1P - Detection of breast cancer and abnormal mammograms with a rapid point-of-care breath test
|Date||08 May 2014|
|Session||Welcome reception and Poster Walk|
|Topics|| Breast Cancer
Cancer Aetiology, Epidemiology, Prevention
Imaging, Diagnosis and Staging
|Citation||Annals of Oncology (2014) 25 (suppl_1): i1-i1. 10.1093/annonc/mdu061|
M. Phillips1, J.D. Beatty2, R.N. Cataneo1, J. Huston3, P.D. Kaplan1, R.I. Lalisang4, P. Lambin4, M.B.I. Lobbes4, M. Mundada1, N. Pappas3
Volatile organic compounds (VOCs) in breath have been reported as biomarkers of breast cancer and abnormal mammograms, apparently resulting from increased oxidative stress and cytochrome p450 induction. We evaluated a six-minute point-of-care breath VOC assay at three breast cancer screening centers in USA and the Netherlands.
244 women had a screening mammogram (93/37 normal/abnormal) or a breast biopsy (cancer/no cancer 35/79). A mobile point-of-care system collected and concentrated breath and air VOCs for analysis with gas chromatography and surface acoustic wave detection. Chromatograms were segmented into a time series of alveolar gradients (breath minus room air). Segmental alveolar gradients were ranked as candidate biomarkers by C-statistic value (area under curve [AUC] of receiver operating characteristic [ROC] curve). Multivariate predictive algorithms were constructed employing significant biomarkers identified with multiple Monte Carlo simulations and cross-validated with a leave-one-out (LOO) procedure.
Performance of breath biomarker algorithms was determined in three groups: breast cancer on biopsy versus normal screening mammograms (81.8% sensitivity, 70.0% specificity, accuracy 79% (73% on LOO) [C-statistic value], negative predictive value 99.9%); normal versus abnormal screening mammograms (86.5% sensitivity, 66.7% specificity, accuracy 83%, 62% on LOO); and cancer versus no cancer on breast biopsy (75.8% sensitivity, 74.0% specificity, accuracy 78%, 67% on LOO).
A pilot study of a six-minute point-of-care breath test for volatile biomarkers accurately identified women with breast cancer and with abnormal mammograms. A negative breath test might safely “rule out” breast cancer and reduce the number of needless mammograms without loss of diagnostic sensitivity.
M. Phillips: Michael Phillips is President and CEO of Menssana Research, Inc. Funded in part by National Institutes of Health grant 1R43RR030689-01, Dutch Pink Ribbon foundation and the CTMM framework (AIRFORCE project, grant 030-103) Foundation.
All other authors have declared no conflicts of interest.