Breast cancer detection based on incremental biochemical and physiological properties of breast cancers: a six-year, two-site study.
OBJECTIVE
To demonstrate that near-infrared spectroscopy would achieve sufficient sensitivity and specificity in human breast cancer to reach ROC/AUC values in the 90s and yet to warn of the potential liabilities of introduction of a novel technology in this field.


METHODS
116 subjects from two nations (44 were cancer-verified by biopsy and histopathology) were reviewed. NIR spectroscopy of total hemoglobin and its relative oxygenation were monitored in breast cancers and compared to their contralateral breast in a 2D nomogram for diagnostic evaluation. A novel handheld NIR breast cancer detector pad with a 3-wavelength LED and 8 detectors with 4 cm separation between source and detectors was placed on the subject's breast. The method is convenient, rapid, and safe and has achieved high patient compliance with minimal patient apprehension of compression, confinement, or radioactivity.


RESULTS
The absorbance increments of the cancerous region are referred to the mirror image location on the contralateral breast. The two metrics are increased hemoglobin concentration due to angiogenesis and decreased hemoglobin saturation due to hypermetabolism of the cancer. The 2D nomogram display of these two metrics shows Zone 1 contains verified cancers and Zone 2 contains noncancers. ROC evaluation of the nomogram gives 95% AUC for the two sites, Philadelphia and Leipzig.


CONCLUSIONS
A simple, economical breast cancer detector has achieved high patient compliance and a high ROC/AUC score for a population which involved a range of tumors down to and including those of 0.8-1 cm in diameter.
Chance
Britton
B
University of Pennsylvania, Department of Biochemistry, Philadelphia, 19104-6059, USA. chance@mail.med.upenn.edu
Nioka
Shoko
S
Zhang
Jun
J
Conant
Emily F
EF
Hwang
Emily
E
Briest
Susanne
S
Orel
Susan G
SG
Schnall
Mitchell D
MD
Czerniecki
Brian J
BJ
D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D001810:Blood Volume / Q000502:physiology; D001943:Breast Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology*; D005189:False Positive Reactions; D005260:Female; D005858:Germany; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008327:Mammography; D049451:Nomograms; D010100:Oxygen / Q000097:blood; D015143:Philadelphia; D012680:Sensitivity and Specificity; D019265:Spectroscopy, Near-Infrared; D013223:Statistics as Topic; D016387:Women's Health
D015415:Biomarkers; D006454:Hemoglobins; D010100:Oxygen