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London, Ont. researchers offer new breast cancer biopsy method that’s easier on patients

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

According to the study published by Lawson researchers, the new form of mammography software allows patients to have a biopsy done in a more comfortable manner, avoiding the extended use of magnetic resonance imaging or MRIs.

The procedure combines contrast-enhanced mammography or CEM with mammography-guided biopsy technology. It was designed not only to make the biopsy procedure more streamlined and accurate, but also easier for patients and technicians.

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“It is a significant breakthrough,” said Dr. Anat Kornecki, Lawson associate scientist and breast radiologist lead at St. Joseph’s Health Care London.

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CEM is a relatively new form of mammography that works through injecting a chemical substance known as contrast iodine, which is used in X-ray imaging, into the patient’s veins in order for radiologists to spot potential cancerous lesions, or abnormal tissues, in the breast more effectively. If a suspicious lesion is found, then a biopsy is often the next step.

However, Kornecki said that the problem with using only CEM was that detected lesions were usually biopsied with an MRI, which meant working with limited availability as MRIs are not as readily available which could lead to longer procedures.

“The problem is that it is sometimes hard to find the same lesion and the MRI itself can be uncomfortable for the patient,” she said. “Also, some lesions that are close to implants or chest walls cannot be reached with MRI-guided biopsy.

“We needed to be very creative in finding solutions to prove that there is a cancer or to sometimes exclude the possibility of cancer. … Now we can offer them a biopsy more easily and don’t need to wait too long for an MRI appointment to be open,” Kornecki said.

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Lawson is the first in North America to trial CEM-guided biopsies by using new technology created by GE HeathCare. This new software means that patients can have the biopsy done with the exact same modality, avoiding the need for an MRI, according to Kornecki.

“This is a truly game changer to the entire country.”

In testing the procedure, a local study included 50 patients through St. Joseph’s Breast Care Program. According to the research team, 51 potentially cancerous breast lesions were found and biopsies were successfully performed for 46 of them. The results showed that 11 were breast cancer, 10 were high-risk lesions, and the remaining were benign.

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“While the results are comparable to what we see with MRI guided biopsy, it’s shorter time and definitely more convenient procedure to the patient,” said Kornecki, adding that the inability to move for at least an hour while laying on your stomach during a biopsy can make patients feel uncomfortable.

CEM-guided biopsies allow patients to sit or to lay on their sides while still having some mobility and converse with medical staff, Kornecki said.

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She added that patients, especially those who’ve had traditional biopsies in the past, also reported having a more comfortable experience with the CEM-guided biopsy method.

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While the procedure is currently only being used as a diagnostic tool only, she hopes that CEM-guided biopsies will eventually be approved as an initial breast cancer screening tool.

“It was not easy during the pandemic because we were only allowed to offer this to women who would 100 per cent benefit from it,” she said. “But I can tell you that more women would benefit from this, and we are now using it in a clinical setting and on a daily basis so we can see how many more women actually can benefit from that.”

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