Our Summary

This research study aimed to understand how often a biopsy of two similar or suspicious-looking areas of calcification (a build-up of calcium) in the same breast can lead to different results. They also investigated how this could influence treatment. They looked at patients who had two or more areas of calcification, which were categorized as Breast Imaging Reporting and Data System (BI-RADS) ≥ 4b and who underwent a specific type of biopsy (DBT-guided VAB). They found that biopsy of two different areas often led to the same or different findings. These findings were split into “actionable” (requiring further treatment) and “non-actionable” (not requiring further treatment).

Out of 206 women who underwent DBT-guided VAB at their institution within two years, 21 had this type of biopsy on two different areas of calcification. The management of these findings was the same for 12 of these women (57%) and different for the remaining 9 women (43%). For these nine women, their different findings would have led to different treatments.

The researchers concluded that even if multiple areas of calcification in the same breast look similar or equally suspicious, they might represent different findings with different treatment implications. Therefore, if there are suspicious calcifications at multiple different areas within the same breast, more than one area should be considered for a biopsy.

FAQs

  1. What was the main aim of this research study on breast biopsy?
  2. What is DBT-guided VAB and how was it used in this study?
  3. How often did biopsies of two different areas of calcification in the same breast lead to different results and treatment in the study?

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 biopsying multiple areas of suspicious calcifications in the same breast. This is important because different areas of calcifications may have different findings and treatment implications, so it’s important to ensure all potentially concerning areas are thoroughly evaluated.

Suitable For

Patients who have multiple areas of calcification in the same breast categorized as BI-RADS ≥ 4b are typically recommended to undergo a breast biopsy. Additionally, patients who have suspicious-looking calcifications that may require further treatment are also recommended to undergo a breast biopsy.

Timeline

Before the breast biopsy:

  1. Patient undergoes a routine mammogram which shows suspicious areas of calcification in the breast.
  2. Patient may undergo additional imaging tests such as ultrasound or MRI to further evaluate the suspicious areas.
  3. A biopsy is recommended by the healthcare provider to obtain tissue samples for further analysis.
  4. Patient may undergo counseling and informed consent process before the biopsy procedure.

During and after the breast biopsy:

  1. Patient undergoes the biopsy procedure, which may be performed under local anesthesia.
  2. Tissue samples are taken from the suspicious areas of calcification in the breast.
  3. Patient may experience some discomfort or soreness at the biopsy site after the procedure.
  4. Tissue samples are sent to a pathology lab for analysis to determine if the calcifications are benign or malignant.
  5. Patient may receive the biopsy results within a few days to a week.
  6. Depending on the biopsy results, further treatment options may be discussed with the patient, such as surgery, radiation therapy, or hormone therapy.
  7. Patient may undergo follow-up imaging tests to monitor the area of calcification and assess the effectiveness of treatment.

Overall, the patient may experience a mix of emotions such as anxiety, fear, and relief throughout the process of undergoing a breast biopsy and waiting for the results. It is important for healthcare providers to provide support and guidance to help patients navigate through this challenging time.

What to Ask Your Doctor

  1. What is the reason for recommending a breast biopsy in my case?
  2. How many areas of calcification are being biopsied in my breast?
  3. Are the areas of calcification in the same breast similar or different in appearance?
  4. What type of biopsy procedure will be used to biopsy the calcifications?
  5. What are the potential risks and complications of the biopsy procedure?
  6. How long will it take to get the results of the biopsy?
  7. If the biopsy results show different findings in the different areas of calcification, how will this affect my treatment plan?
  8. Will I need additional imaging tests or biopsies based on the results of this biopsy?
  9. What are my options for treatment if the biopsy results show actionable findings?
  10. Can you explain the BI-RADS classification system and how it relates to my case?

Reference

Authors: Bode M, Charlotte Huck L, Raaff V, Hitpass L, Braunschweig T, Nebelung S, Katharina Kuhl C. Journal: Eur J Radiol. 2022 Sep;154:110456. doi: 10.1016/j.ejrad.2022.110456. Epub 2022 Jul 28. PMID: 35914364