Our Summary

This study looked at 50 women who had an abnormality show up on a type of breast scan called contrast-enhanced mammography (CEM), but this abnormality couldn’t be seen on other types of scans. The women then had a biopsy - a medical procedure where a small piece of tissue is removed for examination. The biopsy was successful for most of the women, although it couldn’t be done for five of them. On average, the biopsy took about 16.6 minutes. The biopsy results matched what was expected based on the CEM scans: 25 were harmless, 10 were high-risk, and 11 were cancerous. None of the abnormalities that couldn’t be seen on the other scans, or that were harmless, turned out to be cancerous later on.

FAQs

  1. What is the success rate of CEM-guided biopsy based on this study?
  2. What types of results were found in the biopsies performed in this study?
  3. What was the average time taken for a biopsy in this study?

Doctor’s Tip

One helpful tip a doctor may tell a patient about breast biopsy is to follow any pre-procedure instructions provided, such as avoiding blood-thinning medications or wearing comfortable clothing. It is also important to communicate any concerns or questions with the healthcare provider before the procedure to ensure a clear understanding of what to expect. Additionally, it may be helpful to have someone accompany you to the appointment for support. After the biopsy, it is important to follow post-procedure care instructions and keep in touch with the healthcare provider for any follow-up appointments or test results.

Suitable For

Patients who are typically recommended for breast biopsy include those with:

  1. Contrast-enhanced mammography (CEM)-enhancing lesions that lack a sonographic or mammographic correlate
  2. Suspicious or abnormal findings on other imaging modalities such as mammography or ultrasound
  3. Palpable breast lumps or masses
  4. Abnormal nipple discharge
  5. Personal or family history of breast cancer
  6. Previous biopsy showing high-risk or atypical cells
  7. Persistent or unexplained breast pain
  8. History of radiation therapy to the chest
  9. Genetic mutations associated with an increased risk of breast cancer (such as BRCA1 or BRCA2)
  10. Any other concerning symptoms or findings that warrant further investigation.

Timeline

Before breast biopsy:

  1. Patient may notice a suspicious lesion on a contrast-enhanced mammogram that lacks a sonographic or mammographic correlate.
  2. Patient undergoes a CEM-guided biopsy to further evaluate the lesion.
  3. Biopsy is performed to obtain tissue samples for pathology analysis.

After breast biopsy:

  1. Biopsy is technically successful for most lesions, providing a diagnosis.
  2. Biopsy time typically lasts around 16.6 minutes.
  3. Pathology results reveal the nature of the lesion (benign, high-risk, malignant).
  4. Follow-up is conducted to monitor any high-risk or malignant lesions.
  5. Non-visualized or benign lesions do not show malignancy at follow-up, providing reassurance to the patient.

What to Ask Your Doctor

  1. What is the reason for recommending a breast biopsy for this specific lesion?

  2. How will the biopsy be performed and what can I expect during the procedure?

  3. What are the potential risks and complications associated with the breast biopsy?

  4. How long will it take to receive the biopsy results and how will I be informed of the findings?

  5. What are the possible outcomes of the biopsy results, and what further steps may be needed depending on the findings?

  6. Will I need any follow-up imaging or additional tests after the biopsy?

  7. Are there any specific instructions or restrictions I should follow before or after the biopsy procedure?

  8. What is the experience and expertise of the healthcare team performing the biopsy?

  9. Are there any alternative options or procedures that could be considered instead of a biopsy?

  10. How will the biopsy results impact my future breast health and overall treatment plan?

Reference

Authors: Kornecki A, Bhaduri M, Khan N, Nachum IB, Muscedere G, Shmuilovich O, Lynn K, Nano E, Blyth L. Journal: AJR Am J Roentgenol. 2023 Jun;220(6):826-827. doi: 10.2214/AJR.22.28780. Epub 2023 Feb 1. PMID: 36722757