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PERSPECTIVE For alumni and friends of the
UW-Madison College of Engineering


Inside the box New method for breast cancer imaging 1
By Sandra Knisely
Photos by David Nevala

Inside the
Above: Susan Hagness and Barry Van Veen. Right: An
antenna from the microwave imaging system prototype.

very woman over the age of
40 receives the same initial
screening for breast cancer: a
mammogram. Yet no two women New method for
are identical and neither are their
breast cancer risks, so a team of breast cancer imaging
University of Wisconsin-Madison
researchers is developing a system
better tailored to women with a
particularly high risk factor.

In 2000, a National Academy of Engineering publication identified breast cancer detection
as a healthcare problem in need of an engineering solution. In the subsequent decade, Philip
The density risk
Dunham Reed Professor of Electrical and Computer Engineering Susan Hagness has emerged as
a leader in the search for that solution. Breast tissue is made up of fatty tissues,
The system will offer three-dimensional capabilities similar to a magnetic resonance imaging connective tissues and epithelial tissues, which
(MRI) system along with the affordability and accessibility of traditional mammography. line many of the body’s surfaces and cavities.
Hagness works closely with Electrical and Computer Engineering Professor Barry Van Veen, Collectively, the connective and epithelial
and their collaborators span a variety of fields. Electrical and Computer Engineering Assistant tissues are called fibroglandular tissue, and this
Professor Nader Behdad, Duane H. and Dorothy M. Bluemke Professor of Electrical and Computer tissue determines breast density. If a woman
Engineering John Booske, and Radiology Associate Professors Fred Kelcz and Gale Sisney has a high percentage of fibroglandular tissue,
currently are contributing to the project. her breasts are considered “dense.”

This strong risk is also fairly common. could be used for evaluating breast density
Around 50 percent of women in their 40s and screening women who are at high risk.”
and 25 percent of women in their 70s have
breast tissue that is at least 50 percent
dense, according to the American Journal of An affordable alternative
Roentgenology. “All of these facts point to the
importance of breast density evaluation in
for high-risk women
assessing a woman’s risk and having
clinicians provide appropriate prevention A three-dimensional image of dense breast
protocols,” Hagness says. tissue would allow doctors to sift through
Unfortunately, dense breast tissue makes the entire tissue slice by slice. An MRI is an
it more difficult for doctors to accurately example of a system that can produce these
screen for cancer. Research in Annals of kinds of images, but these scans cost around
Internal Medicine found as many as two out 10 times as much as mammograms.
of every five cancers in women who have Beyond the cost, the accessibility of MRIs
high breast density go undetected.   is not ideal. Not all clinics or hospitals have
The problem is that mammography is MRI machines, and rural clinics are especially
a two-dimensional imaging technique. less likely to have one. In addition, a time-

A mammogram machine takes a three- intensive MRI scan is a difficult experience for
dimensional volume of tissue, passes X-rays claustrophobic or obese patients, who make
through the tissue and creates a shadow up a significant percentage of the population.
gram. All of the tissue is projected onto that Instead, Hagness and Van Veen are
two-dimensional image. developing an imaging system that can
Hagness compares it to trying to find a produce three-dimensional images via
needle in a haystack. “It’s easier to find the microwaves, a technology comparable in
needle if you can sift through the hay layer by cost to a mammogram.
layer; it’s much more difficult if you compress The clinical prototype will look like a box
all of the hay into a thin pile and view it all at similar in shape and size to a vertical Kleenex
once,” she says. tissue box, with tiny copper-colored antennas
However, Hagness and Van Veen don’t mounted on each side. Each antenna will
view their system as a replacement for transmit a low-power microwave signal,
traditional mammography. “Mammography and all the other antennas will record the
is the gold standard that has saved countless scattered signals from the breast. Algorithms
lives, and we don’t see a need for an alternative will reconstruct those signals into a three-
for women who are served well by that dimensional image of the breast tissue.
technology,” Hagness says. Safety is a key component of the system.
“But there is a population that is currently “This will transmit much less microwave
underserved, and we’re interested in devel- power than a cell phone,” Hagness says. “It’s
According to research published in the
oping a safe, low-cost imaging modality that non-ionizing, so there is no health risk.”
New England Journal of Medicine, high breast
density can increase a woman’s risk for cancer
to four to six times that of women with
predominantly fatty tissue. It’s a stronger risk
factor than early-onset menstruation or having
no biological children. In fact, few other
factors exceed dense breast tissue as a risk for
cancer; a Radiology paper found those that do
include a breast cancer gene mutation, age or
prior breast cancer.

