Women's Imaging News

When weighing treatments designed to enable long-term breast preservation for older women with invasive breast cancer, researchers discovered those treated with brachytherapy were at higher risk for a later mastectomy, as opposed to women treated with standard radiation therapy.   The research was led by The University of Texas MD Anderson Cancer Center, where its findings were published in the International Journal of Radiation Oncology.   It is the first to provide a direct comparison of breast brachytherapy posited against a lumpectomy alone control group and an external beam radiation therapy control group (EBRT). They also carried out additional analysis of the American Society for Radiation Oncology's (ASTRO) criteria for selecting treatment options. Brachytherapy transports radiation to a particular region within the breast through the insertion of a catheter, which decreases treatment periods to one or two weeks as opposed to EBRT's four to six week schedule. The authors note brachytherapy is a growing breast cancer treatment used following lumpectomy. However, questions still hover on whether this treatment should be the standard of care based on the ambiguity of which patients may benefit from the treatment and which patients might experience potential harms. "We were interested in comparing how well different treatment strategies work to enable long-term breast preservation. Our results could impact care by helping patients and providers understand the tradeoffs between these two treatment strategies in greater detail,” said associate professor in Radiation Oncology and the study's lead author, Benjamin Smith, M.D. To carry out the study, researchers used the Surveillance, Epidemiology and End Results Medicare database (SEER), collected by the National Cancer Institute, to identify 35,947 women aged 66 years or older who were treated with lumpectomy for breast cancer between 2002 - 2007. The main outcomes for these patients included breast preservation, measured by succeeding mastectomy risk and postoperative complications. Following lumpectomy alone, the five-year subsequent mastectomy risk was 4.7 percent, 2.8 percent after brachytherapy and 1.3 percent after EBRT. Researchers determined that within each ASTRO group, EBRT consistently displayed the lowest subsequent mastectomy risk as opposed to lumpectomy alone, whereas brachytherapy consistently showed some benefit versus lumpectomy alone, but not as much as EBRT. Yet, the authors found that among patients who were labled "suitable" for brachytherapy by the ASTRO consensus statement on partial breast radiation, long-term breast preservation rates were similar for EBRT and brachytherapy. Specifically, in this group, the occurrence of subsequent mastectomy was 1.6 percent for brachytherapy as opposed to .8 percent for EBRT. "Our data provide some support for the ASTRO guidelines and indicate for patients who don't meet the stringent criteria outlined by ASTRO, we might be more careful about offering brachytherapy until additional data from clinical trials become available," said Smith, also of Health Services Research. "The takeaway message to both physicians and older breast cancer patients is that, in general, all of these patients did well with very high likelihood of breast preservation. However, likelihood of breast preservation was best with external beam radiation, worst with no radiation, and in between with brachytherapy." Additionally, Smith noted that brachytherapy displayed a higher postoperative infection risk and risk of other soft tissue complications, such as development of a fluid-filled cavity in the breast (seroma). “Limitations exist, including the need for studies with longer follow-up because recurrence and mastectomy risks increase over time. Several advances in the development of better brachytherapy catheters have occurred since 2007, possibly reducing complications in newer populations of patients,” Smith explained.  The authors also note whole breast radiation is not without toxicities, which can rarely include cardiac events or second ... Read more

In 2009, the US Preventive Services Task Force (UPSTF) established guidelines recommending biennial mammography screening for women between the ages of 50 and 74. While today, researchers suggest that following this recommendation would be just as ... Read more

