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Breast cancer diagnoses: tissue samples soon avoidable?


Breast cancer: New diagnostic procedure to avoid unnecessary tissue samples
The fear of breast cancer accompanies many women and noticeable breast lumps are a real shock to them. However, breast cancer does not always have to be present in such cases. Today's medical practitioners usually gain clarity by taking a tissue sample (biopsy). In the case of a negative evaluation, an unnecessary invasive intervention, which has not been avoided so far. The Heidelberg University Hospital is now to test whether a special diagnosis using a special ultrasound procedure is possible without a biopsy.

In the international study led by the Heidelberg University Gynecological Clinic, the special ultrasound method of so-called elastography in breast cancer diagnostics is tested. According to information from the Heidelberg University Hospital, women who are advised to take a biopsy can participate. The scientists hope to be able to completely avoid the unnecessary biopsies in the future with the new diagnostic method.

If breast lumps are noticeable, a biopsy is often required to ensure clarity. In the future, researchers hope to use this special ultrasound procedure to make a reliable diagnosis - without invasive intervention. (Image: SENTELLO / fotolia.com)

Distinguish benign changes from malicious ones
"Breast lumps are often discovered in women as part of mammography or an ultrasound examination, which initially cannot be clearly classified as benign or malignant," reports the Heidelberg University Hospital. In these cases, it is advisable to take a tissue sample. The new study is now intended to test "how well tissue abnormalities can be assessed using a special ultrasound procedure, so-called elastography," the university hospital continues. The doctors hope to be able to recognize benign changes as such without a biopsy in the future, thereby sparing the majority of women from unnecessary invasive diagnostics.

Study participants wanted
Researchers from Heidelberg and five other German breast centers as well as clinics in the USA, Japan, France, the Netherlands and Portugal are participating in the study. "A total of 1,000 women should be included in the study," said the Heidelberg University Hospital. The high-end ultrasound device will be made available to all participating centers by Siemens for the duration of the study. Women who want to have a tissue sample taken at the study centers on the advice of the attending doctor to clarify an unclear finding can participate. The referral was usually made by the resident gynecologist.

The reliability of the new process is being tested
In the participating women, the elastography should be carried out once after the routine ultrasound examination before the planned biopsy. According to the researchers, the examination will take around ten minutes and will not cause any pain or health risks. The results of the elastography and tissue examination should then be compared to check the reliability and significance of the ultrasound procedure. All data collected will be treated strictly confidentially and are secured against unauthorized access, the Heidelberg University Hospital continues.

Diagnostics should be significantly improved
There is no personal health benefit for the participating women, since the biopsy will definitely be carried out for them, but "through their willingness to participate in the study, the patients will contribute to significantly improving breast diagnostics in the future for women in a similar situation," emphasizes Head of Private Lecturer Dr. Michael Golatta, senior physician at Heidelberg University Women's Clinic. In addition to mammography, ultrasound examinations have often already been carried out as part of preventive care or clarification. Subsequently, the tissue changes discovered are classified using a standardized assessment system.

Up to 90 percent unnecessary tissue samples
Accordingly, the changes can be divided into five categories, with categories 1 and 2 describing benign changes such as cysts or limescale deposits, and category 5 for clearly identifiable malignant tumors, according to Heidelberg University Hospital. In categories 3 and 4, a tissue sample is advisable for further clarification or is strongly recommended, because in category 4a, for example, the risk that the tissue change detected is malignant is up to ten percent. "It would be too risky not to investigate further. At the same time, it means unnecessary tissue removal for at least 90 percent of women in this category, ”explains Dr. Golatta.

With the help of elastography, the degree of hardening of tissue, which is related to the malignancy of a tissue change, could also be recorded here. "Tumor tissue is harder and therefore less elastic than the surrounding healthy tissue," reports the Heidelberg University Hospital. In order to reduce the high percentage of unnecessary biopsies, "we will establish elastography in breast cancer diagnostics as part of the multicentre study," concludes study leader Golatta. (fp)

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