Breast cancer New imaging techniques can avoid many biopsies

Breast Cancer Diagnostics: How Imaging Procedures Can Avoid Unnecessary Biopsy

Each year, around 35,000 women in Germany are recommended for a breast biopsy to determine whether they have breast cancer. However, only about half of them actually have a malignant tumor. Researchers now report how imaging techniques can avoid unnecessary tissue samples.

The most common malignant tumor in women

According to projections by the Robert Koch Institute in Berlin, around 65,500 women in Germany are diagnosed with breast cancer every year, "writes the German Cancer Aid. Breast cancer is the most common malignant tumor in women. In general, the sooner the tumor is discovered and the more precisely it can be diagnosed, the chances of recovery increase. A research team of the German Cancer Research Center (DKFZ) in Heidelberg has set itself the goal of improving the diagnosis of breast cancer. In a new study they could now prove that many control biopsies could be avoided after a conspicuous mammographic finding.

After conspicuous findings in mammography screening, many women are advised to have a tissue sample taken. But only some of them actually have a malignant tumor. Researchers now report that many of these biopsies could be avoided. (Image: Tyler Olson / fotolia.com)

Early detection of breast cancer

Although women between the ages of 50 and 69 can take part in the breast cancer prevention program free of charge, in some places only about every second goes to mammography screening. Some women are afraid of the examination - it is not completely painless.

But mammography is one of the most important methods for the early detection of breast cancer. According to experts, over 17,000 carcinomas could be detected within a year.

The examination can reveal changes in the tissue.

Special X-ray examination of the breast

As the DKFZ writes in a communication, around 2.8 million women in Germany undergo breast screening each year as part of a mammography screening of this special X-ray examination.

However, the results are not always easy to interpret. Therefore, every twentieth woman participating in the screening must expect a striking finding.

As soon as the suspicion hardens, doctors usually suggest to take a tissue sample (biopsy).

"This affects almost 35,000 women every year, but only about half of them actually have a malignant tumor," said Sebastian Bickelhaupt of the German Cancer Research Center.

Optimize examination of the female breast

The radiologist, together with his colleagues, has therefore set about optimizing diffusion-weighted magnetic resonance imaging (MRI) for the examination of the female breast and combining it with intelligent computer-based image analysis methods.

Diffusion-weighted MRI makes it possible to visualize the movement of water molecules in tissue and observe them with the aid of a computer algorithm. Malignant tumors alter the tissue structure, which affects the movement patterns of the water molecules.

This relationship, in turn, could be used for early detection of breast cancer - without having to remove tissue samples and without stressing the body with contrast agents.

"The aim is to gain a better non-invasive insight into body tissue and thus provide radiologists with additional tissue information for clinical evaluation in addition to the still important standard procedures," says Bickelhaupt.

Reliable statements about malicious changes

The DKFZ scientists now showed in a study that the optimized diffusion-weighted MRI in combination with intelligent image analysis methods actually allows reliable statements about malignant changes in the breast.

For this purpose, they examined a total of 222 women who were to undergo a conspicuous mammographic findings of a biopsy.

Before the tissue sample was taken, the researchers analyzed the breast tissue of the study participants with their newly developed method.

The promising result: the number of false-positive findings was reduced by 70 percent in the study group. Actual malignant changes were detected by the scientists in 60 out of 61 cases.

This corresponds to a hit rate of 98 percent and is comparable to the reliability of MRI methods using contrast agents.

The study results were recently published in the journal "Radiology".

Further studies needed

"We evaluate the recordings with the help of intelligent software developed by us", explained the computer scientist Paul Jäger, who shares with Bickelhaupt the first author of the study.

"This makes the method largely independent of the interpretation by individual physicians." In this way, it can be ensured that the method achieves equally reliable results at different study centers.

In a next step, the method has to prove itself in larger multicentre trials before it can be used routinely in the clinic. The scientists are currently building up the necessary cooperation.

"If our findings are confirmed in future studies, we have an additional diagnostic tool available to further improve the early detection of breast cancer," said Bickelhaupt. (Ad)