Whats the next step when a biomarker test is positive for cancer but the tumor is too small to be detected with either ultrasound or X-rays? Several years ago, I reported on the BT Blood test (Provista Diagnostics), a revolutionary test for breast cancer. Since then, Power3 Medical entered the market with their BC-SeraPro test. These new biomarker lab tests have the ability to diagnose cancer at just a few cells.
How good are breast cancer blood tests? Digital mammography has an accuracy rate for women under age 50 at 84%; film mammography, 69%. The published results for the BT test reflect 97% accuracy. For women over 50, digital mammography has an accuracy rate at 77%; film, 75%; BT, 86% accuracy.
So what do you do when a blood test comes up positive for breast cancer? I asked Christa Corn, MD, a general surgeon and breast cancer surgery specialist at Phoenix Baptist Hospital in Phoenix, Ariz., and she said, Mammography can miss a lot of cancers in their early stages. Without a positive blood test, these patients would have to wait a year before their next screening. On the best mammogram, we can see a 5-mm lesion. A 5-mm cancer has been growing for five or six years already. If you know there is cancer, the next step would be a MRI. MRI can detect cancer a year or two earlier, which can have a dramatic result in outcomes.
Studies indicated that 1.5T MRI technology can detect 60% more breast cancer tumors than X-ray, but the next generation 3T MRI systems have 100% sensitivity for detecting breast cancer, especially in dense tissue where mammography is limited. This is a key factor since both lab tests are targeted to women under the age of 50 with characteristics that make X-ray breast imaging difficult.
Now, private insurers are starting to reimburse for the blood test (CPT 86316). This will allow more women under the age of 50 that at risk for breast cancer to take advantage of it. So now, patients who test positive for breast cancer will be directed to a MRI, even if not seen yet with mammography. For Breast Health Centers, maybe its time to make sure you have a readily available MRI.