Research raises hopes of avoiding biopsies on benign breast tumours

Published on Saturday 29 November 2008 18:51

SCIENTISTS may have found a way of analysing breast lumps that could reduce the number of biopsies on benign tumours, it emerged yesterday.

A review of almost 2,600 breast MRI exams carried out during a four-year period at the Seattle Cancer Care Alliance found three factors which, when used together, could predict the likelihood of whether lumps were malignant.

Researchers led by Professor Wendy DeMartini believe they could have found a way to overcome problems faced by doctors analysing the results of MRI examinations.

Cancerous and non-cancerous lumps often look alike and behave similarly when further tests are done. A biopsy is often necessary to determine whether a lesion is cancerous.

The procedures can be emotionally traumatic for women when mammograms reveal a suspected breast tumour. About three-quarters of patients who undergo biopsies find they do not have breast cancer.

In a biopsy a needle is inserted into the breast lump and a sample removed which is taken for analysis. In some cases, a more invasive procedure has to be carried out when a patient undergoes a surgical biopsy, which involves the surgeon attempting to completely remove the area of concern, often along with a surrounding margin of normal breast tissue.

The researchers found three characteristics that, when taken together, were an effective way of predicting malignancy that could remove the need for such a biopsy.

They were the reason that the woman was having a breast MRI, the size of the lump or lesion, and the pattern observed when dye is injected to the area of concern. Dye is often injected to the breast during an MRI in an attempt to determine if the lump is cancerous.

Most likely to be benign were lumps found in women – who were being screened because they are considered to be at high risk for developing cancer – that were found to be small and their dye enhancement increased over time.

"In lesions which had those three characteristics, the likelihood of malignancy was 1%," said DeMartini.

"This is so close to zero that rather than doing a biopsy we could instead follow the patient by doing another MRI in a few months, or we may not need to do any additional testing."

Nearly one in three cases of cancers in women is breast cancer. Nearly 46,000 women are diagnosed with the disease each year in the UK and more than 1,000 British women die from it every month.

In Scotland, there are 3,500 new breast cancer cases diagnosed every year.

DeMartini warned that more research is needed before this statistical model can be used as standard practice.

Her views were presented in a paper at the annual meeting of the Radiological Society of North America.