New method at London, Ont., research centre makes breast biopsies easier

A team of radiologists at the Lawson Health Research Institute in London, Ont., have found that a new breast cancer biopsy method may provide more accurate results and comfort for patients. 

Lawson is the first site in North America to offer the streamlined procedure, to patients at the St. Joseph's Breast Care Program. 

The new form of mammography software allows patients to have a biopsy done with the same modality and avoid magnetic resonance imaging (MRI).

"It is a game changer with certainty," said Dr. Anat Kornecki, the breast radiologist lead on the study. "This is now a great added component for patients, which makes it a very good tool." 

The software is a combination of the already existing contrast enhanced mammography (CEM) and mammography guided biopsy technology. It's designed to make the biopsy procedure efficient for both patients and technicians. 

"It's fairly unique, and our study set the ground for this to be accepted as a general standard of care modality," Kornecki said.

CEM works through injecting contrast iodine — a chemical substance used in X-ray imaging — into the veins, which allows radiologists to spot potential cancerous lesions, an area of abnormal tissue, in the breast. If a suspicious lesion is found, a biopsy becomes the next step.

A problem with only using CEM was that detected lesions had to be biopsied through MRIs, which aren't as readily available and lead to longer procedures, sometimes even surgery, without confirmation that a lesion is cancerous or not, Kornecki said. 

"MRIs are not ideal because we have limited resources and because we're not using the same modality to sample the lesion, there may be a chance that we don't see it or we won't be sure that this is the right area."

The study included 50 patients through the St. Joseph's program. Researchers found 51 potentially cancerous lesions and performed successful biopsies on 46 of them. Results found that 11 were breast cancer, 10 were high-risk lesions and the remainder were benign.

To Kornecki's surprise, the reported results from CEM-guided biopsy were similar to MRI gathered biopsies, she said.

"It definitely has the potential to also replace an MRI gathered biopsy, even for lesions initially seen on MRI. Now we have an alternative for these patients," she said. 

Patients feel more comfortable

Kornecki said the method was more convenient for patients compared to MRI because it allows them to have increased mobility during the procedure. 

The aspect of laying on the stomach with the inability to move for at least an hour while the biopsy takes place can make patients feel uneasy, she added. 

"In a positon like this, the nose tends to drip and you don't hear well because you're wearing earplugs, so the feeling can be fairly claustrophobic for all types of patients." 

With CEM-guided biopsies, patients can sit or lay on their sides while still being able to see medical staff and talk with them. 

Tracey Jones is the executive director at Wellspring London, which provides support to cancer patients, their families, and caregivers. She believes this method is exactly what's needed. 

According to Jones, the ability to spot where cancerous lesions potentially are before needing to be more invasive, is a huge step in helping women through the very lonely diagnosis process.

"I think it's an amazing first step to know that 'This is an area we need to check out closer.' The least invasive methods of diagnoses are perfect," she said.

"The barriers are also much less than the process of MRI or surgery because they can take people out, away from working and other life obligations, even if it's for a short time with recovery and length."

Kornecki believes this can open the door for women of different ages to have better health outcomes, and hopes other centres can also CEM-guided biopsies.