Windber scientists study new breast cancer test

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June 28, 2009

By RANDY GRIFFITH The Tribune-Democrat Sun Jun 28, 2009, 11:44 PM EDT

Local scientists are hoping to expand the power of a new breast cancer screening option already showing promise for early detection in younger, high-risk patients.

Called the Pap test for breast cancer, the HALO system collects fluid from the breast to analyze for signs of disease.

Currently, pathologists must locate cells within the nipple aspirate fluid and determine how many are abnormal, said Rachel Ellsworth, director of translational medicine at Windber Research Institute.

Sometimes, the analysis is difficult, she said.

“This is an easy way to collect the nipple aspirate fluid,” Ellsworth said.

“When you collect the fluid, you get a drop or two if you are lucky.”

A drop might have only 10 cells or less for analysis. If one or two appear abnormal, the patient could be referred for additional testing or put on a more frequent screening schedule.

“You are still dealing with pathology (science) from 50 years ago,” Ellsworth said.

Working with Vanderbilt University in Nashville and doctors from The Breast Center at DeCesaris Cancer Institute in Annapolis, Md., Windber’s scientists hope to improve the odds.

The study is being funded by a grant from the Susan Love Research Foundation.

Instead of relying on a handful of cells in the fluid, researchers hope to identify changes in the fluid itself, Ellsworth said.

“Abnormalities could be in the duct fluid,” Ellsworth said.

“We thought: Can we use molecular data to identify patients with abnormalities.”

The first step was to find out if they could analyze such small amounts of fluid.

“We have proven we can detect 120 proteins in the (fluid),” she said. “We know there are proteins in fluid. Can we see a difference in patients who have the disease and people who don’t?”

Windber and Vanderbiltresearchers expect to spend about 18 months analyzing fluid collected from breast cancer patients and those who are cancer-free. Those results will be used to develop a lab test to be used in clinical trials for approval by the Food and Drug Administration.

“We hope to find some signature in this fluid that says, ‘This patient has breast cancer,’ or ‘This patient is going to get breast cancer,’ ” said Dr. Lorraine Tafra from the Anne Arundel Medical Center in Annapolis, home of The Breast Center.

The process could be improved with more participating physicians. Ellsworth said she is not aware of any area doctors using the HALO system, which is gaining popularity among doctors in some areas.

Tafra and her colleagues have been using it for more than a year as part of their risk-assessment formula.

“It is important to know all the patient’s risk factors,” Tafra said. “That then allows you to develop a tailored monitoring program, with more treatment or surveillance.”

Manufactured by NeoMatrix LLC of Irvine, Calif., HALO uses massage, warmth and suction to bring the fluid from the milk ducts where

95 percent of all breast cancers originate, the company says.

Although not currently a replacement for routine mammograms and a breast exam routine, the HALO system is another screening option for high risk patients, especially those younger than 40. Mammograms are not recommended for those under 40 to reduce lifetime exposure to

X-ray radiation and because they are less effective in dense tissue of younger women.

Before the HALO system was developed, doctors were required to use a needle biopsy or other invasive method to collect breast cells for screening.

“This is a test that allows you to get cells from the breast without doing an invasive biopsy,” Tafra said.

She and Dr. Barbara Urban of the Anne Arundel Medical Center will be in Windber from

11 a.m. to 1 p.m. July 8 to demonstrate the HALO system for physicians and other medical workers during a seminar on management of high risk breast cancer patients. More information is available by contacting the Windber Research Institute.

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