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Elastography vs. biopsy - technique effective

 
 
Reply Sat 2 Dec, 2006 09:46 am
Interesting news re breast cancer screening -
SOURCE


Elastography could displace biopsies
by Shubha Krishnappa - December 2, 2006


An experimental ultrasound technique would enable doctors identify the harmless breast lumps and cancer instantly, without performing biopsy, a small study said.

The technique, called "elastography" that measures how easily breast lumps compress and bounce back, would help doctors tell the difference between harmless and malignant lumps in women's breasts.

In a small study of 80 women, the technique has distinguished harmless lumps from malignant ones with nearly 100 percent accuracy. The ultrasound technique correctly identified 17 out of 17 cancerous tumors, and 105 out of 106 harmless lesions.

The findings were reported at the Radiological Society of North America's annual meeting in Chicago this week.

Jonathan Ophir of the University of Texas Medical School in Houston, who pioneered the technique during the 1990s, described it as an extension of one of the oldest tools in medicine, palpation, in which a doctor presses lightly on the surface of the body to feel the shape and firmness of tissue.

Although, both conventional ultrasound and elastography follow the same track, but elastography goes a step further. Both techniques use echoes from high-frequency sound waves to create pictures of what is going on inside the body.

In traditional ultrasound, a technician puts a hand-held device on the surface of the body that sends high-frequency sound waves into the body. Organs and tissue reflect the sound back as echoes, which are sent to a computer that turns them into a picture.

Likewise, elastography also measures movement. As the doctor moves the hand-held device against the breast, the device collects echoes before and after the compression or movement of the breast tissue. The emerged images clearly and instantly show stiff tissues as dark areas and soft tissues as light areas.

Elastography could be proved as boons to those women who are bound to face that frightening moment of diagnosing a lump in the breast through biopsy. The technique could not only save them from that very moment, but also from waiting for longer duration, cost, discomfort and anxiety of a biopsy.

"There's a lot of anxiety, a lot of stress, a lot of fear involved" with biopsies, said Susan Brown, manager of health education for the Susan G. Komen Breast Cancer Foundation. "And there's the cost of leaving work to make a second appointment. If this can be done instead of a biopsy, there would be a real cost reduction."

In biopsy, doctors remove cells from the breast, sometimes with a needle or a scalpel and examine them under a microscope. Patients pay hefty amount for this diagnose, between $200- $1,000 depending on whether fluid or an entire lump is removed, and wait for days or longer for the results.

On contrary, elastography can tell the difference between cancerous tumors and harmless lumps in minutes. However, the cost of elastography is still ambiguous, but some experts estimate the procedure might run $100 to $200.
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Phoenix32890
 
  1  
Reply Sat 2 Dec, 2006 09:59 am
It sounds wonderful, but I will take a "wait and see" attitude. I think that the procedure needs to have a longer successful track record before one could say, with certainty, that the test is completely effective.

I think that people are unduly frightened by the idea of a breast (and other) biopsy. After all, the only way to know "for sure" is to look at the cells under a microscope.

I have had a breast biopsy that proved to be benign. It really was not that big a deal. I know of another recent case where the doctor did not want to put his patient through a biopsy, and the area did not seem cancerous to palpation. It was, and the person lost valuable time in starting treatment. Evil or Very Mad
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sozobe
 
  1  
Reply Sat 2 Dec, 2006 10:01 am
I do see what Phoenix is saying, but still, interesting and encouraging news!
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ossobuco
 
  1  
Reply Sat 2 Dec, 2006 10:10 am
I might have used the word effective too fast.

I had a tough needle biopsy; they had fit me into the schedule and I had to wait motionless for almost an hour before they even started. Yikes. Anyway, they took 14 plugs and found a teeny cluster of ca cells in the fourteenth. Given that track record, I'd want a biopsy in the future if I would have something suspicious. Still, I can see the use of this technique if the results hold up with larger studies.
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Phoenix32890
 
  1  
Reply Sat 2 Dec, 2006 10:20 am
It also might be utilized as a screening tool, enhancing the the mammogram. In the past I have had suspicious mammograms. The doctor then ordered an ultrasound. The new technique may be more effective than the traditional ultrasound. Ultimately, it could replace the mammogram.
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ossobuco
 
  1  
Reply Sat 2 Dec, 2006 10:28 am
Yes, I'd thought of that, replacing mammograms. There's an apparent price difference, but that might change.
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Noddy24
 
  1  
Reply Sat 2 Dec, 2006 11:13 am
Last August this procedure might have saved me three weeks of worry.

Also, while money shouldn't drive medicine, (and Mr. Noddy and I have excellent medical insurance) the scan would be a cheaper procedure.
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