Constance Lehman, MD, PhD, Chair
University of Washington

Specific Aims

Test new screening strategies based on individualized risk profiles.
Assess the use of imaging for the measurement of extent of disease and for monitoring and mid-therapy adaptation of treatment protocols.
Reduce the morbidity of breast cancer therapy through non-invasive imaging-guided mechanisms.

Future Plans Overview

A study in development will investigate whether digital tomosynthesis with intravenous (IV) contrast is equivalent to breast MRI with IV contrast in assessing extent of disease in women with breast cancer. The study will enroll women with core-biopsy proven breast cancer for whom contrast-enhanced MRI (CEMRI) suggests more extensive disease. The Breast Committee views this study as a first step in developing this new technology into a high-risk screening technique.

In proposed continuations of the ACRIN 6657/CALGB 150007 trials, the Breast Committee plans to test total choline concentration [tCho] measured using magnetic resonance spectroscopy (MRS), as a potential sensitive and early imaging marker indicating tumor response. Using MRI volume as the basis for evaluating response to treatment, an adaptive trial is now in development to compare outcomes in a group randomized to treatment options with those in a group assigned to treatment options based on a molecular classifier. The adaptive trial design provides a mechanism for introducing and rapidly evaluating the effectiveness of phase 2 agents in the neoadjuvant setting.

The ACRIN 6674 study, a collaboration with InSightec will investigate the potential for focused ultrasound ablation under MR guidance (MRgFUS) to treat breast cancer noninvasively.