pad for approximately ten minutes.  Then we milk the tissue moving the cells towards the ductal system of the breast.  Once that has been completed, we wipe the breast  nipple off in case there are any keratosis or plugs that are in the duct, place the device with a filter that is almost the same kind of device used for breast-feeding mothers, the pump, breast pump; we pump for two minutes.  Cells land onto the filter and then that is sent out after a fixative is placed on there to fix those cells onto the filter and then it is analyzed at the laboratory. 

So what would be an example of the predictive value? 

Dr. Dube:  If you have somebody who has a mother who had breast cancer and a grandmother who had breast cancer, and the patient had fibrocystic breasts, well they are at a higher risk, because of family history for breast cancer. Based on the results of a large study linking abnormal cells from the milk ducts and future breast cancer, doing this study would give us a two--year predictive value for an increased risk for breast cancer or not and at early stages.  If there is hyperplasia that is seen on the filter when it is analyzed, then we can do treatment with estrogen modulators and change the course of the direction for breast cancer.

This is sort of like a Pap smear? 

Dr. Dube: The Pap smear has revolutionized cervical cancer diagnostics since its inception. Just like the pap smear can detect atypical cells that may turn into cervical cancer, the ForeCYTE test can detect atypical cells. ForeCTYTE is also similar to the Pap smear in that both tests should be considered as annual screening tools.

How often do mammograms fail?  

Dr. Dube: I had a case that where a patient came in for a complete physical.  She was an older woman; in her late 60s.  She brought in her information, her prior labs, her mammogram, x-rays that she had done for me to review.  When I did her physical, I felt a lump in her right breast.  I reviewed the mammogram and the mammogram came back as normal, but dense breasts.  I sent her back to be reevaluated and when she was reevaluated for that lump on the physical, it was proven to be breast cancer.   

This would be extremely important for a patient?  

Dr. Dube: Extremely important for high risk; women who have had breast cancer as well.  When you have had breast cancer, you have increased risk of breast cancer number one recurrent, and contralateral or the opposite breast with breast cancer, so again this would also be a good study to give you predictive value for follow-up from even having breast cancer. 

How big of a breakthrough would you say that this is?  

Dr. Dube: Huge.  It is absolutely huge.  To me, this is a new frontier that we have in medicine in helping turn the direction of breast cancer and again instead of being reactive; surgery, mastectomies, radiation, chemotherapy; we are talking about changing the whole course with perhaps using an estrogen modulator picking up hyperplasia or abnormal cells in the ductal system; treating for six months and not having cancer at all.  So again, preventive as opposed to reactive. 

Having a test like this could really change the course of a lot of women’s lives?   

Dr. Dube: For breast cancer indeed. The BRCA, we have got to remember if anybody in the general population does a BRCA less than 0.1% is going to have mutations that really direct them in their breast care.  That is such a small percentage of a population that the BRCA is going to work for. That study is better for patients who have had family history of breast cancer, doing the BRCA is going to be much more predictive for that client than it is for somebody who is off the street and does not really have a family history or risk factors; doing a BRCA is really not going to give them much information at all. 

Who is this test best for? 

Dr. Dube: This test is best for anyone who has fibrocystic breasts, lumps or bumps or abnormalities on mammograms or family history.

How would you describe it? 

Dr. Dube: I think that this is a test that really should be brought in as part of a routine physical exam; with risk factors.  A lab would be done looking for any abnormalities.  . 

Why do you have to continue to get the mammograms? 

Dr. Dube: Because nothing is 100 percent; we want to make sure that we are following through especially for those high risk patients to pick up breast cancer early if it does occur. 

The test takes just under 15 minutes and it adds such a tremendous value to a patient’s life. 

Dr. Dube: Yeah and this really could be done at any doctor’s office.  It is not like you have to have a lot of special equipment.  The practice really does not need to buy anything other than just have the client there who is willing to do the study. I have been doing some interviewing with patients and finding out if they were interested and there is a large population out there that is very interested in doing this study; just so that they can have the relief from breast cancer, because again 1 out of 8 women.  That is a lot of women out there, potential breast cancer candidates. 

This information is intended for additional research purposes only. It is not to be used as a prescription or advice from Ivanhoe Broadcast News, Inc. or any medical professional interviewed. Ivanhoe Broadcast News, Inc. assumes no responsibility for the depth or accuracy of physician statements. Procedures or medicines apply to different people and medical factors; always consult your physician on medical matters.