A new study that shares the discoveries made by an international team of scientists from the United Kingdom, Denmark, Brazil, and Germany as they attempt to develop a new detection tool and treatment technology for breast cancer patients. The study’s findings were published in the Journal of Alloys and Compounds. Present diagnostic techniques such as mammograms can only detect between 65% and 95% of tumors, and developing better ways of enhancing detection is of primary concern; for if not detected and treated early enough, breast cancer can spread to other areas of the body, increasing the likelihood that the disease will become fatal. The cohort of scientists have been using the Polaris instrument at the ISIS pulsed neutron and muon source at the Rutherford Appleton Laboratory (Harwell Oxford, UK) to develop a new bio-nanocomposite that they hope will ultimately lead to earlier detection, and more successful treatment, of breast cancer. The new substance harps on the fact that cancer cells attract a molecule called hydroxyapatite, which is a constituent of bones. The researchers are developing magnetic nanoparticles covered with a biocompatible polymer that includes hydroxyapatite nanocrystals. When inserted into the body, these nanoparticles should travel directly to cancer cells, and once they do, they make it a lot easier to detect the tumor on an MRI scan. Moreover, not only do the nanoparticles help to identify tumors, but they could also help to obstruct the metastasis to other areas of the body, as hydroxyapatite is known to stifle and restrain that aspect of tumor activity. The next phase of study is to integrate antitumor agents into the nanoparticles. The magnetic structure of the nanoparticles means that they can be directed to the site of the tumor by using magnets outside of the body. If antitumor drugs can be supplemented to the nanoparticles, then they can be used to deliver the treatment directly to the tumor, maximizing the effectiveness of the treatment and significantly curtailing the risk of harmful side effects, for instance picture a fleet of tiny drones, delivering anticancer weapons right where they are needed. The research is still in its early stages, and thus more study is required, according to the scientists, before it can be developed into a treatment ... Read more

According to a recent study, the problem of possible dangers from mammography have been brought out center fold in a New York Times op-ed piece stating that “the false alarms in breast cancer screening are a problem that needs to be fixed." The op-ed article was predicated on a commentary published online December 30 in JAMA Internal Medicine, which accompanied a small prospective study of a decision aid to help women to get a better handle on the benefits and risks of breast cancer screening. That study involved women aged 75 years and older, who were given a decision aid pamphlet detailing the risks and benefits of mammography screenings. They reported being better informed about the possible exchanges and seemed to feel less apprehensive about their definitive choices, report Mara A. Schonberg, MD, MPH, and colleagues from Beth Israel Deaconess Medical Center and Harvard Medical School in Boston, Massachusetts. In the commentary, H. Gilbert Welch, MD, MPH, and Honor J. Passow, PhD, from the Geisel School of Medicine at Dartmouth University in Hanover, New Hampshire, determine that of 1000 US women aged 50 years who are screened year-round for a decade, 0.3 to 3.2 will be spared from dying of breast cancer, 490 to 670 will have at least 1 false-positive result, and 3 to 14 will be overdiagnosed and overtreated. “A screening program that falsely alarms about half the population is outrageous" and that "whether you blame the doctors or the system or the malpractice lawyers, it's a problem that needs to be fixed,” said Welch when discussing their findings in the op-ed pages of the New York Times. In search for at least a temporary solution to the problem, Schonberg and colleagues proffered their decision aid to 84 women, 45 of whom agreed to participate and completed the study. The women, with an average age of 79 and had no history of breast cancer, were handed a pamphlet describing breast cancer risk, life expectancy, competing mortality risks, and possible outcomes of screening. The pamphlet also comprised a values-clarification exercise and asked participants about their intentions in regards to screening following reading the pamphlet. The authors discovered that the decision aid helped to boost participants' knowledge of the risks and benefits of mammography, as calculated by a median of 1 more question answered correctly on a 10-question index. Furthermore, among women with a life expectancy of 9 years or less, who would be least likely to benefit from screening, a considerably smaller fraction said they intended to have screening after reading the pamphlet as opposed to before. "In contrast, we found no difference in screening intentions among women with more than a 9-year life expectancy," the researchers write. There were no major declines from pre- to post-test in decisional conflict or the number of women who said they preferred to take an active role in decision-making. All in all, 42 of the 45 women said that they found the decision aid useful and helpful, and 43 said they would recommend it to others. In their commentary, Welch and Passow acknowledged that their calculations of risks and benefits range widely and that women may prefer better estimates of potential results, such as breast cancer deaths prevented, percentages of false-positive results, and frequency of overdiagnosis. "Our suspicion is that the top priority for most women would be to have a more precise estimate of the benefit in the current treatment era. It has been 50 years since a randomized trial of screening mammography has been done in the United States. Given the exposure of tens of millions American women to this intervention, perhaps we are due for a second look," they ... Read more

Studies have demonstrated that women with dense breast tissue are prone to having a higher rate of contracting breast cancer. Eighteen states have endorsed dense breast notification laws, and 10 more have laws currently in the works, waiting to ... Read more

According to a study published in the Journal of the National Cancer Institute, radiotherapy (RT) after breast conserving surgery (BCS) has been known to diminish the risk of breast cancer recurrence. However, although younger women tend to have ... Read more

