Scientists are developing a test that dentists could use to screen patients for breast cancer. The test checks saliva for marker proteins that give an early warning of the disease.

Scientists from the University of Texas Dental Branch analyzed saliva samples from 30 patients and found 49 proteins that differentiated those who were healthy from those who had breast cancer.  The proteins could also distinguish between tumors that were benign or malignant.

According to the researchers,  many women visit dental offices more often than they see a physician,  and use of saliva is a noninvasive,  quick way to detect diseases.  Saliva analysis has been used in the past to monitor patient response to chemotherapy or surgical treatment of the disease.

Although the results are promising,  the study looked at samples from only a small number of people. Further work needs to be done to see whether the method could be used to routinely screen for cancer.

Streckfus,  C.F.,  Mayorga-Wark,  O.,  Arreola,  D., Edwards,  C.,  Bigler,  L.,  &  Dubinsky,  W.P. (2008). 
Breast cancer related proteins are present in saliva and are modulated secondary to ductal carcinoma in situ of the breast.
Cancer Investigation, 26(2), 159 - 167.

Virtual Biopsy possible with Skin Scanner
Anoninvasive diagnostic tool to detect surface cancers quickly and painlessly using technology currently used to calculate body composition has been developed by an Australian physicist.  The experimental technique measures irregularities in cells,  allowing for a “virtual biopsy” of suspicious lesions without the need to cut and test the skin in a laboratory.

The technique uses bioimpedance spectroscopy to diagnose cervical and skin cancers.  It measures the electrical characteristics of biologic tissue.

If a cell’s structure has changed,  the impedance characteristics change, and clinicians may be able to use the changes to diagnose the type of lesion and its boundaries. The technique picked up changes inside cells,  in cells’  membranes,  and in the space between cells.

Virtual biopsy cuts out the need for diagnostic surgery.  (2008).  Retrieved March 24,  2008, from   http://www. sciencedaily.com/releases/2008/08118093231.htm

Copay May Be a Deterrent to Getting Mammograms
Small insurance copayments are enough of a deterrent to keep many older women from getting mammograms to detect breast cancer,  according to a recent study.

The study looked at 174 Medicare managed-care plans insuring 366,475 women aged 65 - 69 years.  During the four-year period studied, the number of plans requiring a copayment for a mammogram rose to 21 in 2004 from 3 in 2001. Screening rates were 8.3% lower for women in insurance plans requiring a copay than in plans that picked up the full cost of mammograms. Most copays were $20, but the amounts ranged from $12.50 - $35.

The researchers said that managedcare plans would be wise to exempt older women from mammogram copayments because breast cancer is less expensive to treat when caught early. The study bolsters the idea of “value-based insurance” in which insurers lower copays and other costs to patients as a way to promote the use of tests and drugs that are proven to be cost effective in the long run.

Trivedi,  A.N.,  Rakowski,  W.,  &  Ayanian,  J.Z. (2008).  Effect of cost sharing on screening mammography in Medicare health plans.
New England Journal of Medicine,  358(4), 375 - 383.

Contributing Editor Deborah McBride, RN, MSN, CPON®, is a nurse at the Kaiser Permanente Oakland Medical Center and a faculty member at Samuel Merritt College in Oakland, CA.