Julie & Sherry P’s Stories as told by them.  (Blood from my breast.)

The story of early breast cancer detection and its’ treatment. 

 

     In early December 2002, while getting ready for the holidays, I awoke one morning and noticed blood on my pajamas.  I soon discovered that the blood had come from my left nipple.  I was both surprised and scared, and all of my plans and my husband’s plans, for the holidays soon came to a screeching halt.  I had just been to my Ob/Gyn earlier in the year and had been told my mammogram was normal.  While I knew I had fibrocystic (FCD) disease and had recently stopped taking hormone therapy to reduce my risk of heart disease and cancer, I wasn’t ready for the possibility of breast cancer.  Clearly, the mammogram hadn’t detected anything anatomically.  Upon the advise of friends and family members, I went to have a different type of test which could help tell me determine whether this blood was from a cancer or possibly something else.  Known as Breast Enhanced Scintigraphy Test (BEST) and currently pending a US patent, this study used a combination of technology from both breast cancer and heart disease testing.  The test had been developed almost fours years earlier and had been shown to distinguish between normal breasts, FCD, abnormal regions of the breast referred to as cellular atypia or hyperplasia and breast cancer itself.  The test was available in two centers, The Fleming Heart & Health Institute located in Omaha, Nebraska in conjunction with a not-for-profit (“The Camelot Foundation”) organization and the second at the Block Medical Center in Chicago, Illinois, with several other centers requesting information on how it could be established in their cities.

 

BEST Imaging (Using blood flow and mitochondria to find cancer).

 

     I arranged for the appointment and was greeted by Dr. Fleming and his staff who had developed the test 4 years earlier after his wife had been diagnosed with breast cancer.  Conventional tests like mammograms, MRI, and ultrasound used anatomy or the structure of the cancer to find it.  This study would use nuclear imaging to detect the function or physiology of the breast.  Dr. Fleming had developed a method to more accurately detect heart disease in 1995 using high-dose dipyridamole and had presented his findings in Helsinki.  Since cancers are rich in blood supply, he surmised that using this approach could improve the delivery of the isotope (substance used in nuclear imaging to find a problem) to a cancer and enhance its detection.  Furthermore, the isotope (sestamibi) was known to be taken up by the mitochondria within cells of the body.  It is the mitochondria, which provide the energy for the cell, and since cancer cells have more mitochondria than other cells, this increased uptake of sestamibi, now enhanced by the dipyridamole, had been shown to improve the detection of breast cancer.  Now it was my turn to find out what BEST imaging would show as the source of bleeding from my left nipple.  Dr. Fleming had assured me, and he was right, that the test was painless.  There would be no compression of the breast and no x-rays used.

 

The Day of the BEST Test - A Day of Answers.

 

     I arrived on Monday, the 9th of December and was greeted by Larry Boyd the nuclear technologist who would, along with Dr. Fleming, be present with me for the study.  It would take a total of 45 minutes to find some answers to my questions.  I was given a gown and had a catheter placed in a vein in my arm.  For four minutes dipyridamole slowly relaxed my blood vessels, increasing the ability to deliver the isotope to my breasts where pictures would be taken 15 minutes later.  While the pictures were taken, I began by laying on my back on top of a six-inch foam cushion.  Pictures were taken for 5 minutes and then I turned over onto my stomach where my breasts were allowed to relax through two openings in the foam cushion.  Again pictures were taken, first 5 minutes on one side, then five minutes on the other.  After the pictures were taken, the IV was removed and I got dressed.  I went and waited for Dr. Fleming.  

 

     Fifteen minutes later Dr. Fleming came into the conference room and brought the pictures taken by the camera and showed them to my husband and me.  The pictures and the information obtained from them revealed either hyperplasia or an early cancer (DCIS).  If this was the case, then further surgery might not be needed, but we needed to get a piece of the tissue to find out.  I imagined scars on my breast and possible mastectomy, but Dr. Fleming proposed a different approach.

 

Ductoscopy (microductectomy with endoscopy).

 

     Dr. Fleming arranged for me to see a colleague of his, Dr. William C. Dooley at the University of Oklahoma.  The two doctors had presented information two years earlier at a medical conference in Toronto on the use of BEST and Ductoscopy to more accurately detect breast cancer and possible find even earlier changes in the breast, improving treatment success and the odds of survival for women with breast cancer.  To date they had studied hundreds of women using this approach and I was hoping they were right this time as well.  I saw Dr. Dooley and his staff on the 17th of December.  The following day, using the information provided by Dr. Fleming, Dr. Dooley found the source of the blood.  It was ductal hyperplasia with atypia.  The final diagnosis matched the BEST image and the source of bleeding.  In contrast, the woman who joined me had a different result.  Her mammogram had shown FCD, but her BEST image had revealed cancer.  While I had received news that my hyperplasia could be treated medically and monitored using BEST imaging, she had been diagnosed with breast cancer.  Unlike me, she had not experienced bleeding, but had a sense that something was wrong.  There’s something to be said for intuition, and rather than waiting for the cancer to be large enough to be detected by mammography, she had found out about BEST imaging and found the cancer earlier than she might otherwise have.  This earlier detection increased the likelihood that she (Julie) would successfully recover from her cancer and live to help others.  Julie went on to have surgery and her sentinel lymph nodes were negative.  She is receiving radiation therapy today and we keep in touch.  In six months she will repeat her BEST image to look for recurrence of the cancer.  I will be there too, not only for me but also for her.