Our Summary

This research paper studies the effectiveness of a method called digital breast tomosynthesis-guided vacuum-assisted breast biopsy (DBT-VAB) in diagnosing breast lesions that cannot be seen on ultrasound. The study analyzed data from 72 women who had this procedure.

The procedure successfully took samples from the target lesions in 99% of the cases and took an average time of 16 minutes to complete. No major complications were reported.

The results showed that 24% of the lesions were cancerous, 4% were at high risk, and 72% were benign (harmless). In 86% of the cases, the pathology results (study of the disease) from the biopsy matched the radiology (imaging) findings, while in 14% of the cases, they didn’t.

However, the procedure missed one cancerous lesion and four complex sclerosing lesions (a benign condition that can look like cancer on a mammogram), resulting in a misdiagnosis rate of 7%.

The conclusion is that DBT-VAB is a quick and safe method to biopsy breast lesions that can’t be seen on ultrasound, and that a biopsy is necessary for suspicious mammographic lesions. However, careful comparison of the pathology and radiology results is essential, and if they don’t match, surgical excision should be performed.

FAQs

  1. What is digital breast tomosynthesis-guided vacuum-assisted breast biopsy (DBT-VAB)?
  2. What is the success rate of DBT-VAB in diagnosing breast lesions?
  3. What should be done if the pathology and radiology results from the biopsy don’t match?

Doctor’s Tip

A helpful tip a doctor might tell a patient about breast biopsy is to follow up closely with your healthcare provider after the procedure to discuss the results and next steps. It’s important to communicate any concerns or questions you may have, and to make sure you understand the recommended course of action based on the biopsy results. Additionally, it’s crucial to attend regular follow-up appointments and screenings to monitor any changes in your breast health.

Suitable For

Patients who are typically recommended for breast biopsy include those with suspicious mammographic findings that cannot be easily assessed with other imaging techniques such as ultrasound. This may include patients with abnormal calcifications, masses, or architectural distortions in the breast tissue.

Additionally, patients with a personal or family history of breast cancer, those with a history of previous breast biopsies showing atypical or high-risk lesions, and those with symptoms such as breast lumps, nipple discharge, or skin changes may also be recommended for a breast biopsy.

Ultimately, the decision to recommend a breast biopsy is based on a combination of factors including the patient’s medical history, physical examination findings, and imaging results. It is important for patients to discuss their individual risk factors and concerns with their healthcare provider to determine the most appropriate course of action.

Timeline

Before the breast biopsy:

  1. Patient undergoes a routine breast cancer screening, such as a mammogram or MRI.
  2. Suspicious lesion is found on the imaging.
  3. Patient may undergo additional imaging tests, such as ultrasound or MRI, to further evaluate the lesion.
  4. Patient consults with a healthcare provider to discuss the need for a biopsy.
  5. Patient schedules the biopsy procedure.

After the breast biopsy:

  1. Patient arrives at the medical facility for the biopsy procedure.
  2. Local anesthesia is administered to numb the area.
  3. Biopsy is performed, either using a needle or a surgical excision to remove the tissue sample.
  4. Patient may experience mild discomfort or pain during or after the procedure.
  5. Tissue sample is sent to a pathology lab for analysis.
  6. Patient receives the pathology results, which will determine if the lesion is cancerous, benign, or at high risk.
  7. Patient may need further treatment, such as surgery or radiation therapy, depending on the biopsy results.
  8. Patient follows up with their healthcare provider for further guidance and monitoring.

What to Ask Your Doctor

  1. What is the reason for recommending a breast biopsy in my case?
  2. Are there any alternative methods to biopsy the suspicious lesion?
  3. What are the potential risks and complications associated with the biopsy procedure?
  4. How long will it take for me to receive the results of the biopsy?
  5. What will the biopsy results tell us about the nature of the breast lesion?
  6. What are the next steps if the biopsy results show cancer or a high-risk lesion?
  7. What is the likelihood of a misdiagnosis with this biopsy method?
  8. Will I need further imaging or follow-up tests after the biopsy?
  9. How experienced are you in performing digital breast tomosynthesis-guided vacuum-assisted breast biopsy?
  10. Are there any specific instructions or restrictions I should follow before and after the biopsy procedure?

Reference

Authors: Senapati GM, Chikarmane SA, Denison CM, Giess CS. Journal: Diagn Interv Radiol. 2022 Mar;28(2):171-178. doi: 10.5152/dir.2022.20830. PMID: 35548902