Quick, accurate, comfortable: Biopsies guided by contrast-enhanced mammography as alternative to using MRIs

The first group in North America is trying mammography—instead of MRIs—to guide biopsies. Researchers at Lawson Health Research Institute in London, Ont., found that new contrast-enhanced mammography (CEM)-guided biopsy technology may be a more accurate and streamlined biopsy procedure compared to MRI-guided biopsy. And it may also be more comfortable for patients. CEM uses contrast iodine that is injected intravenously. It allows radiologists to better identify cancerous lesions. Previously, people who had a lesion identified through CEM would get an ultrasound, and if needed, an MRI-guided biopsy. This is a longer procedure compared to CEM-guided biopsy and may have included a lengthy wait time because of limited MRI availability. “If a lesion is detected only by CEM we usually offer an MRI guided biopsy, but we first need to find the same lesion on an MRI,” said lead author Dr. Anat Kornecki, a Lawson Health Research Institute associate scientist and breast radiologist lead at St. Joseph’s Health Care in London, Ont. “The problem is that it is sometimes hard to find the same lesion and the MRI itself can be uncomfortable for the patient. Also, some lesions that are close to implants or chest walls cannot be reached with MRI guided biopsy.” Read: More breast cancer patients can choose smaller surgery The study involved 50 women (with a total of 51 lesions) who had a biopsy guided by contrast-enhanced mammography. The biopsy was successful for 46 lesions and the procedure took an average of 16.6 minutes. Five lesions were not visualized. All the biopsies had concordant pathology, which showed 25 were benign, 10 were high-risk and 11 were malignant. There was no malignancy detected at follow-up for those lesions that were not visualized or were benign. “These are very similar results that were reported through MRI-guided biopsies, which means that this new method can replace the MRI,” Dr. Kornecki said in a Lawson Health Research Institute press release. Patients reported that the CEM-guided biopsy method was comfortable. “It is a game changer with certainty,” said Dr. Kornecki. “This is now a great added component for patients, which makes it a very good tool.” Two centres in Europe were the first to try the technology, which has been approved by Health Canada. CEM-guided biopsies are currently being offered to patients who had lesions initially located on an MRI but where a biopsy would be difficult due to the location of the lesion. The study was published in the American Journal of Roentgenology. Read: Severe lack of research on cancer in Black communities in Canada: study

Quick, accurate, comfortable: Biopsies guided by contrast-enhanced mammography as alternative to using MRIs

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