Microbubbles – The Innovatory Technique Of Breast Cancer Detection

Revolutionary British know-how could now prove immensely beneficial for numerous breast cancer patients by preventing further surgical intervention.

Employing microscopic bubbles, the doctors from the Maidstone and Tunbridge Wells NHS Trust have evolved an innovative means of detecting cancer that has metastasized to the lymph nodes.

This method would mean the removal of malignant tissue present in the breast and lymph nodes in just one operative procedure, instead of the need to go in for another one –which is presently the practice followed.

With more than forty-five thousand women being detected with breast cancer annually, it turns out to be the prevalent form of cancer in the United Kingdom.

During the surgery for removal of the breast tumour, the surgeons additionally require checking if the cancer has metastasized or spread to the lymph nodes in the underarm area.

The lymph nodes being part of the lymphatic system carry out the drainage of the fluid from tissues present throughout the body back in the blood stream. Due to this, there is a risk of the cancer cells getting inside the system and the disease spreading.

The spread of breast cancer firstly affects the nodes present in the underarm area. This is observed to occur in nearly twenty-five percent of the breast cancer cases.

Conventionally the procedure followed is the removal of all those nodes that number about twenty in each underarm area in an attempt to eliminate any migrant malignant cells.

However, this could lead to severe side effects inclusive of lymphoedema – an excruciating swell up in the arm. This could be a long-standing condition occurring due to the disruption that has taken place in the lymphatic drainage system leading to the accumulation of the lymphatic fluid in the arm.

Earlier on, the doctors found that if they could detect in which lymph node the tumour has initially drained into, then they could check merely that single node – known as the sentinel node.

However till lately, this identification could only be done at the time of the surgery that is done by injecting a blue dye near the nipple area or the tumour, followed by a brief waiting time of a couple of minutes wherein the dye would seep into the lymphatic system and reach the first lymph node, prior to its removal for testing purposes.

Women then had to go through the niggling ordeal of waiting for close to fourteen days to be able to find if all the lymph nodes would require removal.

However, in this path-breaking technique, the team from Maidstone are infusing small bubbles – ranging in size of about a third of a RBC or red blood cell inside the body to assist in detecting the cancer. This is carried out prior to the surgery, so that better knowledge is gained as to whether the removal of the nodes is needed.

The microscopic bubbles are filled with sulphur hexafluoride gas that is trapped in a greasy casing to impede it from being absorbed into the system and thus help in better viewing during the time of the ultrasound scan.

The injection of these bubbles is done on the area near the nipple or the tumour site. As the bubbles follow their course to the sentinel node analogous to what the blue dye does, their progress is tracked employing an ultrasound scan. On reaching the sentinel node, a delicate needle is used for taking a small amount of tissue sample being done under the influence of local anaesthesia.

In case cancer cells are detected, the removal of the lymph nodes is done during the same instance that the tumour is being removed. Within a span of a couple of minutes, the casing of the bubbles ruptures following which the gas is taken in by the system.

This method was employed from way back in the 90s for illumination of cardiovascular anomalies or liver tumours, however this the foremost occasion that it has been employed in the lymphatic system.

It is quite a disturbing piece of news to be given to women that have been through breast cancer surgery to be told that they would require another surgery due to the cancer spreading to the sentinel node. The additional stress of waiting for the outcome of the pathological tests and additional surgery could lead to immense angst.

This novel test seems to provide an option that could lower the requirement for further surgery and offer a lucid image of the treatment choices to the patients right from the beginning.