Re: Ultrasound method may supplant biopsies

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CHICAGO - An experimental ultrasound technique that measures how easily breast lumps compress and bounce back could enable doctors to determine instantly whether a woman has cancer or not — without having to do a biopsy. ADVERTISEMENT In a small study of 80 women, the technique, called "elastography," distinguished harmless lumps from malignant ones with nearly 100 percent accuracy. If the results hold up in a larger study, elastography could save thousands of women from the waiting, cost, discomfort and anxiety of a biopsy, in which cells are removed from the breast — sometimes with a needle, sometimes with a scalpel — and examined under a microscope. "There's a lot of anxiety, a lot of stress, a lot of fear involved" with biopsies, said Brown, manager of health education for the G. Komen Breast Cancer Foundation. "And there's the cost of leaving work to make a second appointment. If this can be done instead of a biopsy, there would be a real cost reduction." Up to 1 million biopsies

are performed each year on suspicious breast tissue detected by mammograms and self-exams, but as many as eight out of 10 of these biopsies find that the lumps are benign. Biopsies can cost $200 to $1,000, depending on whether some fluid or an entire lump is removed, and it can take days or weeks to get the results. The cost of elastography is not yet clear, but some experts said the procedure might run $100 to $200. And it can yield results in minutes. When checked against biopsies of women's breast tissue, the ultrasound technique correctly identified 17 out of 17 cancerous tumors, and 105 out of 106 harmless lesions. The findings were reported at a national radiology meeting in Chicago this week. Scientists said the approach may also be used someday to rapidly diagnose damaged hearts and guide the treatment of prostate cancer. The technique was pioneered during the 1990s at the University of Texas Medical School at Houston

by Ophir and his colleagues. Ophir describes elastography as a way to measure and picture the elasticity of body tissue. In effect, it is an extension of one of the oldest tools in medicine, palpation, in which a doctor feels the shape and firmness of body tissue. To explain elastography, Ophir likens the body to a box-spring mattress, but "a crazy mattress made out of millions of small springs and each one is a little different. Each is moving around at a different rate, depending on their individual stiffness." Cancerous tumors are like stiff springs. Normal tissue and benign lesions compress more easily. Both traditional ultrasound and elastography use echoes from high-frequency sound waves to create pictures of what is going on inside the body, but elastography goes a step further. In traditional ultrasound, a doctor or technician places a handheld device on the skin that sends high-frequency sound waves into the

body. Organs and tissue reflect the sound back as echoes, which are sent to a computer that turns them into a picture. Many people have seen ultrasound images of fetuses in the womb. Elastography, though, also gauges movement. As the doctor moves the handheld device against the breast, the device collects echoes before and after the compression or movement of the breast tissue. The resulting images show stiff tissues as dark areas and soft tissues as light areas. Breast cancer shows up larger on an elastogram than it does on a traditional ultrasound image, perhaps because the elastogram can "see" the scar tissue around the cancer, Ophir said. "It's like finding a marble in Jell-O," said Dr. Barr, a professor of radiology at Northeastern Ohio Universities College of Medicine who reported his findings at the Radiological Society of North America annual meeting. Germany-based Siemens AG provided the ultrasound equipment and software

for Barr's study. Ophir and other researchers said breast cancer diagnosis will be elastography's first real-world application. "If it doesn't fly there, it won't fly anywhere," said Konofagou of Columbia University, who is testing elastography on animals and humans to determine the extent of damage after a heart attack. Uses in prostate cancer and thyroid cancer also are under study elsewhere. Dr. Constantine Godellas, a cancer surgeon at Rush University Medical Center, said some patients and doctors would have trouble giving up biopsies, even if further research confirmed elastography's accuracy. Doctors may fear lawsuits if they do not order biopsies, he said. "With the medical legal climate the way it is, that's a tough call to make," Godellas said. "It won't be until a lot more research has been done that people will really buy into it." Dr. Ellen Mendelson, chief of breast imaging at Northwestern Memorial Hospital in

Chicago, predicted the technique will be used, but may not supplant biopsies, which are becoming less invasive. "The goal of reducing unnecessary biopsies is laudable, but you don't want to miss a cancer," Mendelson said.Janet <doc_jade@...> wrote: Oh honey!! I hope and pray that it is something that is benign. BE PUSHY!!!!! Now is not the time to be pussy footing around with this.

