Our Summary

This research paper explores how two diagnostic systems, the Breast Imaging-Reporting and Data System (BI-RADS) and the International Academy of Cytology (IAC) Yokohama System, are used together to evaluate and categorize breast lumps. The research was done by looking back at the results of all fine needle aspiration biopsies (a type of test where a small sample of tissue is taken from a lump) of the breast from 2016 to 2020.

The results showed that depending on the category of the lump under each system, the chances of it being cancerous were different. For example, under categories I to V, the chances of cancer varied from 0.6% to 100%.

The study also looked at how well the biopsy test performed when they assumed that category III lumps were either cancerous or non-cancerous. The results showed that the biopsy test was very effective, both in terms of correctly identifying cancer (sensitivity) and correctly identifying non-cancerous lumps (specificity).

The BI-RADS system also performed well in correctly identifying cancer and non-cancerous lumps.

The study concluded that fine needle aspiration biopsy is still a very important test for examining breast lumps. Using both the IAC Yokohama and BI-RADS systems together can help doctors more accurately determine the nature of breast lumps.

FAQs

  1. How are the BI-RADS and IAC Yokohama systems used in evaluating breast lumps?
  2. What were the findings of the study about the effectiveness of fine needle aspiration biopsies in identifying cancerous and non-cancerous lumps?
  3. How does the categorization of a lump under the BI-RADS and IAC Yokohama systems affect the chances of it being cancerous?

Doctor’s Tip

A helpful tip a doctor might tell a patient about breast biopsy is to make sure to follow any pre-biopsy instructions provided, such as avoiding blood-thinning medications or fasting before the procedure. It is also important to inform the doctor about any medications or medical conditions you have, as well as any allergies you may have. After the biopsy, it is normal to experience some soreness or bruising at the biopsy site, but if you experience severe pain, bleeding, or signs of infection, it is important to contact your doctor immediately. Finally, make sure to follow up with your doctor to discuss the results of the biopsy and any further steps that may be needed.

Suitable For

Patients who are typically recommended for a breast biopsy are those who have a breast lump or mass that has been detected through imaging tests such as mammograms, ultrasounds, or MRIs. Other patients who may be recommended for a breast biopsy include those who have nipple discharge, skin changes on the breast, or an abnormal area on a breast exam. Additionally, patients with a personal or family history of breast cancer or certain risk factors for breast cancer may also be recommended for a breast biopsy. Ultimately, the decision to recommend a breast biopsy is made by a healthcare provider based on the individual patient’s specific circumstances and risk factors.

Timeline

  1. Patient notices a breast lump or abnormality during self-examination or routine mammogram.
  2. Patient consults with their healthcare provider who recommends a breast biopsy to further evaluate the lump.
  3. Patient undergoes pre-biopsy imaging tests such as mammogram, ultrasound, or MRI to locate the exact position of the lump.
  4. Patient receives information about the biopsy procedure, risks, and benefits, and gives consent for the procedure.
  5. Patient undergoes the biopsy procedure, which can be done using fine needle aspiration, core needle biopsy, or surgical biopsy.
  6. After the biopsy, the tissue sample is sent to a laboratory for analysis by a pathologist.
  7. Patient may experience minor discomfort, bruising, or swelling at the biopsy site for a few days.
  8. Patient receives the biopsy results from their healthcare provider, which will determine the next steps in treatment or monitoring.
  9. If the biopsy results indicate cancer, the patient may undergo further tests and consultations with oncologists to discuss treatment options such as surgery, chemotherapy, or radiation therapy.
  10. If the biopsy results are non-cancerous, the patient may be advised to continue with regular breast screenings and monitoring.

What to Ask Your Doctor

  1. What type of biopsy do I need and why?
  2. What are the risks associated with the biopsy procedure?
  3. How accurate is the biopsy in determining whether the lump is cancerous?
  4. How long will it take to get the results of the biopsy?
  5. What will happen if the biopsy results come back positive for cancer?
  6. Are there any alternative tests or procedures that could provide more information about the lump?
  7. Will I need any follow-up tests or treatments after the biopsy?
  8. How experienced is the doctor who will be performing the biopsy?
  9. Are there any specific instructions I need to follow before or after the biopsy procedure?
  10. Can I get a second opinion on the biopsy results if I have any concerns or doubts?

Reference

Authors: Sundar PM, Shanmugasundaram S, Nagappan E. Journal: Cytopathology. 2022 Mar;33(2):185-195. doi: 10.1111/cyt.13085. Epub 2021 Dec 22. PMID: 34866246