Based on a report presented at the illustrious San Antonio Breast Cancer Symposium 2013, the BioZorb™ three-dimensional surgical marker significantly improves visualization of the treatment area for radiation planning and therapy. The scientific account reports that the tissue marker is easy to position, safe to use, and well tolerated by patients. During the presentation, a sequence of consecutive early-stage breast cancer patients were implanted with the device at the time of lumpectomy. The 3D BioZorb marker was reported to supply clinical advantages for surgeons and radiation oncologists."This device could represent a quantum leap in the ability to mark tissue for radiation treatment after surgery," said Christopher Glaser, MD, FACS, the lead author on the poster presentation. Dr. Glaser and poster co-author John Falcone, MD, are surgeons at Mitchell Memorial Cancer Center and Owensboro Health Surgical Specialists, in Owensboro, Ky. Targeted delivery of radiation therapy helps to obstruct and prevent recurrence of cancer and is a crucial part of breast conserving therapy, the authors note. As of today, there is no standardized, accurate method for marking the surgical site of tumor excision, which makes post-operative radiation planning difficult. Methods often used for radiation planning may miscalculate the volume of the treatment area, and may lead to an excessive amount of radiation exposure to normal tissues such as the heart and lungs, resulting in inadvertent complications. "Our radiation oncologists love this thing. Because the marker is placed directly into the surgical cavity at the time of tumor removal and sutured in place, it is very reliable. The visual difference between BioZorb targeting and traditional methods of targeting is dramatic. The marker's unique features make it easily visualized as a clear target site, helping to decrease the amount of breast and adjacent tissues exposed to radiation,” said Glaser. The one of a kind, open-spiral design of the BioZorb marker integrates six permanent titanium clips in a set three-dimensional display and provides specific landmarks at the site of the removed tumor. This poster and other clinical presentations note that the BioZorb marker is useful for radiation treatment planning, patient positioning during treatment, and the ability to facilitate advanced methods of radiation treatment. BioZorb has been successfully applied in both the U.S. and New Zealand. It is made of a bioabsorbable material frequently used in other medical devices, and enables the patient's body to absorb the material slowly, so it does not require surgical removal after treatments are finished. BioZorb has been awarded 510(k) clearance from the U.S. Food and Drug Administration (FDA). The device is currently available in a variety of sizes to accommodate a range of clinical ... Read more

According to the Food and Drug Administration (FDA), a nipple aspirate test should not displace the mammography imaging procedure or otherwise be used on its own to screen for breast cancer. "The FDA is not aware of any valid scientific data to show that a nipple aspirate test by itself is an effective screening tool for any medical condition including the early detection of breast cancer or other breast disease. Manufactures have promoted these tests of fluid, extracted with a pump rather than invasive sample collection, as a stand-alone evaluation to screen and diagnose breast cancer, claiming they detect pre-cancerous abnormalities and diagnose breast cancer before mammography with just a sample of a few cells,” the FDA alerted in a released statement. The alert, which involved the National Association of Attorneys General, comes as a response against Atossa Genetics’ improper claims about its ForeCYTE Breast Health Test and the Mammary Aspiration Specimen Cytology Test. “Those tests were voluntarily pulled from the market in October with a class I recall, which means that the product is dangerous or defective and has a reasonable chance of causing serious health problems or death,” the alert read. Additionally, the only test mentioned in the alert that remains on the market was Halo Healthcare’s HALO Breast Pap Test. The FDA said it will be keeping a close watch on this development and any other nipple aspriate test manufacturers with persistent observation of promotional activity. Halo Healthcare's Website calls its nipple aspirate test an "early warning system" to exhibit abnormal cells "years before they might turn into a cancerous lesion" and grow into tumors large enough to be seen on a mammogram. A disclaimer cautions that HALO is FDA approved for the collection of nipple aspirate fluid for cytological assessment, but is not a diagnostic test and will not replace the need to receive other clinical breast screenings, such as mammography. Halo Healthcare has not had any direct contact with regulators on the issue other than standard reviews of labeling and materials, which haven’t led to citation for any violations, a company spokesperson said. Yet, the FDA expressed that it, in accordance with the CDC, National Cancer Institute, American Cancer Society, and other organizations, “agree that mammography is the most effective method for detecting breast cancer in its earliest, most treatable stages.” The latest National Comprehensive Cancer Network guidelines explicitly state that as ‘clinical utility of nipple aspiration is still being evaluated, it should not be used as a breast cancer screening technique.’ The FDA expressed concern that women and their physicians might believe the build up around such tests and skip mammograms, biopsy, or imaging all together. On the other hand, "False positive results may lead to needless patient anxiety, along with unnecessary additional testing and treatment," the statement added. "There was hope a number of years ago that you might be able to wash cells out of the milk ducts and find cancer that way," said director of breast imaging at Massachusetts General Hospital, Daniel Kopans, MD. "Those of us in the field were skeptical, and it turns out our skepticism was correct." Donald Berry, PhD, a biostatistician at the University of Texas MD Anderson Cancer Center who serves on the National Cancer Institute’s screening and prevention PDQ editorial board, did see a potential role for the test but only with suitable outlooks. “It’s not a replacement for mammography,” he said in an interview at the San Antonio Breast Cancer Symposium. 'A finding of abnormal cells in the aspirate fluid raises the level of risk and might contribute to decisions about mammography for younger women. With the right kind of counseling it’s appropriate, but it’s not always possible to get the right kinds of counseling. It’s a dicey issue to be assessing somebody’s risk for two reasons: You don’t know what you’re going to do if somebody’s risk comes out one way or the other. And the other is what is it doing to the woman in terms of her quality of life and concern,” he ... Read more

