2 Ways to Detect Breast Cancer Through Elastography ~ Pina-Pinas

A Boost to Early Breast Cancer Diagnosis in the Philippines

Unusual lumps on the breast are the common signs of breast cancer. Women beyond 30 are recommended to have regular mammogram to facilitate early breast cancer diagnosis. However, majority of patients with breast cancer have been diagnosed at a later stage. Cancer treatment at advanced stages is expensive and painful. Moreover, patients in advanced stages have higher risks considering that certain types of cancer can aggressively spread to adjacent areas.

Currently, women who are found to have a suspicious lump on the breast are recommended to have a mammogram test. A mammo procedure will require the patient to stand between plates for the X-ray. The breast must be as ‘flat’ as possible so that the ray can break through the least possible layers. It is especially painful when the procedure takes more than 20 minutes. The plates are studied and results made available after a few days, depending on the attending radiologist.

Painless and fast breast cancer diagnosis is now available through a new imaging technology, called the Ultrasound with Elastography. Pioneered by Hitachi Medical Corporation and exclusively distributed by Himex locally, the ultrasound provides real-time scanning, so you get instant result making breast cancer diagnosis immediate and increases the patient's survival.

Ultrasound Elastography started during the late 1990s and has since been widely studied in the US, Europe and other Asian countries. Like most new medical intervention, the elastogram withstood objections from different fields of medicine until multi-center and comparative studies revealed at least 99% accuracy of results. One particular study, lead by Dr. Jocelyn Cuyos of Jose R. Reyes Memorial Medical Center, was presented in a medical conference last October 23, 2010.

Tsukuba Scoring of Hitachi Medical Systems

Elastography is a non-invasive and painless ultrasound used to distinguish malignant from benign tumors. The sensitive equipment uses 2 ways in identifying malignant mass by color mapping and gauging hardness.

With the elastogram, the ultrasound uses Tsukuba Scoring. In contrast to the display of traditional ultrasound computers, the elastogram features a colored display of blue and green tones. Green massive areas show that the suspected lump is harmless, while areas in blue indicate malignant cell growth. The surrounding areas will show the extent of infection if the cancer has spread.

Cancer cells, generally, come from irregular cell growth and production. There are no clinically identified particular activities or direct factors that lead to cancer growth. Any irregularity in the body that disturbs regular cell growth and duplication can lead to the growth of tumors. These tumors can be cancerous, also called malignant, or non-cancerous, referred to as benign. Some malignant cells are aggressive; so it is pertinent to get immediate results to prepare a patient for early treatment.

Malignant cells are relatively 4 to 20 times harder than surrounding tissues. In verifying hardness, the new ultrasound automatically computes for fat-to-lesion ratio which will confirm whether the lump is benign or malignant. Fat to lesion ratio determines the breast tissues’ elasticity by comparing the suspected areas with the hardness of surrounding normal tissue. A score of 4 and above will confirm that the lump is malignant.

Jose R. Reyes Memorial Medical Center, Manila

As of now, only JRMMC has the real-time scanning elastogram in the Philippines. The JRMMC medical team will be studying its applicability and efficiency on cancer diagnosis in the thyroid within the next months. Worldwide, the elastogram has been used in early cancer diagnosis in the breast, thyroid, pancreas, splint, prostate and liver.


Ultrasound with Elastography @ JRMMC

The software was developed by Dr Ei Ueno and Dr Tsuyoshi Shiina of Tsukuba University in cooperation with Hitachi. The elastogram can detect and diagnose tumors as little as 2mm. With this intervention, women can be spared from the painful and possibly unnecessary mammography and biopsy. And of course, early diagnosis of breast cancer will increase the chances of survival of patients.

The service will soon be open to the public. Please contact JRMMC Radiology Department for more information, +632-712-7010. Follow me to get updates of hospitals that will offer elastography. Just a sneak peek: 2 new medical facilities in Mindanao will have the new Hitachi Ultrasound Diagnostic System.

Many thanks to Ms. Ana Margarita Trista, Ultrasound Specialist (Himex - JRMMC), for giving me an overview of some cancer diagnostic equipment and JRMMC’s initiatives in early cancer diagnosis; and to Ms. Paula Marie Gonzales, RRT, Ultrasound|CTI|MRI Specialist (Himex – JRMMC) for helping me understand how the elastogram works.