Nuclear medicine has acquired powerful 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
While the term "nuclear" may seem frightening, here, it is not a question of explosion but of medical precision. These weakly radioactive molecules, injected intravenously, diffuse into the blood and make it possible to locate cancer cells. " A part of the molecule emits radiation, which makes it possible to have images; other attaches to a receptor," explains Dr. Romain-David Seban, nuclear physician at the Curie Institute. 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 according to their stage, location and the presence of hormone receptors, making accurate diagnosis essential. This is where nuclear medicine comes in: it scans the body without a biopsy and with unparalleled finesse. Dr. Seban cites the example of a patient with triple-negative cancer who came for an extension assessment to see if her disease was contained 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 revolution in treatments?
Current imaging is largely based on PET-scanners. The latter uses a radiotracer to target the cancer cells that are most sugar hungry. As effective as it is, 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 in the tumor microenvironment) could improve the diagnosis of triple-negative breast cancers, the most aggressive. In addition, some tracers could even predict the effectiveness of treatments or anticipate a relapse.
Radiotracers targeting hormone receptors are also being developed to adjust hormone 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 that we 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, states that " The image is revolutionizing cancer care. Far from a photograph that describes, we are in the image that treats, or 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.