How a Blood Test Will Improve Breast Cancer Detection
Recently there have been incredible leaps in the ability to treat breast cancer. With greater understanding of the genetics of breast cancer, we have new tools for combatting the disease and for giving women new options for improving their outcomes and survival.
But for all the progress in treating breast cancer, some of the biggest challenges in improving outcomes for women lie at the starting point – effectively screening women for the earliest possible diagnosis.
In my practice as a radiation oncologist, I see this challenge every day, particularly among black women. In general, too few women are getting screened when they should. Only about 67% of women who are eligible for mammograms actually have one. There are multiple reasons for skipping mammograms: fear, insurance issues, lack of understanding to name a few. For women of color, missing or omitting mammography as part of health screening is a risky proposition.
Black women with breast cancer are more likely to die of their disease. Why? Missed screening opportunities means some women will be diagnosed later, when the disease is more advanced and harder to treat and less likely to be cured. Black women are also at higher risk of being diagnosed with more aggressive types of breast cancer. And while half of all women have dense breasts, which can make it easier for cancers to hide on mammograms, it’s more common in black women to have denser breast.
So how do we close the gaps? For one, it’s critically important for every woman to know the importance of screening. While family risk due to genetic abnormalities have captured a great deal of attention, the vast majority of breast cancer is diagnosed in women without a hereditary risk.
Second, we need to look for ways to make cancer screening easier on women. One recent study makes a clear point about how important this is: it found that women who receive a false positive result are more likely to delay follow-up screening.
In truth, the imaging tools we use to spot cancer don’t always give us a clear answer. Too many women hear that their mammogram result was suspicious or abnormal, and end up in a difficult “grey zone” of decision-making. For these women, they will either undergo more imaging or biopsy, or ride out a worrisome six-month period of “watch and wait.”
That’s where the opportunity lies. The same kind of scientific leaps that have brought about new breast cancer treatment options are yielding new opportunities in detecting breast cancer. By understanding more about the unique biologic properties of breast cancer, one company has developed a new blood test that can help spot breast cancer’s unique protein signature and provide more clarity for physicians like me, when images give us fuzzy answers. An abnormal mammogram doesn't always mean cancer and many women have additional imaging — the blood test in conjunction with the mammogram may indicate who actually needs additional imaging.
I learned about this test when it was in development and made an easy decision to join the clinical research study to evaluate the technology. Based on my own experiences in treatment of women, I knew exactly the benefit I was hoping for. I was hoping for a better way to rule out breast cancer in women who had abnormal findings but “probably” didn’t have a reason to worry. I wanted a better way to see past dense breast tissue, so I could be more confident a cancer wasn’t hiding under my nose. I wanted a better way to select the right patients to biopsy, so I could reduce the number of women braving their way through the procedure, only to find out they don’t have cancer. And I wanted better information to help me zero in on the patients who truly need a very careful second look in order to catch a cancer.
As one of the first physicians in the country to be using the test as part of an early access program, I’ve already seen it making a difference in exactly the ways I’d hoped. Until the test makes its way into doctor’s offices around the country, women can take important steps in closing gaps.
Ask this question: “Do I have dense breasts?”
- If you’ve ever had a mammogram, ask your healthcare provider whether you have dense breasts.
Recognize your risk
- If you do have dense breasts, you have an increased risk of breast cancer as well as a higher likelihood of cancer going undetected on your mammogram.
Don’t let ongoing debate around screening guidelines make things confusing
- If you’re not sure when you should start getting a mammogram, talk to your doctor. An emerging recommendation notes that the starting age for screening may vary based on your personal situation.
Get clearer answers
- Mammography results may be unclear or may not provide the information needed to confidently rule out breast cancer. Connect with your healthcare provider to talk about complementary technologies that can help provide a clear answer.
I’m encouraged by the fast pace of research and new developments that are helping women survive longer and better with breast cancer. But getting step one right is my passion because I’ve seen the difference it makes. So, to women, I’ll say that in all the “white noise” of health information out there, please don’t lose the simple message about the importance of breast cancer screening. I will hold up my end of the bargain by making sure I use all the tools I have at my disposal to make the screening process as easy, and stress free as I can for my patients.