Our Summary

This research paper discusses the use of contrast-enhanced breast MR imaging (Magnetic Resonance Imaging) in diagnosing and treating breast cancer. The American Cancer Society recommends this type of imaging for women who are at high risk for breast cancer, in addition to regular mammography screenings. The paper focuses on how this imaging technology can be used for planning biopsies and surgeries, and for monitoring the response to a type of treatment called neoadjuvant chemotherapy. The authors also discuss current procedures that use MR imaging to address both non-cancerous and cancerous breast diseases, including real-time imaging during surgery.

FAQs

  1. Who is recommended to undergo contrast-enhanced breast MR imaging according to the American Cancer Society?
  2. How can contrast-enhanced breast MR imaging be used in planning biopsies and surgeries?
  3. What is the role of MR imaging in monitoring the response to neoadjuvant chemotherapy?

Doctor’s Tip

A doctor might tell a patient undergoing a breast biopsy to avoid taking blood-thinning medications or supplements, as they can increase the risk of bleeding during the procedure. Additionally, they may recommend wearing a supportive bra post-biopsy to reduce discomfort and swelling. It is important to follow any post-biopsy care instructions provided by the doctor to ensure proper healing and recovery.

Suitable For

Patients who are typically recommended for breast biopsy include those with abnormal mammogram findings, such as suspicious masses, calcifications, or architectural distortions. Additionally, patients with a palpable breast lump or nipple discharge may also be recommended for a biopsy. High-risk patients, such as those with a strong family history of breast cancer or genetic mutations like BRCA1 or BRCA2, may also be recommended for a biopsy to assess their risk of developing breast cancer.

In general, any patient with a concerning breast abnormality that cannot be definitively diagnosed through other imaging modalities, such as mammography or ultrasound, may be recommended for a breast biopsy. It is important for patients to follow their healthcare provider’s recommendations for further evaluation if they are advised to undergo a breast biopsy, as early detection and treatment of breast cancer can significantly improve outcomes.

Timeline

Before breast biopsy:

  1. Patient notices a lump or other abnormality in the breast during self-examination or routine screening.
  2. Patient sees a healthcare provider who performs a physical examination and orders imaging tests such as mammography, ultrasound, or MRI.
  3. Imaging tests suggest the presence of a suspicious lesion, prompting the healthcare provider to recommend a biopsy.
  4. Patient consults with a radiologist or breast surgeon to discuss the biopsy procedure and potential risks and benefits.

During and after breast biopsy:

  1. Patient undergoes a biopsy procedure, which may involve a fine needle aspiration, core needle biopsy, or surgical biopsy.
  2. Tissue samples are collected and sent to a pathology lab for analysis to determine if the lesion is benign or malignant.
  3. Patient receives the biopsy results and discusses next steps with their healthcare provider, which may include additional imaging tests, surgical removal of the lesion, or treatment for breast cancer if diagnosed.
  4. If cancer is detected, the patient may undergo further imaging tests, such as contrast-enhanced breast MRI, to assess the extent of the disease and plan for treatment.
  5. Patient may undergo surgery, chemotherapy, radiation therapy, or other treatments based on the biopsy results and imaging findings.
  6. Patient undergoes follow-up imaging and monitoring to evaluate the response to treatment and detect any recurrence of cancer.

What to Ask Your Doctor

  1. What type of biopsy do you recommend for me and why?
  2. How will the biopsy be performed and what can I expect during the procedure?
  3. How long will it take to get the results of the biopsy?
  4. What are the potential risks and complications of the biopsy procedure?
  5. How accurate is the biopsy in diagnosing breast cancer?
  6. Will I need any additional tests or follow-up appointments after the biopsy?
  7. What are my treatment options if the biopsy results are positive for cancer?
  8. How will the biopsy results impact my overall treatment plan?
  9. Are there any lifestyle changes or precautions I should take before or after the biopsy?
  10. Can you explain the role of contrast-enhanced breast MR imaging in my diagnosis and treatment plan?

Reference

Authors: Gombos EC, Jagadeesan J, Richman DM, Kacher DF. Journal: Magn Reson Imaging Clin N Am. 2015 Nov;23(4):547-61. doi: 10.1016/j.mric.2015.05.004. Epub 2015 Jul 8. PMID: 26499274