Tuesday, November 28, 2006
Can You Avoid a Breast Biopsy?
As a doctor, I know one of the most frightening things for a patient to hear is "you might have cancer." I have had to deliver that news on countless occasions, and I know it leads to lots of worry, lost sleep and anxiety. In the case of breast cancer, 80 percent of lesions biopsied are found to be benign. That's good news for a lot of women, but it may also mean that too many breast biopsies are performed. So for years, doctors have been looking for ways to cut that number down. And they may have discovered an answer, called elasticity imaging. The results of a small study on this technology were presented this week at a meeting of the Radiological Society of North America.
Elasticity imaging is really no different from a conventional ultrasound for a patient. As with an ultrasound, the test is completely noninvasive and involves no needles. The difference lies in what happens to the images after that. While an ultrasound is very good at detecting an abnormality in the breast, adding "elasticity" software helps better define the characteristics of those lesions. So, for example a harmless breast cyst would have one distinctive appearance and a malignant tumor would look strikingly different. The hope is that one day a biopsy could be called off, based on ultrasound images alone. We are not there yet.
Your doctor, like most doctors, will probably want to see more studies before they are comfortable trusting this technology. The existing study results, though, are very good. Out of 80 women with 123 suspicious masses, elasticity imaging correctly identified 17 of 17 malignant tumors and 105 of 106 benign lesions. One downside of ultrasound imaging is that it depends very much on the operator's skill - so these terrific results might vary from hospital to hospital.
Still, it is hard to argue with data that are almost as accurate as a biopsy. Almost.
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