BSGI Offers Bright Spot in Breast Cancer Detection

Despite a lumpy, hard feeling in Sandra Dianna’s breasts, first one mammogram, then another, was clear.

Even a biopsy didn’t show anything—it was done in the wrong place.

Finally, Dianna ended up at Riverside Diagnostic and Breast Imaging Center in Newport News, Virginia, on a BSGI machine—a cutting-edge camera that uses nuclear physics to detect the tiniest of tumors.

Her cancer lit up like a Christmas tree. Within a few days, Dianna had a bilateral mastectomy. Fortunately, the aggressive cancer had not spread, and Dianna didn’t need further treatment.

That was almost three years ago. Today, at age 53, the Hampton, Virginia, schoolteacher is feeling lucky.

“I am a survivor because of the BSGI machine,” Dianna says. “I am alive because this machine found the cancer before it had a chance to do more harm.”
BSGI stands for breast specific gamma imaging, sometimes called molecular breast imaging. It’s put to work in a device made by Dilon Diagnostics, a Newport News-based medical imaging company that designs and manufactures equipment based on research and development done at Jefferson Lab.
Of the 120 BSGI machines nationwide, there are just two in Hampton Roads—both in Newport News. One is located at the Riverside Diagnostic Center in Oyster Point; the other is at Sentara’s Dorothy G. Hoefer Comprehensive Breast Center in Port Warwick.
The next closest machine is located at the University of Virginia Hospital.

More sensitive than a mammogram, which uses basic X-rays, the BSGI camera is able to detect tumors in very dense breast tissue. The process involves injecting a patient with a radioactive material that is picked up by cancer cells. Tumors as small as 1mm—as opposed to the 1 cm to 1.5 cm typically found by a mammogram—can be found.

The “radiotracer” solution goes right to the tumors, then accumulates within the abnormal cells. As the radioactive material decays, it emits high-energy photons that give off gamma rays. The BSGI camera senses the gamma rays and displays them as computer-generated images. On a screen, the cancerous areas light up—which is exactly what happened in Dianna’s case.
More than 300,000 women in the United States are diagnosed with breast cancer each year.

It’s the most common form of cancer that women get, and the second leading cause of cancer death in women, according to the American Cancer Society.

With early detection, breast cancer has about a 95 percent survival rate. In fact, according to the American Cancer Society, death rates from breast cancer have been declining since about 1989, with larger decreases in women younger than 50. These decreases are believed to be the result of earlier detection through screening and increased awareness, as well as improved treatment.

Mammograms are still considered the go-to tool for screening breast cancer with diagnostic tests, such as ultrasound, MRI and BSGI, used in follow-ups. Yet despite the BSGI’s ability to easily detect cancers, it’s not used as a routine screening tool because it involves the injection of the radioactive tracer.

The company that makes the BSGI is working on a way to use a less radioactive dose, which could mean that the camera could be used for screening and not just for diagnostics—particularly for those women with very dense breast tissue, like Dianna had.

Having dense breasts increases one’s likelihood of getting breast cancer to that of a woman who has a family history of breast cancer, says MaryBeth Gibson, president of Beyond Boobs, a Williamsburg, Virginia-based breast cancer support, education and awareness group.

In 2012, Virginia was one of 19 states that began mandating that doctors inform women they have dense tissue after a mammogram. As a result of that law, insurance denials for the BSGI began to decrease, says Bob Moussa, chief executive officer of Dilon Diagnostics. And in early 2013, a Minnesota woman won a Medicare insurance appeal to cover her molecular breast imaging procedure, marking a big milestone for the company.

Dianna, who has become an outspoken proponent of early detection, has a petition going on to lobby insurance companies to change their medical policies to cover molecular breast imaging as a
diagnostic test for women with dense breast tissue and inconclusive mammograms.

Her hope is that no woman will have a mammogram and be told to just keep an eye on it.

“That’s the bigger thing to me,” Dianna says. “How can I get other women to be a success?”