the study have been cited hundreds of times. Overall, the team is focused on moving
Piloting the future of “We can distinguish dense tissue from fatty the clinical prototype forward so the small-
tissue, and that’s what you need to determine scale human trial can begin sometime in
breast imaging volumetric breast density,” she says. the next two years. This means developing
Van Veen, who wasn’t directly involved and testing the algorithms that will
Achieving a clinical prototype has been an in the tissue study, says the team’s work has actually generate images from the data
evolutionary process that has taken several evolved because of those findings. “Initially gathered from the antennas. The team also
years of research. From 2002 to 2007, we had assumed tumors were these different is working on the actual sensor array that
Hagness led a large multi-institutional study objects that would scatter a lot more micro- will be placed around the subject’s breast.
to establish that breast tissue microwaves wave signals than the healthy tissue,” he says. “We’re beginning to make the transition
could convey important physiological “But both tumors and healthy tissue scatter from pure laboratory research toward
information. The study involved measuring similar levels of energy back. That knowledge clinical studies,” Hagness says.
hundreds of freshly excised tissues from has changed the type of signal processing we The pilot will test around a dozen
mastectomies, breast reductions and do for this problem.” women. Participants will lie face down
biopsies. The samples included healthy and The change means a shift from a radar-like on an MRI support platform and place
cancerous tissues with a range of densities. approach to an imaging approach that looks their breasts in a stabilizing structure that
Hagness found that dense fibroglandular for changes over time or changes due to suspends the breast in the prototype “box.”
tissue does in fact have different electric contrast agents. With funding from the The antennas will send a low dose of safe
properties from fatty tissues—a contrast U.S. Department of Defense, Hagness and microwaves through the breast tissue, and
that is necessary to evaluate breast density colleague John Booske are studying micro- the signals will be converted into a three-
with microwaves. The work remains the bubbles and carbon nanotubes as possible dimensional image. Participants will also
definitive study on microwave properties of contrast agents that will target tumors and undergo an MRI scan as a control test.
breast tissue, and the papers associated with make them more “visible” to the antennas.

Applying engineering
to healthcare
The field of electrical and computer
engineering is becoming a more common
A model of the new
home for healthcare research, says Booske,
breast cancer imaging
system. Electrical and
who chairs the UW-Madison Department
Computer Engineering of Electrical and Computer Engineering.
Assistant Professor “Currently, at least 13 of our faculty are
Nader Behdad pushing back the research frontiers in topics
co-developed the at the interface of ECE and biomedical or
antennas and sensor biological technology fields, and more get
array with Hagness involved each year,” he says.
“Being involved in this research on
breast cancer detection and treatment has
been one of the most exciting experiences
of my career,” he adds. “My interests and
expertise in the science of how electro-
magnetic waves interact with media
has enabled me to contribute, and I’ve
learned so much by working alongside the
interdisciplinary team of experts brought
together by Professors Hagness and
Van Veen over the years on this initiative.”

“A significant part of the
human body is electrical in
nature. The nervous system,
the brain, cell membranes—
electrical engineers can fully
understand that side of the
human body,” Hagness says.

Van Veen says the team’s overall breadth When Hagness joined UW-Madison in the “All engineering fields offer enormous
of expertise is what sets it apart from others late 1990s, it wasn’t long before Van Veen opportunities to address a variety of
working on similar research. “From state- began asking questions about her interest in challenges in the medical arena. The
of-the-art electromagnetics to sophisticated breast cancer imaging, and the two began reason why engineering offers this
signal processing, we have a wide breadth collaborating. “My expertise is essentially opportunity is because fundamentally,
that other research teams working on this in problems where multiple, different we’re problem- solvers,” Hagness says.
problem don’t have,” he says. “We’re well sensors simultaneously measure a physical “When a clinical need is identified, it’s a
positioned to hopefully ultimately solve phenomenon, such as electromagnetic natural fit for engineers to try to address
the problem.” scattering from breast tissue, ” he says. that need, and in electrical engineering,
Solving the problem is the fun part for In addition to her expertise in electro- we have a lot of tools and skills to offer.”
Van Veen, who jokes about his broad range magnetics, Hagness is a champion for “A significant part of the human body is
of signal-processing research experiences. increasing interest in engineering by electrical in nature. The nervous system, the
“I like to say I’ve worked on problems from showing students how the field can help brain, cell membranes—electrical engineers
A to Z, though I haven’t quite gotten to Z,” solve global and societal challenges. She can fully understand that side of the human
he says. “I started my career applying signal leads an introductory engineering course body,” she says.
processing to acoustics and have made it to dedicated to the topic and works on major
W, wireless communications.” engineering outreach initiatives.