When the pandemic began, Dr. Susan Love Foundation for Breast Cancer Research faced a dilemma: How could we continue our research without putting people at risk?

I was especially concerned about our project to map the normal anatomy of the breast ducts. After many years and many approaches, we had finally identified the perfect imaging modality to accomplish our goals — QT Ultrasound, which uses sound waves being passed across the breast of a woman lying on her stomach, with her breast submerged in a water bath.

With QT Ultrasound, the speed of the sound transmission is measured and then transformed into a 3D image of the fat, ductal tissue, and fibrous tissue that makes up the breast. And these images are amazing!! Here’s one that was made from the breast of a 64-year-old woman.

We had just identified a location in Beverly Hills to house a QT Ultrasound machine that had been loaned to us for a study to assess images of the breasts of women and men at different points of their lifecycle when the pandemic hit! We could not morally or ethically justify recruiting healthy women and men for a non-urgent research study during a pandemic, so we put the study on hold. Frustrated, I asked the company if they had any images that we could look at in the interim and, low and behold, they had one set of 400 images that had been acquired at different points in a woman’s menstrual cycle — and many more. So, our research has moved in a new direction. We will now arrange to use their software to transform these breast images into duct maps, which will allow us to learn more about the general patterns of duct distribution. This will give us a head start on the research project we had initially envisioned, and also allow us to answer the question of whether the duct patterns changes throughout the menstrual cycle.

We also learned that we could have access to another collection of about 1000 images that can be used to identify the ducts and how they are distributed. So, it is indeed true: obstacles can turn into amazing opportunities you might never have imagined!

Our NIH-funded “self-reading” ultrasound research that was underway in Guadalajara, Mexico, is also on pause because of the pandemic. We started this study because, in low-to-middle income countries, where screening is not common, most breast cancers are in premenopausal women and present as breast lumps. Yet, most lumps in premenopausal women will be benign. This means we need to figure out a way to tell which lumps are more likely to be cancerous so that not everyone with a lump joins the long list of people waiting for a biopsy. The self-reading ultrasound is being designed to differentiate between which lumps are benign and which should be tested. This means only the patients who really need to have a biopsy will have to get one, reducing the waitlist dramatically. The silver lining of the pause: while waiting to re-start the study, we had time to fine-tune the artificial intelligence software that we need to use to differentiate between the benign lumps and those that need to be tested, making sure we are keeping up with the changing technology.

As you can see, we are not easily diverted from our path to figuring out how and where breast cancer starts and how to prevent it once and for all — even in the midst of a pandemic!

 

 

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