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Nuclear medicine has important allies in the fight against breast cancer: tracers. Invisible but powerful, these molecules detect tumors and metastases with surgical precision.
A little nuclear, a lot of medicine: radiotracers enable cutting-edge, less invasive and more effective imaging to better diagnose and treat breast cancer.
The role of radiotracers in cancer detection
If the term “nuclear” may seem frightening, here, there is no question of explosion but of medical precision. These weakly radioactive molecules, injected intravenously, diffuse into the blood and make it possible to identify cancer cells. “Part of the molecule emits radiation, which allows images to be obtained; another attaches to a receiver“, explains Dr Romain-David Seban, nuclear doctor at the Institut Curie. These images make it possible to locate tumors and assess the extent of the disease.
Breast cancer remains a formidable enemy, with more than 61,000 new cases each year in France and 12,000 deaths. Breast cancers vary depending on their stage, location and the presence of hormone receptors, making accurate diagnosis essential. This is where nuclear medicine comes into play: it scans the body without a biopsy and with unparalleled finesse. Dr Seban also cites the example of a patient with triple negative cancer who came for a follow-up assessment to see if her disease was circumscribed or not. “As there were no metastases, she was eligible for treatment with surgery, chemotherapy and radiotherapy, plus immunotherapy as her tumor was relatively aggressive.“, he explained.
Towards a treatment revolution?
Current imaging is largely based on PET scanning. The latter uses a radiotracer to target the cancer cells that consume the most sugar. However effective it may be, it sometimes presents false positives or misses certain metastases. To overcome these weaknesses, new tracers are being studied. For example, a tracer targeting fibroblasts (cells of the tumor microenvironment) could improve the diagnosis of triple negative breast cancers, the most aggressive. In addition, certain tracers could even predict the effectiveness of treatments or anticipate a relapse.
Radiotracers targeting hormone receptors are also being developed to adjust hormonal treatments according to the specific needs of each patient. Anne Vincent-Salomon, director of the Women’s Cancer Institute, speaks of a real “revolution”: “More and more trials are seeking, by combining imaging and nuclear medicine, to see which patients will respond very well to treatment or for whom we could reduce chemotherapy and/or immunotherapy tomorrow, or even who could no longer operate. “.
The future: imaging, AI and combined treatments
Nuclear medicine continues to progress. In the future, a technique called “vectorized internal radiotherapy”, already used for other cancers such as prostate cancer, could be used to treat breast cancer. Steven Le Gouill, director of the Curie hospital complex, affirms that “The image is revolutionizing cancer care. Far from a photograph that describes, we are in the image that deals with, even predicts“.
With the help of artificial intelligence, imaging promises even faster and more accurate diagnoses. Each new advance in this field offers additional hope for cancer patients, making treatments more targeted and effective.