The tools below are under study for use in breast cancer diagnosis. They may give information about tumors that can help guide treatment.
There's growing interest in breast magnetic resonance imaging (MRI) as a tool to find and diagnose breast cancer.
Breast MRI uses magnetic fields to create high quality images that in some cases may be more useful than mammograms and breast ultrasound images.
Learn more about breast MRI and breast cancer screening.
Breast MRI may help diagnose breast cancer in some women.
For women with hard-to-find (occult) breast cancers who have cancer in the lymph nodes in the underarm area (axillary nodes) or metastases at diagnosis, MRI may help find the original tumor in the breast .
Other uses for breast MRI under study include distinguishing cancerous breast lumps from benign (non-cancer) ones and checking whether cancer has spread to the axillary lymph nodes [75-76].
An increasingly common, but controversial use of breast MRI is as a tool to help decide whether a woman should have mastectomy or lumpectomy.
Breast MRI can find small tumors in the breast that may be missed by a mammogram. Some health care providers use breast MRI to see how widely the cancer appears to have spread throughout the breast.
Breast MRI can find small tumors in the breast that may be missed by a mammogram. Some health care providers use breast MRI before surgery to see how widely the cancer appears to have spread throughout the breast.
A major concern about using breast MRI in this way is that it's not clear if the small masses an MRI finds are more effectively treated with mastectomy or with lumpectomy plus radiation therapy [80-81].
Studies have shown women who have breast MRI before surgery are more likely to have a mastectomy instead of a lumpectomy plus radiation therapy [77-79]. Based on the breast MRI images, women chose mastectomy though it may not have been a better option.
A meta-analysis that combined the results of 4 studies showed using breast MRI before surgery to make treatment decisions did not lower the risk of breast cancer recurrence .
This means women chose mastectomy over lumpectomy based on breast MRI results when lumpectomy plus radiation therapy would have been an equally good option. So, preoperative breast MRI may lead to more mastectomies rather than more effective treatment.
Some findings also show women who have breast MRI before surgery are more likely to have prophylactic mastectomy of the healthy (contralateral) breast .
These topics are still under study.
Talk with your provider if you have any questions about the benefits and risks of using breast MRI for planning treatment.
Special imaging machines can take multiple, standard two-dimensional (2D) digital mammograms. Computer software combines the 2D X-ray images into a three-dimensional (3D) image (called breast tomosynthesis).
3D mammography is under study for use in breast cancer diagnosis and staging [82-83].
Learn about the use of 3D mammography in breast cancer screening.
Positron emission tomography (PET) is a test that shows how much sugar is consumed by cells.
With PET, a radioactive sugar is injected into the body. Cancer cells tend to consume more sugar than normal cells and the radioactive sugar can be detected by a special camera that images the cells.
PET is used to find metastases (cancer that has spread beyond the breast to other organs, such as the bones, lungs, liver and brain).
PET is under study for breast cancer staging and finding cancer that has spread to the lymph nodes in the underarm area (axillary nodes) [85-86].
However, findings suggest it cannot give a detailed enough image to make it a good tool for this task [87-88].
Visit the Society of Nuclear Medicine's discoverMI.org website for more information on PET.
Every cell in your body has genes that contain the blueprints (genetic code) for your body. Similarly, every cell in a breast tumor has genes. These genes contain the blueprints for the tumor.
Tumor profiling (using gene expression profiling tools) gives information about the genes in cancer cells. These tests allow researchers to study many tumor genes at one time.
Tumor profiling tests take a sample of the tumor (removed during a biopsy or surgery) and look at a set of genes.
Specific genes (or combinations of genes) may give useful information about prognosis and may help guide treatment decisions.
The gene profiles of some tumors may help predict whether the cancer is more likely to recur (when cancer comes back) and metastasize (when cancer spreads to other organs) .
People with breast tumors that have gene profiles showing a high risk of metastasis may be more likely to benefit from chemotherapy than people with tumors that have gene profiles showing a low risk.
Tumor profiling is currently used to help make treatment decisions in some people with estrogen receptor-positive cancers.
Three tumor profiling tests recommended by the American Society of Clinical Oncology (ASCO) are Oncotype DX® (looks at a set of 21 genes), PAM50 (also called Prosigna®, looks at a set of 50 genes) and MammaPrint® (looks at a set of 70 genes) [36-37].
Breast Cancer Index® is a tumor profiling test that looks at a set of 6 genes to give prognostic information for some breast cancers.
Breast Cancer Index may be considered when making treatment decisions for some estrogen receptor-positive, HER2-negative, lymph node-negative breast cancers .
* Please note, the information provided within Komen Perspectives articles is only current as of the date of posting. Therefore, some information may be out of date at this time.
There's growing interest in learning how molecular and genetic differences among breast cancers relate to prognosis and treatment.
Understanding these differences may help predict how a person's cancer will respond to a certain treatment.
Most studies divide breast cancer into 4 major molecular subtypes:
At this time, molecular subtypes are used mostly in research settings and are not included in pathology reports.
Prognosis and treatment decisions are mainly guided by tumor stage, tumor grade, hormone receptor status and HER2 status.
Learn more about the molecular subtypes of breast cancer.
Circulating tumor cell levels can help predict survival time for people diagnosed with metastatic breast cancer [89-93].
The more circulating tumor cells in the blood, the more advanced metastatic breast cancer is likely to be [89-93]. Having more of these cells may also predict a lack of response to treatment.
Similarly, circulating tumor DNA is under study for use in monitoring metastatic breast cancer and predicting treatment response in metastatic cancers [94-95].
At this time, circulating tumor cell and circulating tumor DNA tests (sometimes called liquid biopsies) should not be used to guide treatment because they have not been shown to offer benefit [96-98].
However, these topics are under study.
Circulating tumor cells may also help predict how well women with early breast cancer will do over time in terms of survival, but study findings are mixed [99-104].
Learn about the latest Komen-funded research on circulating tumor cell tests (liquid biopsies) in a recent Science Buzz.
Our commitment to research
At Susan G. Komen®, we are committed to saving lives by meeting the most critical needs in our communities and investing in breakthrough research to prevent and cure breast cancer. Our Research Program is an essential driving force for achieving this mission. Since our inception in 1982, Komen has provided funding to support research grants that have greatly expanded our knowledge of breast cancer and helped us understand that breast cancer is not just a single disease but many diseases, unique to each individual. Going forward, our commitment to research will contribute significantly to our ability to achieve our bold goal of reducing the current number of breast cancer deaths in the U.S. by 50 percent by 2026.
To date, Komen has provided more than $956M to researchers in 48 states and 21 countries to support research that has resulted in a better understanding of breast cancer; earlier detection; personalized, less invasive treatments for what was once a “one-treatment-fits-all” disease; and improvements in both quality of life and survival rates.
Learn more about our continuing investment in research and the exciting research that we are funding, because nothing would make us happier than ending breast cancer forever.
Breast Imaging Methods
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