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Could This Be the End of Breast Biopsy?

December 4th, 2006 Medgadget Editors Oncology

Research presented at the annual meeting of the Radiological Society of North America (RSNA) shows that ultrasound elastography distinguished between harmless breast lumps from malignant ones with 100 percent accuracy!
From from RSNA statement:

“In our work, elasticity imaging has been found to have high specificity,” said Richard G. Barr, M.D., Ph.D., professor of radiology at Northeastern Ohio Universities College of Medicine and radiologist at Southwoods X-Ray and MRI in Youngstown. “If our results can be reproduced in a large, multicenter trial, this technique could significantly reduce the number of breast biopsies required…”
Elasticity imaging is a modification of a routine ultrasound exam. It is like a manual self-exam but much more sensitive. The noninvasive technique works by gauging how much tissue moves when pushed, and it can detect how soft or stiff an object is.
“There are no needles,” Dr. Barr explained. “The patient does not notice any difference from a standard ultrasound.”
Dr. Barr used a real-time, free-hand, elasticity imaging technique in correlation with a routine ultrasound exam to study 166 lesions identified and scheduled for biopsy in 99 patients. Lesions were measured for the largest length on both the standard ultrasound image and the elasticity image. Lesions where the elasticity image was smaller than the standard image were characterized as benign, and lesions where the elasticity image was larger were characterized as malignant. Ultrasound-guided biopsies were performed on 80 patients with 123 lesions. Biopsy showed that elasticity imaging correctly identified all 17 malignant lesions and 105 of 106 benign lesions, for a sensitivity of 100 percent and a specificity of 99 percent.
“Our ability to find lesions in the breast has increased significantly over the last 10 years but at the expense of an increased number of biopsies,” Dr. Barr said. “This technique could significantly reduce the number of biopsies and increase the confidence of women that a detected lesion is truly benign.”
He anticipates that elasticity imaging will also help in detecting cancers, but did not evaluate that capability for this study. Dr. Barr and colleagues are planning to expand their research in an international, multicenter trial beginning in January 2007.

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