CHICAGO, Nov. 27 (UPI) -- A simple ultrasound test that adds about two minutes to an examination holds the promise of eliminating at least 50 percent of breast-cancer biopsies, researchers said Monday.
In a preliminary study the ultrasound elasticity test found 17 of 17 cancers and correctly identified 105 of 106 other lumps as benign.
"If the use of the ultrasound elasticity test is extended into general treatment, I think we would be able to make at least half the biopsies being preformed for breast cancer unnecessary," said Dr. Richard Barr, professor of radiology at Northeastern Ohio Universities College of Medicine.
Barr told United Press International that the ultrasound device he used in his study, along with new software, makes it possible for the doctor to diagnose at the time of the test if the suspicious lump found on a mammogram is cancer or benign.
In a news briefing held at the 92nd annual Radiological Society of North American in Chicago, Barr explained that the non-invasive ultrasound test is performed in two parts. First the doctor uses standard ultrasound to visualize the lump identified on a screening mammogram. Then the doctor immediately scans the breast again using ultrasound. This time a special software package that highlights certain characteristics of the lump, including how much the lesion moves or stretches, is utilized.
Barr said that if the second scan shows a larger lump with a stringy network pattern, the lesion is likely cancerous. In all, 80 women participated in the study. The women had a total of 123 lumps in their breasts that were evaluated by doctors. "We found 18 lesions that we thought were cancer," Barr said. "It turned out that 17 of them were cancer."
On the other side of the coin, Barr said the ultrasound "elasticity" test ruled out cancer in 105 other lumps. In this study that was performed to determine the accuracy of the device and its associated software developed by Siemens Ultrasound, all the women underwent biopsy.
"We found all the cancers in this group," Barr said. "We had one false positive."
"Right now, I would not, not do a biopsy on a woman who had a negative elasticity test," said Dr. Ellen Mendelson, professor of radiology at Northwestern Memorial Hospital in Chicago. "However, this is very promising and could eliminate the need for a lot of biopsies. It definitely is worth a large, prospective clinical trial."
She told UPI that other manufacturers are working on similar devices.
Barr said that such a trial is being put together at multiple sites. Again all the women in the study will undergo biopsy to see if the predictive values seen in the small trial can be replicated on a larger scale. He predicted it would be a few years before doctors would be willing to use the elasticity test as the final word on whether a biopsy should be performed.
He said that ability to discern differences in the two images is simple. "We don't know why, but the image of the lump gets larger when we apply the "elasticity" software if that lump is a cancer. Similarly, the image of a non-cancerous lesion gets smaller with the elasticity software.
"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," Barr said. "Even though most of these lumps are benign -- which is what we found in our pilot study -- they still cause considerable concern and anxiety in the woman and add to medical resource expenditures," he said. A biopsy can cost from $500 to $1,000, and 75 percent to 80 percent prove to be unneeded, he said.
"This technique could significantly reduce the number of biopsies and increase the confidence of women that a detected lesion is truly benign," he said.
The Radiological Society of North America meeting -- the largest medical meeting in the United States -- is expected to attract more than 62,000 doctors, researchers, engineers and allied healthcare professionals during its weeklong run at Chicago's mammoth McCormick Place Convention Center.
