Breast Cancer Screening ... at the Dentist?

Not everyone loves the dentist, but most people honor the twice-annual appointment to maintain their pearly whites. Now, a new study shows those trips to the dentist might reveal more than cavities.

A study to be published in the March/April 2007 issue of General Dentistry, the Academy of General Dentistry’s (AGD) clinical journal, finds your dentist could play an important role in breast cancer detection.

Click Here to Ask a Dentist a Question

Currently the American Cancer Society (ACS) recommends clinical breast exams about every 3 years for women over 20, and a yearly mammogram along with the clinical breast exam for women over 40. In 2006 alone, the ACS estimated 212,920 new cases of breast cancer in women.

With the new test, a general dentist could collect a quick spit sample in a tube between flossing and polishing and send a sample off to the lab – intervening in the critical early stages of this disease that is the second leading cause of death among women in the U.S.

A study released on Wednesday in the journal offers an auspicious review of salivary diagnosis — a form of testing that uses samples of saliva instead of blood. The analysis looked at four specific proteins found in saliva in high enough levels to be tested. These proteins are just some of the markers identified for breast cancer tumors.

Currently, almost all tests for tumor markers in most cancers are conducted with blood, urine, or actual tissue samples. According to AGD Spokesman, Dr. Charles H. Perle, DMD, FAGD, a simple saliva test could be widely used as an inexpensive, and non-invasive solution to early detection.

Making Strides With Markers

According to the American Cancer Society, there are currently no tumor markers approved by the Food and Drug Administration (FDA) for early detection of breast cancer. All current breast cancer markers are only for prognosis and monitoring treatment, they cannot provide an early warning for the presence of cancer.

Authors of the study investigated a small protein known to stimulate tumor cells. A salivary test of this epidermal growth factor (EGF) in one study found higher levels in women with breast cancer. The authors conclude testing for proteins associated with this EGF pathway appear to be the most promising for further study, especially detecting breast cancer.

The authors also point to research involving two other markers. These markers from blood samples are already approved to evaluate malignancy and track treatment, but could also be used using salivary testing. Previous studies have found salivary tests for these proteins, erb and CA15-3, are 45 to 50 percent higher in women with breast cancer than those without.

Additionally, salivary erb tests were able to detect 87 percent of the women with breast cancer. In saliva, these markers may be able to recognize the success of cancer therapies, and studies of salivary tests show promise that these markers could also be used to detect breast cancer.

Click Here To Visit's Cancer Center

Saliva Advantages

Authors of this study concede that blood tests are still the gold standard for diagnostic testing. However there are compelling reasons to choose saliva over blood. Saliva is a clear, colorless liquid, whereas blood can undergo color change that can compromise results.

Best of all, saliva testing is relatively safe, with no needles in sight. Collecting a sample is simple — just think of all that saliva dentists already suction out of patients' mouths during cleanings. The authors add that the process would not require any specialized equipment or training.

Dr. Perle, DMD, FAGD, a practicing general dentist, says as long as the test is approved by the FDA and cost-effective, dentists would welcome the chance to improve cancer detection.

“Real simply, if they could come up with a test that could see if a person is a candidate for breast or other cancer, and its not invasive, and it’s simple, I’ll use it,” Perle said.

Dr. Perle says he does not currently ask for cancer histories on patients, but if these tests were available he could routinely test patients with a family risk for breast cancer during their twice-annual exams.

This method would not replace mammograms or blood tests, but rather act as a first line of defense. Beyond breast cancer, there could be other unidentified markers in saliva that could detect different cancers. Currently none of the salivary markers studied for breast cancer have received FDA approval.

According to the ACS, only 20 percent of women eligible for the National Breast and Cervical Cancer Early Detection Program have access to it. Saliva testing may provide an easily accessible starting point for diagnostics for the millions of uninsured and low-income women who lack the access to preventative care. managing health editor Dr. Manny Alvarez reviewed this article. He is chairman of the Department of Obstetrics and Gynecology and Reproductive Science at Hackensack University Medical Center in New Jersey. Additionally, Alvarez is Adjunct Professor of Obstetrics and Gynecology at New York University School of Medicine in New York City.