Sharon Helmer, M.D., Clinical Service Chief, Imaging Department, and Director, Breast Imaging,
Barbara Ann Karmanos Cancer Center; and Clinical Associate Professor, Wayne State University School of Medicine
Sharon Helmer is the clinical service chief, Imaging Department, and director of Breast Imaging at the Barbara Ann Karmanos Cancer Institute. In this Q&A, Dr. Sharon explains the potential benefits of Molecular Breast Imaging (MBI) for patients.
Why did the Karmanos Cancer Institute choose GE Healthcare’s Molecular Breast Imaging (MBI) technology, and what are the potential benefits for patients?
MBI was attractive to the Karmanos Cancer Institute because we realized that a significant number of our diagnosed cancer and high risk patients could not benefit from the functional information that Magnetic Resonance (MR) imaging offers. MBI looks similar to and replicates the views acquired by mammography but it does not produce X-ray radiation.
Instead, MBI uses a nuclear isotope to detect tumors. The patient receives a small injection of a radioactive tracer that locates metabolically active tumors. The patient can choose to sit or stand while scanning takes place. Each image view takes up to ten minutes.
MBI captures clear, precise images, even for those with dense breast tissue. MBI is an option for those who have pacemakers, metal implants or other foreign bodies, and patients with renal challenges. It’s also an option for those who are claustrophobic, have silicone implants, and those whose size exceeds the allowable limit for MR.
What has the patient experience been like?
To date, we have evaluated 17 patients on MBI. Our patients have had a very positive response to MBI. The small intravenous injection of radioisotope has been well tolerated and there are no contraindications. There is no concern related to metallic implants, renal function or claustrophobia.
For example, we recently had a patient scheduled for MR following a malignant result on a biopsy. Despite multiple attempts she was unable to tolerate positioning on the breast coil. She was in tears as she knew the benefits of MR preoperative assessment. We were able to discuss MBI as an option with her oncologist and able to expedite delivery of the isotope and perform MBI that afternoon. Her diagnosed cancer was larger than mammography and ultrasound had indicated, but the opposite breast had no area of abnormal uptake. She was very relieved and grateful that this alternative was available. We were able to plan pre-operative localization for this patient more accurately.
What are the benefits of MBI to clinicians at the Karmanos Cancer Institute?
Our clinicians voiced concerns for those patients that have a lifetime risk assessment that falls between 15% and 20%. These patients often desire some complement to mammography that offers additional information. We feel that MBI gives us a reasonable FDA approved and reimbursable alternative to MR for these patients. We have not had an insurance rejection to date. In addition, the gantry can be positioned vertically for imaging of the underarm area.
As a leading cancer center, the Karmanos Cancer Institute is committed to offering our patients the latest cancer treatments, state-of-the-science research and the latest technology to detect cancer early and help save lives. MBI offers a functional imaging tool that is highly sensitive and cost effective and accessible for patients that may not be able to have MR exams. MBI addresses some of the challenges we currently face in breast cancer detection, especially for patients who are at high risk. Although mammography is the mainstay of screening for occult breast disease and for diagnostic evaluation, the MBI system allows better detection of very small lesions in women with dense breast tissue. Not only will MBI potentially help eliminate false positives, it may also help to detect breast cancers earlier when the disease is highly survivable.
By using a multimodality approach to both screening and diagnostic evaluation, we can improve detection rates and help decrease death rates and have a better chance of detecting breast cancer early in women who are considered high risk.
The Barbara Ann Karmanos Cancer Institute
Located in mid-town Detroit, Michigan, the Barbara Ann Karmanos Cancer Institute is one of 41 National Cancer Institute-designated comprehensive cancer centers in the United States. Caring for nearly 6,000 new patients annually and conducting more than 700 cancer-specific scientific investigation programs and clinical trials, Karmanos is among the nation’s best cancer centers. Through the commitment of 1,000 staff, including nearly 300 physicians and researchers on faculty at the Wayne State University School of Medicine, and supported by thousands of volunteer and financial donors, Karmanos strives to prevent, detect and eradicate all forms of cancer. Its long-term partnership with the Wayne State University School of Medicine enhances the collaboration of critical research and academics related to cancer care. Gerold Bepler, M.D., Ph.D., is the Institute’s president and chief executive officer. For more information call 1-800-KARMANOS or go to www.karmanos.org.
“As a leading cancer center, the Karmanos Cancer Institute is committed to offering our patients the latest cancer treatments, state-of-the-science research and the latest technology to detect cancer early and help save lives,” says Dr. Helmer.