Can a PET scan be used for early detection of some forms of breast cancer?
A collaborative pilot study between Stony Brook University Cancer Center’s bioimaging department and Brookhaven National Laboratory (BNL) in New York is funded by the U.S. Department of Energy. The focus of the study is to learn new ways to detect breast cancer before it is visible using standard imaging modalities such as a mammogram, MRI and/or ultrasound.
Led by BNL’s senior scientist Anat Biegon, PhD, with Stony Brook’s Jules Cohen, MD, the study uses radiotracers to image aromatase, an enzyme responsible for the production of estrogen. Because 50 to 60 percent of women with breast cancer have a form that is estrogen-positive, being able to identify and track this enzyme could have wide implications for treatment. In addition, it may yield new information about alternative uses of aromatase inhibitors ‑ compounds that can slow or stop the production of estrogen. Aromatase inhibitors currently are used in follow-up treatment for patients with breast cancer to cut down on the recurrence rates of cancer.
For the study, women with new diagnoses of breast cancer who have not yet had surgery or begun treatment undergo a PET scan. They are given the radiotracer vorozole, a compound that binds to aromatase, to help detect whether the enzyme is expressed. Researchers then review the results to see if they can diagnose breast cancer from the scans. To date, they have been able to.
“Our premise is that if we can detect known breast cancer with this receptor, it may have multiple applications, including early detection,” says Dr. Cohen. “However, we may also be able to use this modality to monitor a patient’s responsiveness while using an aromatase inhibitor to ensure appropriate dose and optimal benefits. We might also be able to use it to monitor the therapy of patients with metastatic cancer as well.” Dr. Cohen believes this study is just the tip of the iceberg. He envisions using different radiotracers with a PET scanner to detect neuroinflammation, or inflammation of the brain, in order to see which areas of the brain have been affected by chemotherapy. “This will allow us to make objective assessments of cognition and better understand what people call ‘chemo brain’ or ‘chemo fog,’ which has long been considered one of the major side effects of chemotherapy.”