Our Summary

This research paper discusses the use of digital breast tomosynthesis (DBT), a relatively new technology in breast cancer screening, and its comparison to the standard full-field digital mammography (FFDM). While DBT has shown improvements, such as decreased recall rates and increased cancer detection, it has some limitations. For instance, some cancers detected by FFDM may not be diagnosed with DBT-only screening. Also, calcifications, which are important signs of cancer, may appear less suspicious or not visible at all on DBT.

The study suggests that a combination of DBT and FFDM might be the best approach, but this would double the patient’s exposure to radiation. However, the development of a computer algorithm that creates two-dimensional synthesized mammography (SM) views from DBT data may be a solution, as this improves the visibility of calcifications and reduces radiation exposure.

The paper also mentions that the use of DBT has led to the development of DBT-guided biopsy, which may be more successful and quicker than traditional biopsy methods.

However, it also highlights that while DBT has many advantages, it’s important to understand its limitations, particularly in detecting calcifications.

FAQs

  1. What are the advantages and limitations of using digital breast tomosynthesis (DBT) in breast cancer screening?
  2. How does the combination of DBT and full-field digital mammography (FFDM) potentially improve the screening process?
  3. What is the significance and potential benefits of a computer algorithm that creates two-dimensional synthesized mammography (SM) views from DBT data?

Doctor’s Tip

A helpful tip a doctor might tell a patient about breast biopsy is to discuss the use of digital breast tomosynthesis (DBT) as a potential option. DBT has shown improvements in decreasing recall rates and increasing cancer detection compared to standard mammography. However, it’s important to be aware of its limitations, particularly in detecting calcifications. A combination of DBT and full-field digital mammography (FFDM) or the use of a computer algorithm to create synthesized mammography views from DBT data may provide the best approach for accurate diagnosis. Additionally, consider the option of DBT-guided biopsy, which may be more successful and quicker than traditional biopsy methods.

Suitable For

Patients who are typically recommended for breast biopsy include those with suspicious findings on mammograms, such as abnormal masses, calcifications, or distortions in breast tissue. Additionally, patients with a history of breast cancer or a strong family history of the disease may also be recommended for biopsy. Other factors that may increase the likelihood of a recommendation for biopsy include age, breast density, and hormonal factors. Overall, the decision to recommend a breast biopsy is based on the individual patient’s risk factors and the specific characteristics of the suspicious findings on imaging studies.

Timeline

Before a breast biopsy, a patient typically undergoes a screening mammogram, which may show suspicious findings such as a lump or abnormal calcifications. If additional imaging is needed, the patient may undergo a diagnostic mammogram or ultrasound. A biopsy is then recommended if the imaging findings are concerning for cancer.

After the decision to undergo a breast biopsy is made, the patient will likely meet with a radiologist to discuss the procedure and give consent. The biopsy procedure itself involves using a needle or surgical instrument to remove a sample of tissue from the breast for further examination. The patient may experience some discomfort or pain during the procedure, which is usually performed under local anesthesia.

After the biopsy, the tissue sample is sent to a pathologist for analysis. The results are typically available within a few days to a week. If the biopsy shows cancer, the patient will work with their healthcare team to determine the best course of treatment, which may include surgery, radiation therapy, chemotherapy, or hormone therapy.

Overall, the timeline of a breast biopsy involves initial imaging, decision-making, the biopsy procedure, waiting for results, and potential treatment planning. Advances in technology, such as DBT and DBT-guided biopsy, have improved the accuracy and efficiency of breast biopsies, but it is important to be aware of the limitations and considerations when using these technologies.

What to Ask Your Doctor

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

  1. What type of biopsy do you recommend for me and why?
  2. What are the risks and benefits of undergoing a breast biopsy?
  3. How accurate is the biopsy procedure in detecting breast cancer?
  4. Will I need to undergo additional imaging tests before or after the biopsy?
  5. How long will it take to receive the biopsy results?
  6. What are the potential complications associated with a breast biopsy?
  7. Will I experience any pain or discomfort during or after the biopsy procedure?
  8. How should I prepare for the biopsy procedure?
  9. Are there any restrictions on activities or medications before or after the biopsy?
  10. What follow-up care or monitoring will be necessary after the biopsy results are received?
  11. Can you explain the differences between DBT-guided biopsy and traditional biopsy methods?
  12. How will the results of the biopsy impact my overall breast health and treatment plan?

Reference

Authors: Horvat JV, Keating DM, Rodrigues-Duarte H, Morris EA, Mango VL. Journal: Radiographics. 2019 Mar-Apr;39(2):307-318. doi: 10.1148/rg.2019180124. Epub 2019 Jan 25. PMID: 30681901