Better Breast Biopsy

April 19, 2006 Breast cancer is the most commonly diagnosed cancer in American women and the second leading cause of death from cancer (lung cancer is the leading cause). This year, the American Cancer Society estimates 212,920 cases of invasive breast cancer will be diagnosed in American women. About 40,970 women will die of the disease. Screening and Diagnosing Breast Cancer The gold standard for breast cancer diagnosis is mammography (an X-ray of the breast). The American Cancer Society recommends that all women have a screening mammogram every year, beginning at 40. If the mammogram detects a suspicious abnormality, a patient may require a more complete mammogram and/or biopsy. A biopsy is the removal of a small sample of the suspect area of tissue for examination in a laboratory. There are several different types of biopsies. In a fine needle biopsy, a thin needle is inserted into the breast lump to remove a few cells or fluid from the suspicious area. A core needle biopsy is a similar procedure, except doctors use a needle with a bigger diameter. With the bigger needle, doctors are able to retrieve small samples of tissue. In needle biopsies, doctors may use imaging techniques, like ultrasound, to precisely locate the target area and ensure accurate insertion of the needle. A biopsy can also be performed surgically (by making a cut into the breast). In an excisional biopsy, the entire mass is removed along with some surrounding healthy tissue. An incisional biopsy removes only a piece of tissue from the target area. Incisional biopsies are rarely used for diagnosis of breast cancer. The technique is often reserved for women with advanced stages of the cancer or those with very large tumors. Researchers estimate about one million breast biopsies are performed each year in the U.S. Only 20 percent of women who need to have a biopsy because of an abnormal mammogram will receive a confirmed diagnosis of cancer. VACORA® Breast Biopsy System Some physicians are using another type of breast biopsy system, called VACORA®. The system uses a needle and a vacuum to cut out and remove the tissue sample. First, doctors use ultrasound to confirm the location of the suspect lesion. A small amount of anesthetic cream is placed on the skin of the breast. Next, a tiny cut (about 4 to 5 mm wide) is made into the skin. Using the same ultrasound techniques for guidance, the physician guides the needle through the opening in the skin to the target mass. As the lesion is cut, the vacuum pulls the tissue section inside the needle. The needle is then withdrawn. The incision site is so small, there is no need for stitches. Patients only require a bandage to cover the cut. Doctors say there is little to no pain associated with the VACORA system. Some patients experience mild bruising and tenderness. Patients are usually able to resume normal activities by the next day. VACORA enables patients to have a biopsy without the need for surgery. It provides larger samples of tissue than standard core needle biopsies (about six to ten times a larger tissue sample). With more tissue to review, pathologists are more likely to obtain an accurate result. Doctors using the system can use ultrasound, stereotactic X-rays or MRI to guide the placement of the needle. Researchers say about 400 of the VACORA systems are being used in the U.S. For more information, log on to the companys website at http://www.bardbiopsy.com. AUDIENCE INQUIRY For information on VACORA®, http://www.bardbiopsy.com For general information on breast biopsy and breast cancer: American Cancer Society, http://www.cancer.org, or contact your local chapter The Susan B. Komen Breast Cancer Foundation, http://www.komen.org National Cancer Institute, http://www.cancer.gov Y-ME National Breast Cancer Organization™, http://www.y-me.org BIBLIOGRAPHY Berg, Wendie, M.D., Ph.D., "Image-guided Breast Biopsy and Management of High-risk Lesions," Radiology Clinics of North America, September 2004, Vol. 42, No. 5, pp. 935-946. "Biopsies Beat Noninvasive Tests in Determining Which Breast Abnormalities are Cancer," Dallas: The Susan B. Komen Breast Cancer Foundation, downloaded from website (http://www.komen.org), March 15, 2006. "Biopsy," Dallas: The Susan B. Komen Breast Cancer Foundation, downloaded from website (http://www.komen.org), March 15, 2006. Bonifacino, A., et al., "Accuracy Rates of US-guided Vacuum-assisted Breast Biopsy," Anticancer Research, May-June 2005, Vol. 25, No. 3c, pp. 2465-2470. "Breast Cancer," Atlanta: American Cancer Society, downloaded from website (http://www.cancer.org), March 15, 2006. 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Lehman, Constance, et al., "Clinical Experience with MRI-guided Vacuum-assisted Breast Biopsy," AJR: American Journal of Roentgenology, June 2005, Vol. 184, No. 6, pp. 1782-1787. Lomoschitz, Friedrich, M.D., et al., "Stereotactic 11-Gauge Vacuum-assisted Breast Biopsy," Radiology, September 2004, Vol. 232, No. 3, pp. 897-903. Masood, S., "Core Needle Biopsy Versus Fine Needle Aspiration Biopsy," Clinics in Laboratory Medicine, December 2005, Vol. 25, No. 4, pp. 679-688. Mendez, Angela, M.D., et al., "Evaluation of Breast Imaging Reporting and Data System Category 3 Mammograms and the Use of Stereotactic Vacuum-assisted Breast Biopsy in a Nonacademic Community Practice," Cancer, February 15, 2005, Vol. 100, No. 4, pp. 710-714. "Needle Biopsy or Aspiration," Chicago: Y-ME National Breast Cancer Organization™, downloaded from website (http://www.y-me.org), March 15, 2006. Research compiled and edited by Barbara J. Fister