New scan will spare women from cancer surgery

Women with breast cancer could be spared unnecessary surgery as a result of the development of a new technique for detecting how far the disease has spread. Jeremy Laurance, Health Editor, reports.

A new scanning technique invented by scientists from the Imperial Cancer Research Fund can show whether cancer in the breast has spread to the lymph nodes under the arm.

The technique will allow surgeons to tell women in advance how extensive surgery to remove the cancer will have to be. Currently, the only way to detect the spread is to surgically remove the lymph nodes and examine them in the laboratory. That means that women with no cancer in their lymph nodes have unnecessary treatment.

A pilot study conducted on 29 women at St Bartholomew's hospital, London, showed the technique was 90 per cent correct in predicting cancer spread. Rob Carpenter, consultant surgeon at St Bartholomew's breast unit, said: "We are extremely encouraged by the results. They mean that in future we will be able to let patients know what to expect from their breast cancer operation and help them deal with it more effectively."

The technique involves injecting radioactive markers designed to home in on, and stick to, cancer cells. Pictures of the lymph nodes are taken twice over 24 hours using a gamma camera and the two images are compared by a computer which indicates the probability of cancer being present.

There are 35,000 new cases of breast cancer each year and almost all affected women have surgery to remove the lump. The more advanced the cancer the greater the likelihood of spread to the lymph nodes. In the most extreme cases this results in a radical mastectomy in which the breast and all the underlying tissue including the lymph nodes is removed.

The need for radical surgery has declined as improved detection and screening has led to earlier diagnosis. The researchers say that as breast cancers are detected earlier the need for a scanning technique to determine whether the disease has spread to the lymph nodes will grow because in an increasing number of cases the nodes will be unaffected.

The research team, led by Professor Keith Britton, head of the ICRF Nuclear Medicine Unit, is now looking at the possibility of injecting a tiny amount of the radioactive marker by the tumour and using a probe to check the lymph nodes.

Professor Britton said: "If the node is positive it can be removed and examined in the laboratory to double check if cancer is present. That way we can tell women in advance just how extensive their breast cancer operation is going to be."

Results of the pilot study were announced at the launch of a fundraising drive by ICRF and Macmillan Cancer Relief in association with General Accident, the insurance company, expected to raise pounds 200,000.