Our Summary

This study looked at the differences in breast biopsies before and after the introduction of Digital Breast Tomosynthesis (DBT)-guided biopsy, a newer method to guide breast biopsies. The researchers compared the types of targets biopsied, the results of the biopsies, and the rates of disagreement between what the imaging showed and what the biopsy revealed. They looked at data from a single breast center over a 4-year period, two years before and two years after DBT was implemented.

The study included 1,313 women who had 1,405 breast biopsies. About half of the biopsies were done using the older method, Digital Mammography (DM), and half were done using DBT. The researchers found that the most common target for biopsy in both groups was calcifications, or small calcium deposits in the breast. However, there were significantly more biopsies of architectural distortions (changes in the structure of the breast tissue) in the DBT group compared to the DM group.

The overall rate of finding cancer was similar between the two groups. However, DBT-guided biopsy was more successful in identifying radial sclerosing lesions, a type of benign (non-cancerous) breast condition. The rate of disagreement between the imaging and the biopsy was higher in the DBT group compared to the DM group.

In conclusion, the transition to DBT-guided biopsy resulted in more biopsies of architectural distortions, more identification of radial sclerosing lesions, and a higher rate of disagreement between imaging and biopsy results, but a similar rate of cancer diagnosis.

FAQs

  1. What is the main difference between Digital Mammography (DM) and Digital Breast Tomosynthesis (DBT)-guided biopsy?
  2. Was there a significant difference in the rate of cancer detection between DM and DBT-guided biopsies?
  3. What were the most common targets for biopsy in both the DM and DBT groups?

Doctor’s Tip

A helpful tip a doctor might give a patient about breast biopsy is to discuss with them the differences between Digital Breast Tomosynthesis (DBT) and Digital Mammography (DM) guided biopsies. It’s important for patients to understand that DBT may result in more biopsies of architectural distortions and a higher rate of disagreement between imaging and biopsy results, but it can also be more successful in identifying certain benign breast conditions. Patients should feel comfortable asking their doctor any questions they may have about the biopsy procedure and the imaging techniques being used.

Suitable For

Patients who are typically recommended for breast biopsy include those with suspicious findings on imaging tests such as mammograms or ultrasounds, such as masses, calcifications, or architectural distortions. Additionally, patients with a personal or family history of breast cancer, or those with symptoms such as nipple discharge or changes in breast size or shape may also be recommended for biopsy. It is important for patients to consult with their healthcare provider to determine if a breast biopsy is necessary based on their individual risk factors and imaging results.

Timeline

Before the breast biopsy, a patient may undergo a screening mammogram or other imaging tests that reveal suspicious findings such as a lump, calcifications, or architectural distortions in the breast. The patient may then be referred for a biopsy to obtain a tissue sample for further evaluation.

During the breast biopsy procedure, the patient will typically receive local anesthesia to numb the area, and a small incision will be made to remove tissue samples using a needle or other specialized tool. The tissue samples will be sent to a pathology lab for analysis to determine if the cells are cancerous or benign.

After the breast biopsy, the patient may experience some discomfort, bruising, or swelling at the biopsy site. The pathology results are typically available within a few days to a week, and the patient will meet with their healthcare provider to discuss the findings and determine the next steps in their treatment plan. If cancer is found, further tests and treatments may be recommended, such as surgery, radiation therapy, or chemotherapy.

Overall, the breast biopsy process involves a series of steps from initial imaging to tissue sampling and diagnosis, followed by appropriate treatment and follow-up care based on the results. The introduction of newer technologies like DBT-guided biopsy may offer benefits in terms of targeting specific types of breast abnormalities and improving diagnostic accuracy, but may also present challenges in terms of interpretation and agreement between imaging and biopsy results.

What to Ask Your Doctor

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

  1. What type of biopsy method will be used (e.g. DBT-guided, DM-guided, ultrasound-guided)?
  2. What is the reason for recommending a biopsy in my case?
  3. What specific area of the breast will be targeted for the biopsy?
  4. What are the potential risks and complications associated with the biopsy procedure?
  5. How long will it take to get the results of the biopsy?
  6. What are the chances of the biopsy results showing cancer or a benign condition?
  7. What follow-up care or treatment may be needed depending on the biopsy results?
  8. How experienced is the healthcare provider performing the biopsy procedure?
  9. Are there any alternative imaging methods or biopsy techniques that could be considered?
  10. How often should I have follow-up imaging or monitoring after the biopsy?

Reference

Authors: Rochat CJ, Baird GL, Lourenco AP. Journal: Radiology. 2020 Mar;294(3):518-527. doi: 10.1148/radiol.2019191525. Epub 2020 Jan 21. PMID: 31961261