A new MRI technique being developed in Israel could dramatically speed the detection and treatment of breast cancer.
Hadassa Degani of the Weizmann Institute of Science was one of several Israelis to share research news at a breast cancer symposium in San Francisco last week.
“Winning the War Against Breast Cancer,” held March 18 at the Ritz-Carlton, was co-hosted by two pioneering Israeli research institutions — Ben-Gurion University of the Negev and the Weizmann Institute. Guest speakers discussed new developments in the diagnosis, treatment and epidemiology of the disease.
Degani is experimenting with injecting patients with a color-coded agent and using high-resolution magnetic resonance imaging (MRI) to detect, identify, diagnose and define the character of breast cancer lesions. The procedure, presently in clinical trials in the United States, makes it possible to identify smaller tumors than those spotted with a mammogram, she said.
Although MRIs are not new in breast cancer screening, the use of an agent that color codes the cells, surrounding tissue and blood vessels, is. The color contrast makes it possible to detect lesions, define their character and determine whether they are malignant or benign. Such information, until now, could only be learned through extracting tissue surgically.
“You can look at the tissue non-invasively,” said Degani. “The MRI will tell you about the spaces between cells. You can measure the density of cells, how they are distributed and the density of the blood vessel.”
Unlike surgery, the MRI has no side effects.
The procedure can also be used to monitor the effect of presurgical treatment on a tumor, she said. The color-coded MRIs are much easier to read than the traditional mammogram.
Early detection, panelists agreed, is the most effective weapon against breast cancer.
“Breast cancer still kills one-third of the women diagnosed with it,” said moderator Dr. Susan Love, a professor of surgery at UCLA and medical director of the Santa Barbara Breast Cancer Institute. Her best-selling “Dr. Susan Love’s Breast Book,” now being translated into Hebrew, is widely regarded as the bible on the subject for lay women.
Discussing the magnitude of the problem, panelist Dr. Susan Blumenthal, assistant surgeon general of the United States, said there is no greater health concern for the Clinton administration than the battle against breast cancer. “Women’s health has been ignored all too long.”
To overcome that inequity, Blumenthal said the administration is providing more than $600 million in federal funding for breast cancer research. It is also addressing economic disparities in access to health care, and has created a breast cancer hotline to provide information.
In addition, the Food and Drug Administration is working to develop a fast track for the review and approval of drugs to treat breast cancer and establish standards for mammogram readers, she said.
Other panelists outlined various attacks on breast cancer — from treatment to prevention.
Shraga Segal, head of the Cancer Research Center at Ben-Gurion, has focused his research on the metastatic process.
“If we could prevent metastases, we could save most of the patents who are doomed to die,” said Segal. By understanding why some cells metastasize and other don’t, Segal hopes to develop drugs that will kill the bad cells and leave the healthy ones intact, and maybe eventually develop an anti-cancer vaccine.
Yosef Yarden of the Weizmann Institute talked about his research in the growth factors of cancer cells and whether the introduction of certain antibodies can inhibit growth.
Another line of attack was outlined by David Geffen of Ben-Gurion. He is analyzing the demographics of breast cancer, such as its frequency in different populations, to better understand what causes it.
In her summary, Love said the approach to treating breast cancer has changed.
It’s no longer “slash, burn and boil,” she said. Instead, it’s “targeted therapy that comes from understanding how breast cancer works. There’s better treatment. Better detection. Better results. Ultimately, maybe we can prevent it.”
Guest of honor Dr. Ernie Bodai discussed his two-year campaign to persuade Congress to approve the 40-cent breast cancer stamp.
“I wanted to raise money for breast cancer research and got the idea for a stamp,” said Bodai. “The mortality rate [for breast cancer] has not changed in 50 years.”
Bodai’s proposal — to charge more than the actual cost of postage and earmark the difference for research — had never been tried before.
“It took an act of Congress,” said Bodai, drawing laughs from the largely female audience of about 400. The Breast Cancer Research Stamp Act was passed by an overwhelming margin — only three “no” votes in both houses — and in August 1997, the stamp was issued. It has become a best seller, raising hundreds of thousands of dollars for cancer research and knocking the Bugs Bunny stamp out of second place. Its sales are only surpassed by the Elvis stamp.