Can a machine catch a breast cancer tumor better than a human?
Radiologists at Lynn Women’s Health & Wellness Institute at Boca Regional Hospital have been working to find that answer. They began adding artificial intelligence technology to existing 3D mammography for breast cancer screening in 2020. With three years of results, they discovered AI can make a significant difference in finding cancer.
Both the radiologists at the Institute (part of Baptist Health South Florida) and the machines read thousands of mammogram results each year. In some instances, AI helped catch cancers before they could be detected by the human eye. Since implementing AI, their detection rate has improved 23%.
“In the past, if we found 100 cancers, today with AI we will find 123,” said Dr. Kathy Schilling medical director of Lynn Women’s Health & Wellness Institute.
“This is significant, because finding a cancer earlier could mean that a patient may not require chemotherapy or radiation therapy,” she says. “The types of cancers we are currently finding are smaller and of lower stage, reducing the need for advanced treatments.”
Dr. Louise Morrell, an oncologist at Lynn Cancer Institute at Boca Raton Regional Hospital, said the findings have led Baptist Health to expand the use of AI to all imaging centers across the hospital system.
Artificial intelligence also is being studied for customized treatment. A team at University of Florida is studying whether the right combination of chemotherapy and immunotherapy can combat aggressive breast cancer and how AI can help. Mohammed Gbadamosi, a researcher in the University of Florida College of Pharmacy, has secured a $1.25 million grant to launch his own independent academic research laboratory and build a team focused on developing breast cancer treatment strategies. The team will apply artificial intelligence to construct computer models for personalizing treatment based on a patient’s tumor genetics.
Other local research and clinical trials
Medication is evolving to better treat certain types of breast cancer and keep them from spreading. Oncologists at The Michael and Dianne Bienes Comprehensive Cancer Center at Holy Cross Health in Fort Lauderdale are enrolling patients with HR+, HER2-negative breast cancer in a clinical trial for a drug made by Tolmar called TOL2506. The trial is evaluating whether the medication suppresses ovarian estrogen production in premenopausal women who are undergoing chemotherapy. If effective, this would reduce the risk of the breast cancer coming back. It also is evaluating the safety of the drug in men. So far, Holy Cross has one patient participating and is screening three more for the trial.
A chemical compound may help stop breast cancer in the earliest of stages. A team of University of Florida medicinal chemists and cancer biologists has created a compound that can help cells dispose of proteins that cause cancer cells to grow. In laboratory testing in breast cancer cells, the compound, known as YX968, effectively targeted unwanted proteins in cancer cells and then degrading them — without harming healthy genes. Only a small amount of the YX968 compound was needed.
“These compounds act like matchmakers, bringing together two proteins so one can destroy the other one,” said Yufeng Xiao, the study’s co-first author. The researchers are refining the compound’s design to make it more of a drug so it can be tested in animal models. The long-term goal is to develop a new therapeutic that is safe and effective. Xiao said that will require a clinical trial in humans which will take several years.
Race may be affecting the late stages of breast cancer diagnosis. Black women have a 40% higher death rate compared to white women, according to the American Cancer Society. Studies are underway in South Florida to learn more.
- Florida Atlantic University Christine E. Lynn College of Nursing researchers recently conducted a study in a sample of about 400 Black women receiving care at its nurse-led FAU/Northwest Community Health Alliance Community Health Center in West Palm Beach. They looked at mammography screening frequency, beliefs about breast cancer including perceived susceptibility, perceived benefits and perceived barriers to screening. Almost half reported having annual mammograms; the remainder reported having mammograms every two to three years, and some women never had a mammogram in their lifetime, despite being age 40 or older. The majority of the women believed their chances of getting breast cancer was “very unlikely” but they did feel that having a mammogram would be beneficial. “Perceived barriers to and beliefs about mammography screening should be taken into consideration when designing interventions to increase breast cancer screening in Black women,” said Karen Wisdom-Chambers, co-author of the study and an assistant professor in FAU’s College of Nursing.
- University of Miami’s Sylvester Comprehensive Cancer Center researchers are participating in a clinical trial designed to understand why Black men and women are at higher risk of developing and dying from aggressive prostate and breast cancer. The national trial, called the African Cancer Genome Registry, is recruiting cancer patients to participate. “Please, please do it, if not for yourself, then for the next generation,” said Charinus Johnson-Davis, a Miami breast cancer survivor and one of the first local trial enrollees.
Treatments and interventions
Mindfulness is a technique Dr. Ashwin Mehta, who leads Memorial Cancer Institute’s Integrative Cancer Survivorship Program, sees as a key component to breast cancer treatment. In a new report in the Journal of Clinical Oncology, he recommends cancer patients use mind-body techniques to manage their feelings, anxiety and depression during and after treatment as part of integrative medical approach to care.
“Depression and anxiety often emerge when patients complete their treatment and begin to reflect on the trauma they have endured,” Mehta said. “Recognizing that not all patients prefer traditional medication for these symptoms, we’ve achieved remarkable success with mindfulness-based interventions and other integrative therapies in helping patients overcome these challenges.”
Survivors’ groups make a difference, says Isabel Toca, a 59-year-old Miami resident whose breast cancer was detected early. Toca needed lumpectomies for removal, a three-week course of radiation therapy, and a long-term regimen of an oral drug that treats hormone-dependent breast cancer. After her medical treatment, she joined a cancer survivors’ group, which is part of a study at UHealth’s Sylvester Comprehensive Cancer Center. The study is aimed at helping survivors recognize and combat the many manifestations of cancer-related stress. The members benefit not just from the structured program, complete with exercises and homework, but from talking to and learning from each other.
Reconstruction advances
Nipple Preservation. UHealth’s Sylvester Comprehensive Cancer Center physician-scientist Dr. Crystal Seldon Taswell has a new approach to nipple-preserving therapy for patients with early-stage breast cancer. In a phase 1 clinical trial, enrolled patients were not candidates for a nipple-sparing mastectomy. The approach, which uses delayed radiotherapy after breast surgery, resulted in 100% nipple preservation without compromise of local control, as well as excellent patient-reported satisfaction. Seldon Taswell believes study results support further exploration of this nipple-preservation technique, and she is advocating for a broader group of patients to be included.
Fundraising
CEOs of some of Florida’s large and small businesses have formed a power group called CEOs Against Cancer to share ideas for raising funds and encouraging screenings. The group has about 30 CEO members thus far, and this month the focus is on breast cancer.
For Spero Georgedakis, founder of South Florida’s Good Greek Relocation Systems, participation is personal. Georgedakis lost his mother, Stella, to breast cancer in 2001 when she was only 52.
As a newly committed member of the CEO group, Georgedakis will be featured in a campaign for early detection. He also is using his company as a platform to encourage donations for breast cancer research and treatments. A pink Good Greek Making Strides Against Breast Cancer Moving Truck has been making rounds in South Florida, and on it is a QR code for people to make donations. “The truck pops and is eye catching. We have the QR code on there, so it is easy to donate right off the truck,” Georgedakis said. The QR code also is on the company website, television ads, and business cards, he said. “It’s a quick and easy way to get donations.”
Another member of CEOs Against Center, Andrew Koenig, CEO of CITY Furniture, also participates in breast cancer awareness, and like Georgedakis, the cause is personal to him too. Andrew lost his mother, Doreen Koenig, to breast cancer in 2015. During October, CITY Furniture gives out pink pumpkins to spread awareness and hosts a Test Rest Program. When shoppers visit a CITY showroom and complete a mattress test, they get a $25 gift card and trigger a $25 donation to the American Cancer Society on their behalf.