Now, get to know which breast cancer patient responds best to chemo

Washington D.C. [U.S.A.]:  A new optical imaging system that used near-infrared light will identify breast cancer patients who will benefit the most from chemotherapy, a new research has stated.

According to the Columbia University research, the imaging system might be able to predict response to chemotherapy as early as two weeks after beginning treatment.

The optical imaging system was developed in the laboratory of Andreas Hielscher, a professor at Columbia University.

"There is currently no method that can predict treatment outcome of chemotherapy early on in treatment, so this is a major advance," said Hielscher, co-leader of the study.

His dynamic optical tomographic breast imaging system generated 3D images of both breasts simultaneously. The images enabled the researchers to look at blood flow in the breasts, see how the vasculature changes, and how the blood interacts with a tumour.

He added, "This helps us distinguish malignant from healthy tissue and tells us how a tumour is responding to chemotherapy earlier than other imaging techniques can".

Neoadjuvant chemotherapy, given for five to six months before surgery, is the standard treatment for some women with newly diagnosed invasive, but operable, breast cancer. The aim of neoadjuvant chemotherapy is to eliminate active cancer cells, producing a complete response, before surgery.

Those who achieve a complete response have a lower risk of cancer recurrence than those who do not. However, fewer than half of women treated with neoadjuvant chemotherapy achieve a complete response.

"Patients who respond to neoadjuvant chemotherapy have better outcomes than those who do not, so determining early in treatment who is going to be more likely to have a complete response is important," said Dawn Hershman, the co-leader of the study.

The researchers analyzed imaging data from 34 patients with invasive breast cancer between June 2011 and March 2016. The patients comfortably positioned their breasts in the optical system, where, unlike mammograms, there was no compression.

The investigators captured a series of images during a breath hold of at least 15 seconds, which inhibited the backflow of blood through the veins but not the inflow through the arteries.

Additional images were captured after the breath was released, allowing the blood to flow out of the veins in the breasts. Images were obtained before and two weeks after starting chemotherapy.

The researchers then compared the images with the patients' outcomes after five months of chemotherapy. They found that various aspects of the blood inflow and outflow could be used to distinguish between patients who respond and those who do not respond to therapy.

"If we can confirm these results in the larger study that we are planning to begin soon, this imaging system may allow us to personalize breast cancer treatment and offer the treatment that is most likely to benefit individual patients," said Hershman.

Findings from a first pilot study of the new imaging system are published in the journal Radiology.