Dr. Liu on the Limitations of Radiology in Breast Cancer

Minetta Liu, MD, breast cancer specialist, Mayo Clinic, Rochester, Minnesota, discusses the limitations of radiology in metastatic breast cancer treatment.

Liu says that the key in metastatic breast cancer is trying to stay ahead and determine the right time to change therapy. Currently, the gold standard for measuring this is by using imaging such as CAT scans, MRIs and ultrasounds.

However, Liu says, it is difficult for a radiologist to measure these tumors in a reproducible way. A study found a variability of 15% when radiologists were asked to look at two identical images and report if the patient progressed. Liu says that the variation can be higher if it’s the same radiologists looking at the same pictures a week later.

Liu says that a better, more reliable method must be determined. Counting circulating tumor cells (CTCs) are more reliable and reproducible and the variation is only on the order of 1-5%.

Although no test is perfect, having multiple, reliable tools would help physicians to measure the progression of metastatic breast cancer, Liu says.