Technology Transferred from Space, Intelligence and Defense Industries Used to Detect and Diagnose Breast Cancer

WASHINGTON, Sept. 17-Breast cancer researchers have taken defense and espionage technology out of the war room and brought it home to the examination room where doctors are using these sophisticated imaging techniques to improve the early detection and diagnosis of breast cancer.

Two years ago, the Office on Women's Health (OWH) within the Department of Health and Human Services, stimulated an innovative partnership between the intelligence, defense and medical communities to improve the early detection of breast cancer. In October 1994, PHS OWH held its first briefing on Capitol Hill to showcase potential ways of applying imaging technologies used for missile and target recognition to find tanks camouflaged behind trees to enhance our ability to find lumps camouflaged in women's breasts. Technologies originally developed for defense and space exploration are now being evaluated for breast cancer detection. PHS OWH will hold a follow-up briefing to mark the progress that has been made over the past 2 years on this technology transfer project on Tuesday, Sept. 17 in the Hart Senate Office Building, Rm. 216, from 8:30 a.m. to 12:30 p.m. to demonstrate the success.

In several institutions across the country, research studies, including some clinical trails, are under way using technologies developed as the part of the Hubble space telescope project and from missile guidance systems to produce high-resolution mammograms and image-guided biopsy technologies that are improving diagnoses of the disorder. Other studies are taking digitized images of the breast and enhancing them, manipulating them, and sending them via modem to medical centers thousands of miles away for consultation with medical experts that will benefit patients nationwide.

The briefing will also examine novel technologies such as magnetic resonance imaging (MRI) and positron emission tomography (PET), which are currently being evaluated for their utilization in improving the detection of breast cancer. MRI helps distinguish between benign and malignant tumors. PET and other molecular imaging methods hold the promise for finding cancers when only a few cells are present for detecting metastases in distant sites in the body.

"I have always believed that if we can image missiles in distant skies, and with the Hubble telescope, see the surface of Mars, then surely we should be better able to detect small lumps in women's breasts right in front of us," said Assistant Surgeon General, Susan Blumenthal, M.D.

Blumenthal said that digital mammography-in which visual information is generated, displayed, enhanced, stored and transmitted by computers instead of x-ray film-has the potential to produce clearer, sharper images and may be especially helpful in viewing dense breast tissue where microscopic cancers are harder to see. Digital mammograms may allow doctors to spot cancer that may not appear with existing technology.

Stephen A. Feig, M.D., professor of radiology at Thomas Jefferson Medical College in Philadelphia, used an experimental digital mammography system to detect a microscopic lump in the breast of Gayle Landis, 47, of Denver, Colorado. The mass was not visible from a film-screen mammogram performed 24 months prior to the digital mammogram. The tumor was biopsied, and Ms. Landis underwent a lumpectomy and radiation therapy. Now free of cancer, she says, "If we had not caught this when we did, I might not have been so lucky."

Digital mammography also enables doctors to conduct telemammography, in which the digital image is transmitted as an electrical signal by telephone lines, dedicated telecommunication lines, or satellite. This superb reproduction of the original, with the high resolution required in a mammogram, can be sent from one part of the country to another by satellite relay in less than 4 minutes.

Other utilization of digital telemammography is the Mobile Breast Care Center (MBCC), a joint project of the Office on Women's Health in the Department of Health and Human Services, the National Cancer Institute (NCI), and the Department of Defense (DoD), which should benefit all women but especially underserved populations and women living in rural areas. Inside the MBCC, a patients digital mammogram can be immediately transmitted by satellite to a breast screening center, where a radiologist could instantly interpret the images and relay any need for additional evaluation back to the mobile unit. By bringing digital mammography and its corresponding access to high-quality breast care and education to the public, the MBCC will meet a critical need and significantly improve breast disease diagnosis in the general public.

Other technologies to be highlighted at the briefing include virtual reality and image-guided treatment. In image-guided treatment, magnetic resonance is opening up new vistas in the noninvasive treatment of cancer. When coupled with focused ultrasound, this new technology has been used in preliminary clinical trials to successfully treat non-cancerous tumors. Leonard Holman, M.D., chairman, Department of Radiology at Harvard Medical School said his institution is one of three in the world to have this new "open" MRI device, which permits "real time" imaging at the bedside. "The technique is using focused ultrasound waves to create heat, which irreversibly damages the tumor tissue," he said. "Magnetic resonance guidance provides a map that accurately defines the boundaries of the tumor as well as the thermal gradient map to tell us which tissue has been destroyed."

With virtual reality, advanced imaging technologies using three-dimensional visualization takes a previously acquired image from any method-CAT scan, MRI, ultrasound, mammogram-and uses a high performance computer to create a full 3-D volume image. The researcher can interact with the image as if the breast were actually there. Interaction includes rotating, slicing in to various planes, making layers transparent and eventually taking a miniaturized view and "flying through" the ducts and glands, looking for disease, including cancer.

In addition to Blumenthal, speakers at the Capitol Hill Briefing include Senator Arlen Specter; Senator J. Robert Kerrey; Daniel Goldin, Ph.D., Administrator, National Aeronautics and Space Administration (NASA); and prominent scientists, government officials and advocates from across the country.

Every year, one in eight American women develop breast cancer, and more than 41,000 women die as a result. If detected early, breast cancer has a 90 percent 5-year survival rate.

According to Blumenthal, mammograms have come a long way since they were first developed, but medicine still lags 10 years behind the defense industry in its imaging technology. Today's mammogram, which uses x-ray film, is currently the best technology we have to detect and diagnose breast cancer, however, it is a 40-year-old technology that has limitations. Mammography detects 15 percent of cancers and three out of four lesions found by mammography are benign, resulting in unnecessary and costly medical procedures such as biopsies, especially in the 40 percent of women in the general population who have dense breast tissue that can mask the presence of a tumor. "I believe all women deserve to have more effective and accurate technology to detect breast cancer early when there is the best time for effective treatment and increased survival rates," Blumenthal said.

An exhibit of the new imaging technologies to detect breast cancer, including MRI, PET, and ultrasound and technologies being developed in collaboration with the CIA, DoD, and NASA, will be on display in the Hubert H. Humphrey Building's Great Hall, Department of Health and Human Services, 200 Independence Avenue, S.W., from 10 a.m. to 6 p.m., Tuesday, Sept. 17.