ASK DR. H: New technique helps study masses

Q: I recently underwent a needle biopsy of my left breast because of a mass that the doctors thought could be cancer. Do you know if there is a better way to tell if a mass is cancer without having to go through a biopsy procedure? 
— A.S., Philadelphia

A: The gold standard for the initial diagnosis of a breast abnormality is still the needle biopsy. That said, there is a new technique known as “elastography” that, when added to a breast ultrasound study, can help distinguish between cancer and benign breast lesions.

Elastography improves upon traditional ultrasonography by measuring the compressibility and mechanical properties of a breast mass. Since malignant breast masses tend to be stiffer than surrounding healthy tissue or cysts, a more compressible mass on elastography is less likely to be cancerous.

As part of an ongoing seven-year study conducted at the Charing Cross Hospital Breast Unit in London, 179 patients underwent breast ultrasound and elastography. The research team obtained 184 elastograms and performed biopsies on all solid lesions. Of 134 biopsies, 56 revealed cancer. Elastography properly identified 98 percent of lesions that had malignant findings on biopsy, and 82 percent of lesions that turned out to be benign. Elastography was also more accurate than ultrasound in gauging the size of the lesions.

Dr. Mitchell Hecht is a physician specializing in internal medicine. Send questions to him at: “Ask Dr. H,” P.O. Box 767787, Roswell, GA 30076. Because of the large volume of mail received, personal replies are not possible.

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