According to research presented by The University of Texas MD Anderson Cancer Center, over a third of younger, early stage breast cancer patients are subjected to needless imaging procedures, including position emission tomography (PET), computed tomography (CT), nuclear medicine bone scans (NMBS) and tumor markers (TM), at the time of staging and diagnosis. Presented at a poster session at the 2013 CTRC-AACR San Antonio Breast Cancer Symposium by assistant professor in MD Anderson's Breast Medical Oncology, Carlos Barcenas, M.D., the study is the first of its kind to examine the issue of over-use of staging procedures, including imaging and tumor markers in the diagnosis setting, more specifically in younger, early-stage breast cancer patients. Over-testing and unnecessary procedures goes beyond cancer care across the healthcare world. In order to effectively discuss and address the issue, the American Board of Internal Medicine began "Choosing Wisely®," a proposal encouraging physicians and patients to have conversations that encourage its reduction. “As part of its participation in the national campaign, last year, the American Society of Clinical Oncology (ASCO) generated a "top five list" which recommended against the use of CT, PET, TM and NMBS in the diagnosis and staging of early-stage breast cancer at low risk for metastasis. Rather, treatment guidelines clearly state that for women with early-stage breast cancer, the proper procedures for diagnosis include mammogram, ultrasound, clinical exam and blood work,” explained Barcenas. "We've known that overuse of staging procedures is a problem as well it may affect the cost-effectiveness in diagnosing women with early breast cancer. With ASCO's inclusion of this issue in its top five recommendations last year as part of its 'Choosing Wisely' campaign, this gave us the idea for the study - to investigate and understand just how pervasive the problem really is,” he added. For the retrospective study, Barcenas and his team examined claims from a national employer-based database of 42,651 women between 2005 and 2010 with an initial diagnosis of breast cancer. All were younger than 65 years old and had received a mastectomy, lumpectomy, and sentinel lymph node biopsy. Patients who underwent axillary lymph node dissection were omitted from the study because this is considered a substitute for node-positive disease. Claims for imaging and tumor markers were analyzed between the time period of three months prior to surgery and one month following surgery. Researchers stratified for age, geographical location, treatment, and insurance coverage, HMO or PPO. The researchers found that 37 percent of early stage breast cancer patients had at least one claim for a pointless staging test, with nominal change in rate of that median over the five-year period. “Of note, 18 percent of the woman had tumor markers performed, which is a staging procedure with no role in the non-metastatic diagnosis setting. Undergoing chemotherapy had the highest association with overuse of staging procedures, with hormone and radiation therapy also associated with overuse,” said Barcenas. Barcenas and the team also came across regional differences in overuse trends, as well as a higher rate of unnecessary procedures in women with PPO insurance coverage as opposed to those with HMO. In addition, women with breast cancer under 35 years old were at higher odds of having one of these tests, Barcenas noted. However, when diagnosed at such a young age, this patient population is perceived by the physician to be at higher risk of metastatic and/or aggressive disease. "While hypothesis-generating, our study is not without limitations. For example, we don't know the receptor status of the tumor, or if the patients had a more aggressive pathology, such as triple negative disease, or if they presented with specific clinical characteristics, such as back pain or an elevated blood level of a liver function test, that called for more investigation. In some instances, there will be justification for the additional imaging procedures," said Barcenas. For now, the researchers intend to follow this trend to see if the rate of unnecessary imaging drops with the continued distribution of the "Choosing Wisely" campaign. They also plan well to assess for cost effectiveness. Professor and chair, Health Services Research at MD Anderson, Sharon Giordano, M.D., thinks the findings undoubtedly support the need for the ASCO recommendations. She said the research provided some insight on the issue of over-use and over-care and offers justification to physicians so that they have permission not to order unnecessary tests. “Often, doctors think they're not being good to their patients if they don't do all they can. Yet there's been a shift in focus to doing what matters for the patient and what's proven to improve outcomes, rather than testing for the sake of testing. Ultimately, our goal is to bring the best care and value care to our patients,” said ... Read more

