Thousands of volunteers are being sought for a clinical research to see whether 3D mammograms are more effective than traditional 2D imaging in detecting advanced malignancies.
Do 3D mammograms detect advanced malignancies more accurately than traditional 2D imaging?
In an attempt to find out, a scientific experiment is enlisting hundreds of volunteers, many of whom are Black women who have inequities in breast cancer death rates.
To aid with the research, people like Carole Stovall, a psychologist in Washington, D.C., have volunteered for the study.
“Since everyone needs a mammogram, why not do it in conjunction with a study that advances scientific understanding and advances efforts to develop better treatments and potentially even preventative measures?” stated Stovall.
Long-standing concerns about the underrepresentation of women and minorities in research have an impact on health issues such as COVID-19, stroke, and Alzheimer’s disease. Lack of diversity in trials results in gaps in our knowledge of how new medicines affect patients universally.
The research won’t change until more Black women participate in clinical trials. Additionally, greater science is needed for Black bodies, according to activist and breast cancer survivor Ricki Fairley, who is working on the problem.
Compared to white women, black women have a 40% higher death rate from breast cancer and typically receive a diagnosis earlier. It’s unclear, though, if 3D mammography is more beneficial for them, according to National Cancer Institute physician Worta McCaskill-Stevens.
McCaskill-Stevens questioned, “Are there populations for whom this might be important to have early diagnosis?” Does it cause excessive false alarms or unnecessary follow-up tests and treatments, or is it harmful?
Black McCaskill-Stevens is in charge of NCI’s initiatives to increase minority and rural populations’ access to cancer research.
Although the more recent 3D method has been available for ten years, there has never been solid proof that it is superior than 2D for identifying advanced malignancies. The screening method creates an image that resembles three dimensions by combining several images of the breast obtained from various perspectives. Both 2D and 3D mammograms employ minimal radiation dosages and compress the breast.
Although earlier research indicates that 3D detects more malignancies than 2D, more cancers detected does not always translate into more lives saved. Standard screening may miss certain tumors that don’t develop or require treatment. The gold standard for research was not followed in prior studies, which did not randomly assign patients to a screening procedure.
According to McCaskill-Stevens, the idea “that if it’s new, it’s shiny, then it’s better” isn’t always accurate. “We need well-designed randomized trials until we have the evidence to support that.”
With a target enrollment of 128,000, the trial has enrolled close to 93,000 women thus far. Currently, 32 U.S. states, Canada, South Korea, Peru, Argentina, and Italy are participating in the NCI-funded study. Soon, patient enrollment will start at a location in Thailand.
The study’s principal investigator, Dr. Etta Pisano, stated, “We added more international sites to enhance the trial’s diversity, particularly for Hispanic and Asian women.”
Hispanic individuals make up 42% of the total. Enrolling Black women and other women of color would “absolutely” continue as a focus as recruiting goes on, according to Pisano.
After receiving a series of 2D or 3D mammograms at random, participants are monitored for a number of years. We will compare the quantity of advanced tumors found using the two techniques.
Compared to a conventional cancer treatment trial, where 9% of participants are Black, 21% of study participants in the U.S. research locations are Black women, according to McCaskill-Stevens.
More Black women have enrolled at the University of North Carolina than at any other study location. At UNC’s two sites, over 25% of the almost 3,000 women enrolled are Black.
Lead investigator for the UNC portion of the study, Dr. Cherie Kuzmiak, stated that women in North Carolina desire to be a part of something greater than themselves. “They desire this hands-on involvement in shaping the future.”
Stovall was convinced to participate in the study by a fortuitous meeting at her hair salon. She met Georgetown University cancer researcher Lucile Adams-Campbell as she was waiting for a hair appointment. The two Black people struck up a conversation.
Stovall, who leaped at the chance to catch up on her mammograms after the COVID-19 outbreak delayed screening for her and thousands of others, stated, “She explained how important it was to get women of color into the program.”
Stovall was motivated to participate in the study on a personal level. Triple negative breast cancer is a dangerous form that hits Black women more frequently than White people; her sister just finished treatment for it.
Trial participants are women between the ages of 45 and 74 who have never had breast cancer. The trial began in 2017. Several women are also contributing cheek swab samples and blood for a database that will be searched for insights.
People have dreamed since the start of screening that we won’t put everyone in a box, according to Pisano. According to the study’s findings, “if we’re successful, assuming people have access to care,” inequities might be reduced.
Following a momentary panic, Stovall, 72, got a standard 2D mammography that revealed anything abnormal. A biopsies excluded cancer.
“I felt so relieved,” Stovall remarked. “I have informed everyone I know that they should get a mammogram.”
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