Our Summary

This research paper discusses a study that compared two different methods of performing biopsies on suspicious-looking calcifications in the breast. The two methods are digital mammography (DM)-guided stereotactic biopsy and digital breast tomosynthesis (DBT)-guided biopsy.

The study involved 1310 patients who underwent these biopsies between May 2017 and December 2021. The decision to use either DM or DBT was made by the radiologist at the time of the procedure.

The team found that the DBT-guided method was quicker (an average of about 15 minutes versus 25 minutes for the DM method) and required fewer exposures to radiation (an average of about 4 exposures versus 9 exposures for the DM method). This remained true even when the individual radiologist doing the procedure was taken into account.

However, there was no significant difference in the detection of cancer or high-risk lesions between the two methods. Both had similar rates of malignancy on initial biopsy (20% vs 19%) and final malignancy rate (23% vs 22%).

In simpler terms, using DBT instead of DM for these biopsies could potentially make the procedure quicker and reduce the patient’s exposure to radiation, without affecting the ability to detect cancer or high-risk conditions.

FAQs

  1. What are the two methods of performing biopsies on suspicious-looking calcifications in the breast discussed in the study?
  2. Does the DBT-guided biopsy method offer any advantages over the DM-guided method?
  3. Is there a difference in the detection of cancer or high-risk lesions between the DBT and DM biopsy methods?

Doctor’s Tip

A helpful tip a doctor might tell a patient about breast biopsy is to discuss with their healthcare provider the possibility of using digital breast tomosynthesis (DBT) as a guiding method for the biopsy. This method may be quicker and involve less radiation exposure compared to digital mammography (DM), while still maintaining the same level of accuracy in detecting cancer or high-risk lesions. It’s important to have this conversation with your healthcare provider to ensure the best possible outcome for your biopsy procedure.

Suitable For

Patients who are typically recommended to undergo breast biopsy include those with suspicious findings on mammograms, such as abnormal calcifications or masses, as well as those with a lump or other abnormality in the breast that is concerning for cancer. Additionally, patients with a personal or family history of breast cancer, a previous biopsy showing atypical cells, or other risk factors for breast cancer may also be recommended to undergo a breast biopsy for further evaluation. Ultimately, the decision to undergo a breast biopsy is made on a case-by-case basis by the patient’s healthcare provider in order to determine the best course of action for each individual patient.

Timeline

Before the breast biopsy:

  1. Patient undergoes a routine mammogram and suspicious-looking calcifications are identified.
  2. Patient is referred by their doctor for a breast biopsy to further investigate the calcifications.
  3. Patient meets with a radiologist to discuss the procedure and consent is obtained.
  4. Patient may undergo additional imaging studies to better locate the area for biopsy.

During and after the breast biopsy:

  1. Patient arrives at the radiology center or hospital for the biopsy procedure.
  2. Local anesthesia is administered to numb the area of the breast.
  3. The radiologist uses either DM or DBT guidance to accurately target the suspicious calcifications for biopsy.
  4. Tissue samples are taken and sent to a pathology lab for analysis.
  5. Patient is monitored for any immediate complications after the procedure.
  6. Results of the biopsy are communicated to the patient by their healthcare provider.

Overall, the use of DBT-guided biopsy may offer advantages in terms of shorter procedure time and reduced radiation exposure compared to DM-guided biopsy, without compromising the ability to detect cancer or high-risk lesions.

What to Ask Your Doctor

Some questions a patient should ask their doctor about breast biopsy include:

  1. What is the reason for recommending a breast biopsy?
  2. What type of biopsy procedure will be used (DM-guided stereotactic biopsy or DBT-guided biopsy)?
  3. What are the potential risks and side effects of the biopsy procedure?
  4. How long will the biopsy procedure take?
  5. How many exposures to radiation will be needed during the biopsy procedure?
  6. What are the chances of detecting cancer or high-risk lesions with the chosen biopsy method?
  7. How soon will I receive the results of the biopsy?
  8. What follow-up care or treatment may be needed depending on the biopsy results?
  9. Are there any alternative biopsy methods or procedures that could be considered?
  10. Can I get a second opinion on the biopsy results if needed?

Reference

Authors: Nguyen DL, Boron A, Oluyemi ET, Myers KS, Mullen LA, Ambinder EB. Journal: AJR Am J Roentgenol. 2023 Feb;220(2):212-223. doi: 10.2214/AJR.22.28320. Epub 2022 Sep 14. PMID: 36102725