Dr. Susan Love Research Foundation | Breast Cancer

Johns Hopkins scientists have found that a method they developed to screen body fluid is more accurate at spotting breast cancer cells than a pathologist using a microscope.

The screen, developed by Sara Sukumar, PhD, and Mary Jo Fackler, PhD, first separates cells from fluid, then sifts through the cells' DNA for chemical tags on certain genes associated with cancer.

Sukumar's research appears in the June 1, 2006, issue of Clinical Cancer Research.

"This screening method can see what the eye cannot see," says Sukumar. "It can be a valuable tool, in combination with pathological review, for breast cancer as well as other diseases where fluid can be obtained relatively easily, such as lung, head and neck cancers, pancreatic and cervical cancers."

Pathologists look closely at a cell's shape to determine if the signs of cancer are present. But there is no microscope powerful enough to allow a pathologist to detect the molecular changes that develop in cells when cancer is just starting.

Sukumar's test assesses whether a cell has high amounts of chemical tags embedded by a process called methylation in critical regions of its DNA. When a cell has too many of these tags it turns a gene switch off, stopping the assembly line of critical proteins found in normal cells. This genetic error may be a sign that cancer is present.

The study compared the cancer-detection rates of the gene screen Sukumar developed with a microscopic review by a pathologist on breast fluid samples. The fluid samples, taken from high-risk women or those diagnosed with breast cancer, were obtained through ductal lavage.

The pathologists correctly identified seven of the 21 fluid samples where cancer was present. In contrast, the gene screen was able to find 15 of the 21 samples known to contain cancer.

"Now that we know the screening tool is effective in finding cancer cells within breast duct fluid, we need to improve the accuracy of obtaining the fluid," says Sukumar. That's because the gene screen may miss cancers if they overlook any hidden breast ducts, Sukumar says.

Dr. Sukumar sits on the National Scientific Advisory Board of the Dr. Susan Love Research Foundation. She is one of the leading researchers utilizing the intraductal approach to breast cancer and has been a key presenter at the Foundation's International Symposium on the Intraductal Approach to Breast Cancer.