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PLoS One

Title:		Rapid point-of-care breath test for biomarkers of breast cancer and abnormal mammograms
Author(s):		Phillips M; Beatty JD; Cataneo RN; Huston J; Kaplan PD; Lalisang RI; Lambin P; Lobbes MB; Mundada M; Pappas N; Patel U;
Address:		"Breath Research Laboratory, Menssana Research Inc., Newark, New Jersey, United States of America; Department of Medicine, New York Medical College, Valhalla, New York, United States of America. Swedish Cancer Institute, Seattle, Washington, United States of America. Breath Research Laboratory, Menssana Research Inc., Newark, New Jersey, United States of America. HackensackUMC Mountainside, Montclair, New Jersey, United States of America. Division of Medical Oncology, Department of Internal Medicine, GROW School of Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands. Department of Radiotherapy (MAASTRO), GROW School of Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands. Department of Radiology, GROW School of Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands. Saint Michael's Medical Center, Newark, New Jersey, United States of America"
Journal Title:		PLoS One
Year:		2014
Volume:		20140305
Issue:		3
Page Number:		e90226 -
DOI:		10.1371/journal.pone.0090226
ISSN/ISBN:		1932-6203 (Electronic) 1932-6203 (Linking)
Abstract:		"BACKGROUND: Previous studies have reported volatile organic compounds (VOCs) in breath as biomarkers of breast cancer and abnormal mammograms, apparently resulting from increased oxidative stress and cytochrome p450 induction. We evaluated a six-minute point-of-care breath test for VOC biomarkers in women screened for breast cancer at centers in the USA and the Netherlands. METHODS: 244 women had a screening mammogram (93/37 normal/abnormal) or a breast biopsy (cancer/no cancer 35/79). A mobile point-of-care system collected and concentrated breath and air VOCs for analysis with gas chromatography and surface acoustic wave detection. Chromatograms were segmented into a time series of alveolar gradients (breath minus room air). Segmental alveolar gradients were ranked as candidate biomarkers by C-statistic value (area under curve [AUC] of receiver operating characteristic [ROC] curve). Multivariate predictive algorithms were constructed employing significant biomarkers identified with multiple Monte Carlo simulations and cross validated with a leave-one-out (LOO) procedure. RESULTS: Performance of breath biomarker algorithms was determined in three groups: breast cancer on biopsy versus normal screening mammograms (81.8% sensitivity, 70.0% specificity, accuracy 79% (73% on LOO) [C-statistic value], negative predictive value 99.9%); normal versus abnormal screening mammograms (86.5% sensitivity, 66.7% specificity, accuracy 83%, 62% on LOO); and cancer versus no cancer on breast biopsy (75.8% sensitivity, 74.0% specificity, accuracy 78%, 67% on LOO). CONCLUSIONS: A pilot study of a six-minute point-of-care breath test for volatile biomarkers accurately identified women with breast cancer and with abnormal mammograms. Breath testing could potentially reduce the number of needless mammograms without loss of diagnostic sensitivity"
Keywords:		"Adolescent Adult Area Under Curve Biomarkers, Tumor/*metabolism Breast Neoplasms/diagnostic imaging/*metabolism Breath Tests Carcinoma, Ductal, Breast/diagnostic imaging/*metabolism Female Humans Mammography Monte Carlo Method Multivariate Analysis Point-;"
Notes:		"MedlinePhillips, Michael Beatty, J David Cataneo, Renee N Huston, Jan Kaplan, Peter D Lalisang, Roy I Lambin, Philippe Lobbes, Marc B I Mundada, Mayur Pappas, Nadine Patel, Urvish eng R43 RR030689/RR/NCRR NIH HHS/ 1R43RR030689-01/RR/NCRR NIH HHS/ Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't 2014/03/07 PLoS One. 2014 Mar 5; 9(3):e90226. doi: 10.1371/journal.pone.0090226. eCollection 2014"