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Breast imaging software helps identify cancers

Last Updated: 2009-11-30 16:32:11 -0400 (Reuters Health)

December 1, 2009

By Julie Steenhuysen

CHICAGO (Reuters) - A software program that helps determine the stiffness of a breast lump may help some women avoid unnecessary breast biopsies, U.S. researchers said on Monday.

They said the technique called elastography, which is used in tandem with a standard ultrasound, correctly identified 98 percent of cancers in women who had an ultrasound to evaluate a suspicious lump in their breast.

It also correctly ruled out breast cancer in 78 percent of women whose lumps were later found to be harmless, Dr. Stamatia Destounis of Elizabeth Wende Breast Care in Rochester, New York told reporters at the Radiological Society of North America meeting in Chicago.

"The addition of elastography could potentially help decrease the need to perform a biopsy or could reduce the need for additional imaging, thus reducing the anxiety and stress on the patient and also the financial hardship that unnecessary biopsy procedures may cause," Destounis told the meeting.

That might help ease some of the concerns about routine mammography screening, which can result in excess biopsies, especially in women who get regular mammograms starting at age 40.

The U.S. Preventive Services Task Force earlier this month recommended against routine breast mammograms for women in their 40s to spare them from some of the worry and expense of extra tests to distinguish between cancer and harmless lumps. About 80 percent of breast biopsies find harmless or benign lumps.

AVOIDING BIOPSIES

Often, when a mammogram turns up a suspicious spot, women get a breast ultrasound, which uses sound waves to create pictures of internal structures of the breast.

"The problem with ultrasound is that it is very sensitive. It will find it for us, but it is not specific enough. It doesn't tell us if that is a benign lesion or a cancerous lesion," Destounis said.

She said many ultrasound machines have elastography software, which can also measure the stiffness of a breast lump.

"The premise is that a malignant tumor will be stiffer than the surrounding normal breast tissue," Destounis said.

Her team has been studying the effectiveness of elastograms compared to regular ultrasounds. So far, they have studied 193 women aged 18 to 92 with a total of 198 lesions.

They did routine mammograms and compared the size of the tumors with the elastogram images done using ultrasound equipment and elastogram software from Siemens AG. Some 58 breast lesions did not require a biopsy.

Of the 140 biopsies, 59 revealed cancers. When they checked the result with the elastogram prediction, they found it was 98 percent accurate at identifying cancers.

The program was 78 percent accurate at identifying lumps that turned out to be harmless, but in some cases it did suggest a tumor might be dangerous when it was not.

Destounis said imaging companies are refining elastogram software programs to make them even more accurate.

"We believe with much more research, elastography could in the near future impact the decision to not perform a biopsy in some of these benign patients," she said.

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