Clinical Trial Detects Hidden Breast Cancer

In 2000, 40-year-old Stephanie Annable had what she thought would be another routine mammogram. But in her film, the radiologist saw a small cluster of calcifications. Those turned out to be Stage 0 breast cancer.

Annable knew how fortunate she was the calcifications were even picked up. As with an estimated 60 percent of American women, Annable had dense breast tissue, which is made up of more connective tissue and appears white on a mammogram. Because cancer also appears white on a mammogram, tumors can be difficult to detect.

“As the breast density goes up, the mammogram’s accuracy drops,” said Marc Inciardi, MD, a breast imaging radiologist at The University of Kansas Cancer Center. “In non-dense breasts, a tumor is easy to see [in a mammogram] as a little white ball. But in a dense breast it’s like trying to find a snowball in a snowstorm.”

After receiving treatment, Annable sought out Breast Cancer Prevention experts at The University of Kansas Cancer Center. Her prevention team educated Annable about lifestyle changes, preventive drug options, additional screening opportunities and future risk assessments. She started taking the breast cancer drug Tamoxifen, and had a mammogram or a sonogram every six months.

“I had a gut feeling this could come back, and I wanted to be fully armed and ready should that occur,” Annable said. “I wanted to do everything in my power to keep this from coming back, and I knew I would be in the best hands here.”

In September 2009, Annable had her six-month mammogram at The University of Kansas Cancer Center. Elated that her mammogram showed nothing abnormal, Annable decided to participate in the new SOMO·INSIGHT clinical trial. The trial studies whether Automated Breast Ultrasound (ABUS) technology is more accurate than a routine screening mammogram alone in detecting breast cancer in women with dense breast tissue.

Through a gentle scanning process, the ABUS scans each breast from the front, outer and inner sides, providing radiologists with a clear 3D ultrasound. “It’s another tool in the fight, so I absolutely wanted to participate,” Annable said. “But I thought, ‘They won’t find anything.’ ”

Annable was shocked to learn the ABUS revealed a spot her mammogram hadn’t showed. Further tests confirmed it was Stage 1 breast cancer.

Though this trial will take at least two more years to complete, Dr. Inciardi, the trial’s principal investigator at the cancer center, has already seen the value in ABUS: In February, breast radiologists detected an early-stage cancer in a second trial participant.

“We will need more results to confirm, of course,” Dr. Inciardi said. “But if the trial results show this is applicable to the general population with dense breasts, this may result in another tool for early detection.”

For her part, Annable said that until a cure is found, services like Breast Cancer Prevention and access to clinical trials at The University of Kansas Cancer Center provide more hope to women.

“I’m so fortunate that because of the clinical trial, they found this cancer so early,” Annable said. “I’m so blessed to have the team at The University of Kansas Cancer Center, and to have had access to this tool.”

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