Anything I can do to help let me know. Also call the HMO corparate offices and tell them just what you wrote here, about the GI Doctor and his not returning phone calls. And it wouldn't hurt to say to them do I have to hire a lawyer to resolve this action. Honey they might thing they have the world by its balls but I got news for them. (Cuse my french but heck fire sometimes you just have to say what you think.) Lots of love and comforting hugs. Janet Sheena <mom4possums2002 > wrote: I appreciate your below post, . I hope everyone is doing as

well as can be. I've been caught up this week in a dilemma. Seems my Cat Scan showed a (small) mass in my liver that "appears to be hepatoma".. cancer of the liver. My GI has never bothered to call me to tell me, nor has he returned my phone calls. I have also been unable to make an appointment with him. I picked up my report myself and took it in to see my Primary Doc this week. Even he had no luck with pushing for an appointment with the GI, I believe that office has written me off entirely. Having an HMO, my Primary Doc has done all that he can, it's the GI doc that MUST shedule a liver biopsy to confirm findings. There is one other GI in the medical group, but I would have to wait at least 8 weeks to see him, and start all over at square one.. I will give them until Wednesday, that will be 2 weeks that they've had the report in their office, then I go to shove to get it done.. I hate to rock the boat with the only GI I have to work with, but it's either rock it, or sink.. How sad the things we have to go through.. I don't know what I'd do without you all. Thank you again..and nope, I'm not on treatment yet, just thankfully good Supplements and my Faith in a God that loves us all, or I suspect I'd be in even deeper doo.. Sheena <marvindamartian05 > wrote: -I certainly sympathize with your point of view, and agree that weshould all be positive and focus on what is important. However, amember of this group was very much interested in discussing the legalremedies that may be available to him, and perhaps he needs toexercise his legal rights in order to obtain the resources fortreatment. Our member may be experiencing stress from dealing withtrying to figure out how to not only pay his doctor bills, but justhave enough money to live on if he is disabled. Since stress is nevera positive thing for us to deal with, anything that we can do toalleviate stress, either by providing information, suggestions abouthow to get

through tx, or just "be there" is helpful to members.Some of us can't use this forum yet to talk about our experiences withtx because if insurance or other issues preventing us from paying fortx! I myself would LOVE to talking about how my tx is going, but dueto insurance issues, I won't be able to start till the spring. I amluckier than many, who don't have any insurance and have no hope ofgetting any.This group is for people suffering from hep c and their families andfriends, NOT just for people on tx!-- In Hepatitis C , Denisa Dodd<denisa_dodd@...> wrote:>> I just had to put my 2cents in. I am not meaning to be rude or outof line. But for real folks, I really think that the focus should beon treating the HCV. If you spend all your time trying to figure outhow you got it, or who gave it to you

I think its a waste of time andenergy. Stop playing the name game and get on with it, finding out howyou got it sure ain't gonna make it go away. The exception is theprison worker thing... That is a little freaky. But how on earth canwe really know for sure how we all got here... The doc's can't evengive you an idea other than speculation. More power to you all, butpersonally I had to put the hows and whys away and focus on tx. I meanno disrespect, just one heppers opinon.> good luck to all> d> > <marvindamartian05@...> wrote:> Thanks, but not an attorney...just a paralegal that's beenat it a > long time...I am actually a compliance officer for a mortgage bank, > so my main practice is real estate and banking law. I have seen lots > of litigation though. Lots of people think it is easy to just sue > others and make "money for nothing" and it ain't the truth! In

the > case of Hep C, AIDs or other diseases that people "catch" from > others, I think that oftentimes people manifest the anger stage of > their diagnosis by wanting to get revenge on the person who infected > them. > > In Bruce's case, it sounds like he may actually HAVE a viable case, > if it can be proved that his employer KNEW that there was a danger > and they failed to protect him. All healthcare professionals know > there is an inherent danger of contracting diseases in the course of > performing their work duties, and thus they are trained in proper > protocol and given the tools and devices to protect themselves. I > don't know what the protocol is at prisons.> > There is a guy in Sheena and my support group that contracted hep c > in prison, and it seems to be rampant there. I would think that by > now there would be protocols in place for correctional

workers, but > maybe not back when Bruce was exposed.> > > > > > I am quit certain I got HCV from my ex-husband. My new > > > husband does > > > > not want me to tell my ex about the HCV because he is worried > > that > > > I > > > > could be sued by him? That he could make me pay for his medical > > > bills. > > > > I have never heard of anything like this. My ex is a real jerk, > > > > though, and if he could get any money from me, believe me he > > would > > > > try. At the same time, I feel obligated to tell him... or > should > > I > > > > even care? I guess I would want to be told... My

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