This story is part of The Salt Lake Tribune’s ongoing commitment to identify solutions to Utah’s biggest challenges through the work of the Innovation Lab.
Mammograms aren’t going away anytime soon – they are still vital in catching and treating breast cancer early, experts say.
But researchers in Utah are working on new ways to screen for breast cancer that would be as easy as getting your vitals checked.
Ioniq Sciences, which is based in Salt Lake City, teamed up with a University of Utah assistant professor from the College of Engineering to create a device that sends an electrical current – so small it can’t be felt – through a patient’s body to detect a change in fluid that may indicate a person has cancer.
“We want to have an impact,” said Benjamin Sanchez-Terrones, an adviser to Ioniq and researcher at the U. “We want to change the status quo of how these patients are diagnosed.”
At Intermountain Healthcare, doctors are expanding a study looking at whether breast cancer can be found through blood tests.
These new screenings, which could be used alongside mammography, are still a ways off from being used in Utahn’s doctors’ offices. But their creators are hopeful they could help in the Beehive State, which regularly has one of the lowest breast cancer screening rates in the country.
Over a 30 year period, the percentage of Utah women 40 and older who reported getting a mammogram within the last two years increased from 51.6% in 1989 to 64% in 2019, according to the Utah Department of Health.
But Utah “still falls far below the national average,” the department reports, with a breast cancer screening rate of 63.1% in 2018, compared to 70.9% nationally.
Still, Utah stats fared better than other states during the early spread of COVID-19, Joelle Fierro, communications and media coordinator for the Utah Cancer Control Program, said. Despite “sharp declines” in breast cancer screenings across the country, Utah “stayed the same,” she said, at 62.69% in 2020.
Why Utah lags behind
One of the most common misconceptions that Fierro and Dr. Brett Parkinson, medical director of Intermountain Healthcare’s Breast Care Center, said they hear is that people who don’t have a family history of breast cancer think they aren’t at risk. In reality, though, most breast cancers occur in people who don’t have that history, they said.
Utah is also generally considered one of the healthiest states, Fierro said, “and so a lot of times, women underestimate their risk for breast cancer.”
Nationwide, guidance around when women should start getting mammograms isn’t standardized, which can cause confusion. “Some places say 50, and some say 45, some say 40,” Fierro said.
In Utah, the recommendation is that all women 40 and older get screened. If you’re younger and have a family history of breast cancer, talk to your doctor, Fierro said, because you may need to start earlier.
Another reason women offer for not getting a mammogram, Fierro said, is that they think they can’t afford a screening. The Department of Health offers free mammograms and cervical cancer screenings, she said. To qualify, you have to have a moderate income and be uninsured or underinsured (if you have a high deductible, etc.). Learn more at CancerUtah.org or by calling 1-800-717-1811.
But above all, Fierro often hears a simple admission for avoiding screenings “that always upsets” her, she said: “They don’t want to know.”
As scary as it can be to be diagnosed, Fierro stressed that breast cancer is harder to treat the longer a person waits. In Utah, 32.7% of cases are diagnosed in a later stage, compared to 29.8% nationally, according to data from the Utah Department of Health.
“The best defense against cancer is detecting it early,” said Sanchez-Terrones from the U., “where there are more treatment options that are perhaps not as invasive.”
Covid-19 vaccines could affect your mammogram
Doctors recommend that women wait about a month for a mammogram after getting the COVID-19 vaccine, whether it’s a first, second or booster shot, said Dr. Brett Parkinson, medical director of Intermountain Healthcare’s Breast Care Center.
The vaccine may enlarge the lymph nodes in the axilla, or armpit, according to Parkinson. That could show up in a mammogram, and doctors may have to perform a biopsy, or the patient could need a follow-up mammogram or ultrasound. The slight delay prevents having to do that unnecessarily, he said.
“If, however, a patient has a lump, we don’t want her to delay a diagnosis,” Parkinson said. “So, we will tell those patients to come in anyway.”
Advances in cancer screening
In the future, Sanchez-Torres and Ioniq Sciences envision a simpler way to screen for breast cancer: A nurse wheels in a cart with a monitor, a couple electrodes and a probe. A patient holds a conductor in their hand, which emits a small electrical current. The patient feels a bit of light pressure from the probe’s tip, about the size of a pencil eraser, on a few points of the body. And doctors soon have a determination.
In a recent study, this Ioniq device was used on 48 women, half of whom had breast cancer and half of whom had non-cancerous breast lesions. Researchers were able to detect certain immune responses and correctly determine when they had cancer in 70% of those patients and when they didn’t for 75%.
The device is still about a year out at least from securing Federal Drug Administration approval, and it wouldn’t replace mammograms, Sanchez-Terrones said.
Mammograms take images of a patient’s breast tissue. The Ioniq device measures what’s called interstitial fluid, the fluid between cells that helps nourish them. When cancer is present in the body, that fluid has different properties because of the immune response, which the device can detect, Sanchez-Terrones said.
“It’s a huge breakthrough for cancer,” Ioniq chief operating officer Michael Garff said.
The technology can also be used to monitor patients as they undergo treatment.
Currently, patients with breast cancer do not receive another mammogram for six months to a year following treatment. The Ioniq device, which does not emit radiation, can be used without harm throughout the process, helping doctors determine whether they should change course.
It’s not meant to be a magic wand that pinpoints where cancer may be. It’s more like a first line of defense, Sanchez Terrones said — ideally more accessible and affordable than mammograms or MRIs, and widely available in clinics, not just specialized offices.
Ioniq is already testing the device with electrical currents for other cancers, such as lung cancer with its ProLung model.
Finding cancer with blood
Pushing research into cancer detection is important, Dr. Sachin Apte, chief clinical officer at the U.’s Huntsman Cancer Institute, said.
In 2017, Intermountain Healthcare announced a three-year study looking at whether breast cancer can be detected earlier through blood tests.
The idea is, Parkinson said, that if as cancer grows in a person, “it will shed dying blood cells into the peripheral bloodstream. And those cells contain tumor DNA, which is different from normal DNA.”
“If we can detect that circulating tumor DNA in the bloodstream before a tumor can be felt, or maybe even before it’s seen on a mammogram … we could improve early detection of breast cancer,” Parkinson said, or even recurrence in cancer.
Researchers have studied blood samples from over 600 patients, Parkinson told The Salt Lake Tribune earlier this month. Of those, 400 were in a control group, and 200 patients had known cancer.
“Early signs are promising,” Parkinson said. “It looks like patients who have cancer are giving off the signal. … And many of the patients who don’t have breast cancer don’t give off the signal.”
To learn more, Parkinson said they plan to add hundreds more patients to the study early next year.
“This is experimental,” Parkinson said, but if it works, it would also “be an incredible breakthrough.”
Becky Jacobs is a Report for America corps member and writes about the status of women in Utah for The Salt Lake Tribune. Your donation to match our RFA grant helps keep her writing stories like this one; please consider making a tax-deductible gift of any amount today by clicking here.