MRI better than MDCT for determining if and how far breast cancer has spread into the breast ducts

November 02, 2015

"Patients have a lower survival rate if their surgical margins are positive for tumor cells. A positive surgical margin is usually the result of inadequate resection of the cancer's intraductal component," said Akiko Shimauchi, MD, at Tohoku University in Sendai, Miyagi, Japan. "Accurate preoperative diagnosis of the intraductal component allows the surgeon to achieve a cancer-free surgical margin," she said.

The study included 69 patients with proven invasive cancer, 44 of which had an intraductal component, said Dr. Shimauchi. MRI correctly identified 33 of the 44 cases, while MDCT correctly identified 27. "MRI revealed the presence of the intraductal component with significantly higher sensitivity (75%) compared to MDCT (61%), Dr. Shimauchi said.

"The lesions that were missed by both examinations were the ductal extension type, i.e. the tumor included a dominant mass with an outward extension of cancer cells, with a relatively small ductal component," said Dr. Shimauchi. MRI was better able to detect the smaller ductal components than MDCT, she said.

The study also found that both MDCT and MRI "generally underestimated the length of the intraductal component," however, MRI was less likely to underestimate the length of the intraductal component than MDCT. "In our institution, surgeons err on the side of caution by using a surgical margin that is 20 mm outside the radiologically determined tumor margin," said Dr. Shimauchi. Underestimation of the length of the intraductal components by 15 mm or more was significantly less frequent with MRI (30%) compared to MDCT (55%), she said.

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The system combines liquid chromatographic separation of proteins driven by hundreds of parallel micro- and nanochannels. These channels, which have dimensions in the micrometer domain, serve to generate an electroosmotic flow. This flow of liquid helps to separate the proteins which are then identified by state-of-the-art mass spectrometric detection instruments. Researchers in Dr. Lazar's laboratory used the microchip to detect cancer biomarkers in cellular extracts generated from the MCF7 breast cancer cell line. 77 proteins were identified with confidence, five of which are known to be cancer-specific biomarkers. The fully integrated microfluidic liquid chromatography system has been shown to be suitable for the detection of multiple disease-specific biomarkers.

An article, "Microfluidic liquid chromatography system for proteomic applications and biomarker screening," by Lazar, P. Trisiripisal, and H.A. Sarvaiya, was published in the August 15, 2006 issue (vol. 78, no. 15) of Analytical Chemistry. A patent application entitled "Microfluidic devices and methods facilitating high-throughput, on-chip detection of separation techniques" has been filed with the US patent office.

This research was supported by a National Science Foundation Career Grant no. BES-0448840.

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