Breast Cancer Clinical Trial
Official title:
A Prospective Validation Study of a Rapid Point-of-Care Breath Test for Breast Cancer
This is a multicenter, blinded prospective study of 2,000 women undergoing mammography for breast -related symptoms or signs. Breath tests will be performed in order to demonstrate that the outcome of mammography results combined with breast test results improves clinical sensitivity and specificity in a group that has an increased prior probability of cancer. Breath will be collected and analyzed with a rapid point-of-care instrument (BreathLink™) and also with a laboratory-based assay of samples collected into an inflatable bag (BreathBag™).
Introduction
Clinical perspective on breath testing for breast cancer:
Breast cancer is the most commonly diagnosed cancer in women, in whom it is second only to
lung cancer as a cause of cancer death. The National Cancer Institute estimated that more
than 232,000 US women would be diagnosed with breast cancer in 2013 and nearly 40,000 would
die of the disease.
Screening mammography and its limitations: In order to reduce the number of breast cancer
deaths, many countries have established screening mammography programs to detect and treat
early-stage disease. However, the impact of screening mammography on mortality has been
questioned. Also, screening mammography is limited by its very low yield: a 2005
retrospective analysis reported that 510 US radiologists performed 2,289,132 screening
mammograms and found 9,030 cancers i.e. only one cancer was found for every 253 mammograms.
99.6% of all screening mammograms were negative for cancer: they provided reassurance, but at
a human cost of millions of women exposed to potentially hazardous radiation and discomfort,
and a financial cost of several million dollars. Also, screening mammography may be
associated with an increased risk of radiation-induced breast cancer, as well as with
overdiagnosis and overtreatment. Many women decide not to take the test even when it is
readily available, and screening mammography may be underutilized because of fear of pain and
radiation exposure, ethnicity, poverty, and level of education.
Breath tests - a new diagnostic tool: Abnormal volatile organic compounds (VOCs) in breath
have been identified in breast cancer. Breath VOC biomarkers have been reported in other
disorders including bronchial asthma, lung cancer, active pulmonary tuberculosis, radiation
exposure, and heart transplant rejection. The Food & Drug Administration (FDA) approved the
nitric oxide breath test in bronchial asthma, the urea breath test for H. pylori, and
Menssana Research's Heartsbreath test for heart transplant rejection under the Humanitarian
Device Exemption regulations.
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