As recently as the late 1970s, breast biopsy was performed by placing women under general anesthesia and using open surgery to collect a sample for analysis. When cancer was discovered, the protocol was often to perform a radical mastectomy there on the spot. That was a troublesome time, but things are very different now.
Fortunately, advances in medicine, technology and cancer treatment have evolved tremendously over the past decades. “One of the major improvements has to do with new state-of-the-art imaging modalities,” says Women’s Imaging Center Medical Director and Breast Imaging specialist Dr. Amanda Aulls. “Advances like 3D screening mammography for earlier discovery of breast cancer, and image-guided biopsy, which enables quick, minimally-invasive, outpatient sample collection, have completely changed how we discover, diagnose and treat breast cancer.”
When breast self-examination, mammography, breast ultrasound or breast MRI captures a lesion within breast tissue and a biopsy is needed, sophisticated image-guidance is used to direct a specialized needle straight to the area under investigation, where several tissue samples can be quickly collected with minimal invasion and discomfort using only a local anesthetic. There are different types of image-guidance for core needle biopsies, to be chosen on a per-case basis. They include:
Stereotactic biopsy – RAO utilizes advanced 3D mammography to locate the site of an abnormality for precise sample collection.
MRI-guided biopsy – Breast MRI is a radiation-free imaging exam that produces highly detailed images, even within very dense breast tissue.
Ultrasound-guided biopsy – Ultrasound is a painless, radiation-free exam that provides effective guidance to lesions. Its speed and comfort make it one of the most patient-friendly imaging tests in existence.
Unlike decades past, these image-guided biopsy methods don’t require general anesthesia or involve surprise life-altering surgeries. Testing is done on an outpatient basis, so patients go home immediately afterward. Pain is usually manageable with Tylenol or ibuprofen.
What if a lesion is cancerous?
When a collected sample shows signs of cancer, full mastectomy is no longer the only solution – in fact, 65% of women elect to have breast-conserving therapy (BCT), such as lumpectomy or quadrantectomy. Long-term data shows that when combined with appropriate treatment like radiation, survival rates for BCT are comparable to mastectomy, with significantly less physical and emotional trauma and an easier, more body-confident recovery.
Leading the Way with SCOUT
When BCT is the applicable choice, RAO is a local pioneer in the SCOUT® radar localization system, a revolutionary replacement for wire localization. Most radiology practices, both historically and today, mark tumor location using wire markers that lead out through the skin. While they provide important location guidance to surgeons, these protruding wires are unnerving to patients and may be easily dislodged, making it paramount that breast surgery be performed on the same day as wire placement. This often causes scheduling challenges and delays in care. In addition, wires can migrate or be placed in spots that don’t produce the best possible cosmetic outcomes. “While wire localization has offered great benefits, we were delighted when something better came out, and that’s SCOUT,” says Dr. Aulls. “It changed the landscape of breast-conserving therapy.”
SCOUT is a tiny reflector that your RAO radiologist places at the tumor, biopsy or lymph node site instead of a wire, to be located by the surgeon using a specialized detector. This tiny implant is safe, accurate and secure, remaining in place for up to 30 days before surgery, eliminating scheduling delays and promoting the optimal aesthetic outcome.
“I hope knowing that there are safer, better options available will inspire women to be less hesitant about getting routine screening mammograms or having a biopsy when they discover a lump during a self-exam,” says Dr. Aulls. “Caught early, breast cancer is not only survivable, the outcomes can be outstanding.”
If your self-exam or breast imaging exam revealed something requiring further testing, talk to your clinician about image-guided biopsy from RAO’s Women’s Imaging Center today.
