Are biopsies a thing of the past?

There's an interesting story on Reuter's today regarding a clinical study published in the May 21 issue of the journal Nature Biotechnology. Here's some tidbits from the Reuters article:

"You don't have to invade the body in any way. We can actually obtain this information in a noninvasive manner," said Dr. Howard Chang of Stanford University School of Medicine, whose work appears in Monday's issue of the journal Nature Biotechnology.

Chang and colleagues at the University of California, San Diego, compared images from radiology scans such as CT scans commonly used to track cancer with lab tools called DNA microarrays -- gene chips -- that screen thousands of genes at a time.

What they found was a way to translate the data from the images into a computer model that could predict what was going on with the genetic material within the tumors.

The researchers said the technique may help eliminate the need for a biopsy, a procedure in which a needle is injected into a tumor to determine what type of cancer a patient has.

If true, this is very exciting news. One of the important advances that microarrays have provided in the fight against cancer is that they've made it a lot easier and faster to tease out differences in tumors. At one point, and it wasn't that long ago, tumors in one type of tissue--say breast, for example--were all assumed to be homogeneous. Now we realize that there are many types and subtypes within each group of cancer tumor.

If the data in this article holds up, doctors will have a noninvasive way to ascertain which type of tumor exists in a patient--which gives a lot of information on what form of treatment is best for the patient--as well as what stage of development that tumor is in. Being able to do this without a biopsy speeds treatment and allows better long term outcome due to faster initial assessment.

I'll be very curious to see how this turns out. I really have trouble believing that the actual tumors will be all that predictable. I don't doubt that there's going to be some strong diagnostic ability here but cancer cells are unpredictable. I'll be curious to hear what SRP thinks. I work on the research side with microarrays; SRP is on the medical side and this would be more in her field.

Comments

kenju said…
I'd be interested to know what SRP thinks too. I would think that this type of test might help to rule out certain types of cancers, but not be a foolproof way to pinpoint the exact type and the level of progression of any tumor. I hope I'm wrong.
Anonymous said…
I like the idea if it would be credible. I've always thought that cutting open anything increases the chances of things spreading. And when I was a child I had a biopsy on my leg at Duke Children's hospital for these dark patches on my legs. It turned out I had incredible dry skin but the only spot that remains is in the scar of the biopsy itself. I guess it couldn't heal.
srp said…
I remember a similar report being published when the CT and then the MRI came out... that it would eliminate the need for pathologic exam of the tissue. That didn't happen.

If it is true, then I will become obsolete... however, if there is one thing I have learned in all my years of practice it is this:

Tumors don't read the text books or the journal articles. They are as individual as the patient involved. Just when you think you have it figured out, something new or a different aspect will pop up and send you back to the drawing board.
utenzi said…
I agree 100%, Roxanne. 110% if that's possible.

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