Army tries new breast cancer test
TAEGU, South Korea — A few months ago, Army Sgt. 1st Class Cynthia Johnson had a mammogram that turned up several lumps in her breast.
The lumps turned out to be benign cysts, and she doesn’t need surgery.
But Johnson, who turned 33 on Jan. 15, knows that even younger women may be at risk for breast cancer. The sergeant believes regular testing is important.
“I know when I was coming up, I really didn’t see the importance of it, because I thought, ‘This could never happen to me,’ ” said Johnson, a member of the 20th Support Group at Camp Henry.
Because of her own recent experience, she said, she was encouraged to hear the Army has launched a five-year test of a new method that can spot the early stages of breast cancer in women under 45.
The trial of “electrical impedance scanning,” or EIS, is under way at Walter Reed Army Medical Center in Washington, D.C. It began in August and aims to enroll 4,800 patients. About 200 are enrolled now, said Maj. Alexander Stojadinovic, a surgical oncologist at the Walter Reed Comprehensive Breast Center, which is conducting the trial.
That’s important to servicemembers because, in the Army alone, women account for 20 percent of active-duty troops, and, like Johnson, 92 percent of that group are under age 40, Stojadinovic said. In the U.S. military overall, women make up about 15 percent of the active-duty force, with 91 percent of those individuals under 40, according to figures provided by the Pentagon.
About 13.3 percent of women in the United States, or about one in eight, will develop breast cancer during their lifetimes, according to a National Cancer Institute report. The incidence of breast cancer in women younger than 50 is lower, but the number of cases is increasing, Stojadinovic said. Moreover, breast cancer often is more aggressive in younger women, he said.
The hope is to expand the testing to other medical facilities within the North Atlantic Regional Medical Command, Stojadinovic said.
The project also is competing for a grant that would expand the trial throughout the armed forces, eventually involving 21,000 test participants.
Any such Defense Department-wide trial might cost from $10 million to $15 million, he said, but he noted that is only an approximation.
The new testing method relies on electricity. Electrical impedance measures how electricity moves through a given material. When a scanning probe that transmits electricity is placed against the breast, cancerous tissue conducts the electricity much more quickly than normal tissue, Stojadinovic said. EIS can detect within five minutes whether further screening should be done.
A monitor displays the “final output” in a colored line of either “suspicious red” or “not suspicious green,” he said.
Participation in the testing is not restricted to active-duty women; all military health care beneficiaries may participate, including servicemembers’ wives and other dependents ages 18 to 45.
They should not have had breast surgery within the past three months, be pregnant or have breast-fed. They also should have no implanted, electrically-powerged devices. They’re neither charged nor paid for participation.
EIS is by no means meant to supplant mammograms. In fact, Stojadinovic emphasized, “it addresses a patient population that would not be getting a routine screening mammography”: younger women.
“Mammography has not been shown to be a benefit in young women,” said Stojadinovic. “The density of the breast tissue precludes accurate diagnosis by mammography in young women.
“So we are searching at the Clinical Breast Care project for a methodology that will enable us to find the disease at its earliest point … in an effort to try to optimize the cure for younger women.”
EIS is much easier to undergo than a mammogram, takes five to six minutes, and the medical staffer doing the scanning requires far less training than those who perform mammograms, Stojadinovic said.
Mammograms involve compressing the breast between X-ray plates.
“Forty-five percent of women who should have a mammogram don’t because of fear and the pain that goes with the compression … and also the anguish that follows waiting for that card in the mail.”
But with EIS, “patients love it because they get their result immediately,” Stojadinovic said.
“We have had an overwhelming response. … It’s all by word-of-mouth, and our schedules are booked. There is no radiation. … There is no compression. … They like the immediate feedback and not having to wait a week to get the card back in the mail.
“These are all factors that will enhance compliance among women.
“Right now, we’ve stumbled upon a technology that is very safe, it’s rapid to perform, it’s radiation-free and it provides immediate results that are not operator-dependent, that are computer software-driven, and that fit nicely as a natural extension of the clinical breast examination.”
“I do find that encouraging,” Johnson said, “simply because there’s lots of women my age in that age bracket. They don’t understand the importance of actually doing their initial breast tests.”
The American Cancer Society and National Cancer Institute recommend that women do monthly breast self-exams a week after menstruation, said Army Capt. Jeffrey Brooks, physician assistant at the Camp Walker Medical Clinic in Taegu.
Those two organizations also recommend that women get a yearly clinical breast exam. Women over 40 should get an annual mammogram, Brooks said.
“That’s what we go by,” said Brooks. “Those are the recommendations we follow.”