New research from University Hospitals (UH) Case Medical Center Seidman Cancer Center and Case Comprehensive Cancer Center at Case Western Reserve University analyzed how changes in the genetic composition of breast cancer tumors following brief exposure to either biologic therapy or chemotherapy can foretell future clinical outcomes in patients. Results demonstrated that through deep genome sequencing, a reduction in the most frequently mutated genes in breast cancer could be observed after just one dose of preoperative therapy. Deep sequencing is a process that involves sequencing the same region several times to distinguish mutations within tumors that hold significance in cancer evolution. The team’s findings were presented during the 2013 San Antonio Breast Cancer Symposium. "Genomics is the new frontier of cancer research, and this study shows that we may be able to accurately determine what treatment methods will and will not be effective for individual patients after just one dose of medicine. The ability to understand potential clinical outcomes for patients earlier in the treatment process would provide physicians with better opportunity to personalize patients' medicines according to their own tumor responses,” said study investigator and Director, Breast Cancer Program, UH Seidman Cancer Center and Professor of Medicine at Case Western Reserve University School of Medicine, Lyndsay Harris, MD. Over 209,000 patients in the U.S. are diagnosed with breast cancer every year. The projected outcome of studying the genetic makeup of breast cancer patients is to decide who will benefit most from certain drug therapies and to apply that information to create a personalized treatment plan for each patient involved. Researchers assessed 120 Stage IIA to IIIB breast cancer patients and compared a first biopsy after brief exposure to either biologic or chemotherapy treatment with a second biopsy taken after surgery. Researchers employed deep genomic sequencing to quantify the abundance of clonal mutations in breast core biopsies, evaluate changes in these mutations following brief exposure to a targeted therapy and then assess the consequent change in abundance of these mutations following exposure. This process of quantifying and observing clonal mutations between preliminary therapy exposure and surgery enabled researchers to find out how changes in the abundance of these mutations related to a patient's response to preoperative therapy. Through this analysis, the researchers concluded that clonal abundance upon brief exposure to therapy may be linked with clinical outcomes. Harris and her team are currently incorporating whole genome profiles with deep sequencing data as they lead a new study at UH Seidman Cancer Center to verify these preliminary findings presented in San ... Read more

