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Urine test promising for assessing breast cancer risk.

SAN ANTONIO -- A simple urine test for selected matrix metalloproteinases may provide a novel noninvasive means of assessing a woman's risk of developing breast cancer, Dr. Susan E. Pories reported at a breast cancer symposium sponsored by the Cancer Therapy and Research Center.

Urinary levels of two biomarkers--matrix metalloproteinase-9 (MMP-9) and a disintegrin and metalloprotease 12 (ADAM12)--appear to be independent predictors of the presence of breast atypical hyperplasia or lobular carcinoma in situ (LCIS), both of which are well established predictors of increased risk of breast cancer, explained Dr. Pories of Beth Israel Deaconess Medical Center, Boston.

She and her coworkers had previously found that levels of MMP-9 and ADAM12 increase with more advanced disease in breast cancer patients.

In the current study, urine samples were obtained from 44 women with atypical ductal or atypical lobular hyperplasia, 24 with lobular carcinoma in situ, and 80 healthy controls.

If a urine sample tested positive for both MMP-9 and ADAM12, the probability that the woman had LCIS or atypical hyperplasia was 100%. If the sample was MMP-9 negative but ADAM12 positive, there was a 67% probability of atypical hyperplasia and a 50% likelihood that the patient had LCIS.

An MMP-9-positive/ADAM12-negative urine sample conferred a 40% chance that the patient had LCIS and a 25% chance that she had atypical ductal hyperplasia or atypical lobular hyperplasia. And a sample that proved negative for both biomarkers was associated with a zero probability of atypical hyperplasia.

The urine test has the advantages of being less invasive, costly, and uncomfortable than mammography. Asked how she envisions the urine test being used, Dr. Pories said in an interview that it will never replace mammography, but it could end up as a useful adjunct. For example, it could help physicians decide whether to biopsy a woman with a Breast Imaging Reporting and Data System (BI-RADS) stage 3 or 4 mammogram. In high-risk women, the test could also be performed between scheduled mammograms in order to provide early warning of a change in status even before a mass appears. She added that further studies with larger numbers of patients are needed to be sure the test is valid.
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Title Annotation:Women's Health
Publication:Internal Medicine News
Geographic Code:1USA
Date:Feb 1, 2006
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