Summary Water suppressed proton nuclear magnetic resonance ('H NMR) spectroscopy of human plasma has been described as successful in detection of malignancy. We designed a prospective study to test the hypothesis that in vitro NMR spectroscopy has a high sensitivity for detecting early breast cancer. One hundred and thirty-five women were referred for breast biopsy due to abnormal mammograms. One hundred of these were recruited through a population-based mammography screening project. Sixty-nine of 135 women were found to have breast cancer and their average line width of the methyl and methylene resonance in the plasma were compared to those women who had a benign or normal histopathology in the biopsy and to the line width for 100 healthy subjects from the same population. Thus the biopsy group was subdivided into one group with malignant and another with benign or normal histological findings. The sample size was predetermined to 120 by power calculations. Our aim was to detect differences in line width of the same magnitude as that described by Fossel, with 80% power and a 5% significance level. One hundred of the women were referred directly from a mammography screening center. The screening was a population-based public health care program for mammography alone.To obtain a reference group that was not subject to preoperative psychological stress, 100 healthy subjects from the same population were enrolled from an ongoing populationbased screening study for primary hyperparathyroidism among women 50 years of age and older. All these women gave their informed consent.
Data collectionOn the day before surgery the women in the biopsy group were asked whether they had had a malignant tumour earlier in life, whether they smoked, whether they were on a special diet, when they had had their most recent meal and what it consisted of. Blood samples for determinations of the line width, serum triglycerides, serum cholesterol, serum FSH and estradiol were then drawn. Data about source of referral, histopathological diagnosis and tumour stage were obtained from the medical records.The healthy women were asked the same set of questions as those in the biopsy group. At the same time as the blood samples were drawn for the primary hyperparathyroidism screening, a blood sample for line width, serum triglycerides and serum cholesterol was drawn.A second blood sample was taken from 20 of the 69 patients with breast cancer 3-4 months after completion of therapy. These women had stage I or II cancer and were considered to be free of disease at the time.Laboratory methods EDTA-prepared tubes were used for blood sampling. The samples were centrifuged to obtain the plasma fraction within 60 min.