Last month, radiologists with Magee-Womens Hospital of UPMC performed the nation’s very first 3-D guided breast biopsy, making it the sole U.S. center to fully complete and provide this kind of sophisticated biopsy procedure for the advantage of its patients. This new system goes hand in hand with the 3-D screening equipment known as breast tomosynthesis that Magee radiologists helped develop.
3-D guided biopsies permit the localization and precise marking of regions of interest using 3-D mammography, which establishes a full reconstruction of the breast, giving radiologists the capability to make out certain abnormalities which can be difficult to identify with conventional screening practices.
The new 3-D biopsy system, which was granted approval by the Food and Drug Administration (FDA), was developed by Hologic, Inc. and has various advantages over conventional stereotactic biopsy procedures, including quicker abrasion targeting, condensed patient procedure time and reduced radiation exposure.
"This biopsy option is especially valuable for women with breast lesions that are hard to reach with standard biopsy procedures, as well as for women with arthritis or other physical issues that make traditional biopsy difficult," said Chief of radiology at Magee, Jules Sumkin, D.O.
A lot of the preliminary 3-D research was carried out at Magee, whose research team is still regarded as the most widely published group in the U.S. in this specific field of technology.
"The ability for us to provide 3-D guided biopsy to our patients represents an exciting new example of our leadership in this area. Magee radiologists continue to play a pivotal role in the development and advancement of this technology,” declared Sumkin.
In conventional-guided biopsies, known as stereotactic biopsies, images are taken at two differing angles of the breast to determine depth of the possible abrasion. The three-dimensional technology has the ability to calculate abrasion depth at higher accuracy rates.
Not all women are in need of a biopsy; but those who do (especially those with hard to detect cancers) will greatly benefit from 3-D guided biopsies.
"If we can do a biopsy with ultrasound guidance, that's preferable. But there is a subset of patients where you can't find it by ultrasound because of body variations,” said Sumkin.
“During a 3-D biopsy a patient sits upright rather than lying on a table. This benefits women who have difficulty lying down due to arthritis or other health complications.”
Other advantages include, shortened procedure time and exposure to radiation is significantly lessened; since stereotactic biopsies call for at least two images be taken, more X-ray doses are required.
“Unlike stereotactic biopsies, which require expensive, standalone machines, 3-D biopsies are performed using a piece of equipment attached directly to tomosynthesis machines, which is a huge cost saving,” added Sumkin.
However, tomosynthesis is still less common than two-dimensional mammography, as Sumkin drew on the reluctance to bring such pricy technology.
"For a hospital to buy this equipment and not be reimbursed for it does not work in this day and age," he said, estimating only about six or seven tomosynthesis machines in Pittsburgh.
By offering women the very latest in mammography and breast biopsy technology, Magee foresees more women regularly screened for breast cancer. Breast cancer is the second-leading cause of cancer related deaths among women, surpassed only by lung cancer. Statistical data shows that one in eight women are likely to be diagnosed with the disease.
The stage at which breast cancer is discovered often plays a crucial role, in a woman’s chances of survival. If identified early, the five-year survival rate sits at a promising 98 percent.
Sumkin also cites Magee has performed 50 to 60 3-D guided breast biopsies.
He remains optimistic for the future of this 3-D technology and expects it to fall into many patients’ insurance plans; for tomosynthesis helps physicians detect and treat fatal cancers early, which in the long run is less costly than treatment at later stages of the process.