Using 'Metabolic Signatures' to Better Predict Breast Cancer Progression

Detecting cancer with the least invasive, most accurate methods is a continually evolving goal that benefits patients and improves the effectiveness of medical care, says Mary Mahoney, MD.

Although imaging modalities have advanced tremendously, imaging alone cannot predict the aggressiveness of a particular patient's tumor. 

"Screening technology for breast cancer has become so good that we are picking up more cancers, earlier and earlier. The question that keeps coming up in the scientific literature is: How do you know that all of these tumors are clinically relevant? Are there some tumors that would never cause the patient a problem?" explains Mahoney, director of breast imaging at the UC Health Barrett Center, professor of radiology at the UC College of Medicine and researcher affiliated with the UC Cancer Institute. "The answer is probably yes—but we currently have no way of definitively determining a tumor's long-term aggressiveness, so you have to treat them all."

With support from a $40,000 pilot grant, Mahoney has assembled a translational research team to study choline metabolite ratios as molecular markers of human breast cancer to help provide insight on this conundrum. 

Choline is a byproduct of cell metabolism, but its role in cancer and tumor progression is unknown. Investigating choline metabolite ratios as human breast cancer markers is a new concept in clinical medicine. 

For this new clinical trial, Mahoney is seeking patients with suspicious breast lesions identified on screening mammography who have been referred for a follow-up magnetic resonance (MR) imaging test and core needle biopsy. A small portion of biopsy sample will be sent for comprehensive chemical evaluation (spectroscopy) on a high-resolution research MR scanner.

"This gives us a tremendous amount of clinical and molecular data that we can then correlate to determine whether there is a clear metabolic signature associated with various forms of breast cancer," says Mahoney. "We hope this information will help us find a way to use spectroscopy to differentiate between benign and malignant disease as well as tumor aggressiveness to help direct patient-specific therapies."

The project is funded by a 2012 Philips Healthcare/RSNA Research Seed Grant. The highly competitive funding program awarded just 80 grants to physician-scientists from across the United States for 2012.  

Collaborators in this breast imaging research study include UC Department of Psychiatry and Behavioral Neuroscience faculty Wenjang Chu, PhD, Jing-Huei Lee, PhD, Rich Komoroski, PhD, Stephen Strakowski, MD, and Jeffrey Welge, PhD. Kim Cecil, PhD, of Cincinnati Children's Hospital Medical Center, is also a collaborator in the study. Spectroscopy analysis will be performed in the Center for Imaging Research, a core facility for the UC College of Medicine used for in vivo study of human anatomy and physiology. 

Mahoney has no financial interests in Philips Healthcare, partial sponsor of the RSNA Research Seed Grant.