Based on results of the PRIME 2 trial presented at the 2013 San Antonio Breast Cancer Symposium, exclusion of radiotherapy is a sensible option for women age 65 or older who receive hormone therapy following breast-conserving surgery for hormone receptor-positive, axillary node-negative breast cancer. "Radiotherapy has been known to reduce the risk of breast cancer recurrence three- to fourfold. However, what our trial has shown is that although this is still the case, the proportion of women who will actually have a recurrence without radiotherapy is very small (less than 5 percent), five years after treatment. We have identified a subgroup of older patients at sufficiently low risk of recurrence for whom omission of postoperative radiotherapy after breast-conserving surgery and adjuvant endocrine therapy is a reasonable option,” said professor of clinical oncology at the Edinburgh Cancer Research Center in the University of Edinburgh, Ian Kunkler, F.R.C.R. "What this study shows is that for every 100 women (from our selected population) treated with radiotherapy, one will have a recurrence anyway, four will have a recurrence prevented, but 95 will have had unnecessary treatment. Once a patient has had radiotherapy, they are unable to have it again on the same breast. Had these women not had radiotherapy, they would have been able to have minor surgery and radiotherapy following a recurrence. Besides, radiotherapy carries its own health risks, particularly in the elderly, as well as the inconvenience of travel for daily treatment for three or four weeks. Allowing us to defer radiotherapy in this group of patients until a recurrence occurs will be of benefit to the patient and to the health service,” Kunkler added. PRIME 2 is an international, phase III, randomized, controlled trial that sought to tackle the question of whether whole-breast radiotherapy can be avoided in carefully defined groups of older patients undergoing suitable therapy. The main endpoint of this trial is recurrence of breast cancer in the same breast, known as ipsilateral breast tumor recurrence (IBTR). The researchers found that at five years, 1.3 percent of patients who underwent radiotherapy had IBTR, and 4.1 percent of patients who were not administered radiotherapy had IBTR. Between 2003 and 2009, 1,326 patients were registered in the trial; 658 patients were randomly assigned to be given radiotherapy and 668 did not receive radiotherapy. All participants were age 65 or older; had hormone-positive, low-grade breast cancer; did not have the disease in lymph nodes adjacent to the breast (axillary node-negative); did not have metastasis; had cancer-free breast tissue margins where tumor was surgically removed; and received hormone therapy. The researchers discovered that at five years, between patients who received radiotherapy and those who did not, there was no considerable difference in overall survival (97 percent vs. 96.4 percent); regional recurrence (0.5 percent vs. 0.8 percent); or breast cancer in the opposite breast (0.5 percent vs. 0.7 percent). The difference in breast cancer-free survival between those receiving and not receiving radiotherapy (98.5 percent vs. 96.4 percent), yet, was statistically significant. "Our results are likely to lead to the consideration of omission of postoperative radiotherapy in patients meeting the eligibility criteria for the trial," said ... Read more

According to a new study, ablating tumors with sound waves may become one effective way to treat breast cancer. In a small study comprising of 12 patients, 10 had successful tumor ablation with magnetic resonance (MR)-guided focused ultrasound,Alessandro Napoli, MD, PhD, of Sapienza University in Rome, and peers reported at the annual meeting of the Radiological Society of North America (RSNA). “But two of those patients had residual tumor left after the procedure, due to a transducer malfunction,” mentioned Napoli. "This procedure allows for safe ablation of breast cancer. At pathology, no significant viable tumor was found in the specimens from these 10 patients,” he said. Salomao Faintuch, MD, of Beth Israel Deaconess Medical Center, who wasn't directly involved in the study, but commented on the results, calling them interesting, but was aware that the work was still at an early stage. "This is very new technology, and we're dealing with a disease that's deadly. Before we use this technology as a sole method of treatment, we definitely need to have a lot more results,” he said. The new method utilizes focused ultrasound waves on a particular point to wipe out tissue, and is effectively heat ablation. It's directed by magnetic resonance imaging, which allows for monitoring not only the location of the targeted tissue, but also the temperature of that tissue. Napoli and peers performed their safety and practicability study in 12 women who were diagnosed with invasive breast cancer. All of them had stage I disease with a lesion that was less than 2 cm in diameter. All women had been scheduled for a lumpectomy and a sentinel lymph node biopsy, and each ablation process was followed by surgery in order to verify how well the treatment worked. “There were no significant complications during or after the procedure, and it was successful in 10 of the 12 patients as revealed by surgical pathology following the ablation therapy. In the other two cases, treatment failed due to a transducer malfunction, they reported, and a pathologist observed some residual tumor,” said Napoli. Napoli also mentioned just how long the ablation procedure is, taking up 2.5 hours in some cases. "It's a long time being on the table of the MR unit," he said, but he expects that it is likely to speed up in the future, since the technology is still hasn’t matured. He noted that patients "like the idea that they can have their cancer removed without being cut open. But it is hard to procure those patients. These patients belong to the surgery community, but we are in the radiological setting, so they are just passing by to us.” Faintuch concurred that it would be hard to change the established, proven method of treatment for breast cancer: "The mainstay of treatment is surgery, combined with additional treatments such as hormonal therapy, chemotherapy or radiation therapy. It won't be widely used until we have enough research to show this new modality has outcomes that are equivalent [to that standard],” he said. He added that physicians in Japan have been applying the technology more frequently, which may add to the small, but growing body of data available on the procedure. "We look forward to more results from the Italian researchers, as well as the Japanese researchers, to move [this technology] on to next level," Faintuch ... Read more