Mammography continues to be the method of choice for the early detection of breast cancer. However, because this technique is not as selective or specific as one would wish, and does not deliver reliable results for every level of tissue density, alternatives are being sought.
Near-infrared fluorescence mammography, which works with rays of near-infrared (NIR) light instead of X-rays, is a highly promising technique - although effective contrast agents have thus far been lacking. A team led by John V. Frangioni at the Beth Israel Deaconess Medical Center of the Harvard Medical School in Boston, Massachusetts, has developed a contrast agent that makes visible the microcalcifications related to malignant breast tumors. The researchers report in the journal Angewandte Chemie that in validation trials in swine their new contrast agent distinguishes specific calcium salts in soft tissues, as well as depicting bones.
As breast cancer develops, calcium salts are deposited in breast tissue. These microscopic calcium deposits consist mostly of hydroxyapatite, a salt containing calcium and phosphate that is also present in bones.
As the basis of their NIR contrast agent, the researchers chose to use the osteoporosis drug pamidronate, a biphosphonate. Biphosphonates, which are also used for the treatment of bone metastases in breast cancer patients, preferentially bind to bone. Frangioni and his team attached a dye that both absorbs light and fluoresces in the NIR region of the spectrum to a pamidronate derivative. Light in this region of the spectrum penetrates especially well into living tissue without damaging it, and is also easy to detect.