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New local test detecting breast cancer earlier
Nov 29, 2008 (The Bakersfield Californian - McClatchy-Tribune Information Services via COMTEX) --
In just five minutes, a new breast cancer screening test offered at her doctor's office confirmed what Judy Esqueda's annual mammograms couldn't: she had abnormal cells in her breast, a condition known to increase the risk of developing the disease.
A biopsy confirmed the 46-year-old Bakersfield resident had early-stage cancer in her left breast.
"Had she not had the test, we would have waited a year for her next mammogram. The cancer could have grown and we have no guarantee it would have been visible on (the next mammogram)," said Peg Board, a nurse and director of operations at the San Dimas Medical Group, a women's health practice at the Mercy Southwest Hospital campus.
San Dimas is the first in Bakersfield to offer the HALO Breast Pap Test, a device that collects fluid from a woman's breast that can be analyzed for precancerous cells. Looking for early signs of cancer at the cellular level means potentially malignant abnormalities could be found years earlier than with a mammogram or self-exams, according to HALO's manufacturer.
Roughly one in eight women will develop breast cancer in her lifetime and an estimated 180,000 new cases of invasive breast cancer will be diagnosed this year, according to the American Cancer Society.
"The whole idea is you can be watched more closely," said Gregory Klis, an obstetrician-gynecologist at San Dimas.
Klis said the HALO test can pick up microscopic cellular changes that may lead to a cancer diagnosis years before the disease is detectable through traditional tests.
For example, it can take up to eight years or more for a tumor to grow to a size noticeable on a mammogram, he said.
NEW ASSESSMENT TOOL
Studies have shown women with abnormal cells in breast fluid have a four to five times higher risk of developing breast cancer than women without abnormal cells. In women with abnormal cells and family history of breast cancer, the risk can be up to 11 times greater.
But until now, collecting breast fluid was difficult and expensive, and only done in cases where a woman was known to be at a high risk of developing the disease.
HALO is a machine, similar to a breast pump, that collects fluid using two adjustable breast cups that warm and massage the breasts and then apply mild suction to extract fluid. The process take just five minutes and lab results usually come back in two days.
Doctors at San Dimas Medical Group now recommend women age 25 to 55 have the HALO test done annually. In women 40 and older, the test does not replace mammograms but is recommended in conjunction with them.
Because it's so new, HALO is not yet covered by insurance companies. San Dimas charges $75 per screening and offers the test to any woman, not just patients of the practice.
HALO's maker, NeoMatrix, says about 200 machines have been installed in medical practices and facilities nationwide. The device is also used locally by Dr. Miguel L. Lascano at the Kern Women's Health Group, a company official said, and Advanced Women's Health Center is testing the machine on a trial basis.
However, some local doctors want to see more information on the machine's effectiveness.
"It sounds like a good machine, but we need to have more data and more research," said Dr. Ramin Bizhang, Kaiser Permanente's chief of services in the obstetrics and gynecology department at the Discovery Medical Plaza in Bakersfield.
About half of women who take the test don't produce fluid, Bizhang said, but that doesn't mean they don't have cancer.
"You could be missing a patient that does have cancer," he said.
Alternatively, a result showing abnormal cells in a woman may cause unnecessary anxiety since abnormal cells don't always develop into cancer, he said.
CONCERNS RUN HIGH
In Esqueda's case, two previous mammograms showed signs of calcification in her breast but because there was no lump found, she was told to continue with annual mammograms.
"It doesn't run in my family but it just really concerned me," said Esqueda, a wife and mother of a 15-year-old daughter and 22-year-old son.
So when Dr. Jigisha Upadhyaya at San Dimas Medical Group mentioned the HALO test during an appointment earlier this year, Esqueda decided to take it.
The test showed atypical cells in fluid from the left breast and, this time, a biopsy was ordered. The results found early-stage cancer in her breast, known as ductal carcinoma in situ.
Esqueda is scheduled to have surgery in December to remove the affected area and her prognosis is good. When breast cancer is caught at this early stage, the five-year survival rate is nearly 100 percent.
"I tell people this machine saved my life," Esqueda said.
HALO's makers and some doctors believe the screening test could do for breast cancer what the Pap test has done for cervical cancer -- drastically reduce the number of deaths through early screening detection. Since the pap smear's introduction in the 1950s, deaths from cervical cancer have dropped more than 70 percent due to early detection.
Even more promising, Klis said, is research under way to treat women with abnormal cells to prevent cancer from developing.
Woman under 40 who may be concerned about breast cancer but too young for a mammogram are also excited about the HALO test, Board said.
"It gives women something they can do" to be proactive about breast cancer, Board said. "Until now, women under 40 could only do a self-exam."
"From that perspective," she said, "it truly is preventative care."
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to http://www.bakersfield.com. Copyright (c) 2008, The Bakersfield Californian
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