The latest technology for the detection and diagnosis of breast cancer, the Breast Specific Gamma Imaging (BSGI) system was launched last week in Kingston, Jamaica and is being hyped as the way to help decrease the mortality rate from the disease. The BSGI is a molecular breast imaging system which developers say will be able to diagnose at least 15 per cent of breast cancer cases that are missed by conventional mammograms.

Radiologist at X-Ray and Diagnostic Ultrasound Consultants Ltd. (XDUCL), Dr. Winston Clarke, said doctors have always been aware of the limitations of mammograms, which prompted the search for an alternative. Dr. Clarke explained that for every 100 women tested with mammograms, only about 80 of them will be diagnosed correctly. The other 20% of tests are usually inconclusive and the patients will be asked to come back to do the test at a later date.

Where mammograms are X-rays that examine tissue density, the technology used by the BSGI will detect cancer cells independent of tissue density. The patient will be injected with a small dosage of radioactive Isotopetyechnetium (used similarly to the tissue dyes utilized in X-rays and conventional mammograms) which will be absorbed by the cells. The BSGI will highlight the cancerous cells, similar to thermal imaging, so that cancers as small as three millimetres can be easily detected. The entire procedure can take up to an hour and will be pain-free because no weight is placed on the breast.

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The BSGI system will be used in cases where further evaluation beyond a mammogram is needed for the detection of cancer such as cases where the patient has dense breast tissue, multiple and suspicious lesions, post-surgical or post therapeutic masses, breast implants or for women who are taking Hormone Replacement Therapy.

Professor Douglas Kieper, Director of Clinical Research and Education at Dilon Technologies, said the BSGI system will also be able to help doctors predict a patient’s reaction to chemotherapy and will make dealing with breast cancer and subsequent reconstruction (when necessary) less challenging.

“We are actually looking at a phenomenon within itself,” he said. “It is a very specific technique which can contribute in a good way to the patient’s treatment.”

Even though the system is being endorsed by a number of doctors including Chief Medical Officer at the Jamaican Ministry of Health and Environment, Dr. Sheila Campbell-Forrester, Dr. Clarke cites a number of pressing challenges with “bringing first world technology to Jamaica”. Paramount among them is the cost to perform the procedure. Currently BSGI costs between the equivalent of J$80,000-$120,000 in the United States to get the test done. Dr. Clarke, however, wants to find the means to offer it for about $45,000 so that more women can be tested. Currently a mammogram costs around $3,500.

Among the cost-related concerns, the supplies needed to conduct the procedure will have to be imported from the United States every two weeks. This includes the radioactive Isotopetyechnetium, which has a brief two-week shelf life. Dr. Clarke said they are also trying to get the insurance companies to come on board to cover the cost for patients who really need the test. In spite of all these challenges, Dr. Clarke said the possibility of saving a life with the machine is more important.