Ultrasound method could mean fewer breast biopsies for women

CHICAGO — An experimental ultrasound technique that measures how easily breast lumps compress and bounce back could enable doctors to determine instantly whether a woman has cancer — without having to do a biopsy.

In a small study of 80 women, the technique, called "elastography," distinguished harmless lumps from malignant ones with nearly 100 percent accuracy. Cancerous tumors are firmer than benign ones.

If the results hold up in a larger study, elastography could save thousands of women from the waiting, cost, discomfort and anxiety of a biopsy, in which cells are removed from the breast — sometimes with a needle, sometimes with a scalpel — and examined under a microscope.

"There's a lot of anxiety, a lot of stress, a lot of fear involved" with biopsies, said Susan Brown, manager of health education for the Susan G. Komen Breast Cancer Foundation. "And there's the cost of leaving work to make a second appointment. If this can be done instead of a biopsy, there would be a real cost reduction."

Up to 1 million biopsies are performed each year on suspicious breast tissue detected by mammograms and self-exams, but as many as eight out of 10 of these biopsies find that the lumps are benign.

Biopsies can cost $200 to $1,000, depending on whether some fluid or an entire lump is removed, and it can take days or weeks to get the results. The cost of elastography is not yet clear, but some experts said the procedure might run $100 to $200. And it can yield results in minutes.

When checked against biopsies of women's breast tissue, the ultrasound technique correctly identified 17 out of 17 cancerous tumors, and 105 out of 106 harmless lesions. The findings were reported at a national radiology meeting in Chicago this week.

Scientists said the approach may also be used someday to rapidly diagnose damaged hearts and guide the treatment of prostate cancer.

The technique was pioneered during the 1990s at the University of Texas Medical School in Houston by Jonathan Ophir and his colleagues.

Ophir describes elastography as a way to measure and picture the elasticity of body tissue. In effect, it is an extension of one of the oldest tools in medicine, palpation, in which a doctor feels the shape and firmness of body tissue.

To explain elastography, Ophir likens the body to a box-spring mattress, but "a crazy mattress made out of millions of small springs and each one is a little different. Each is moving around at a different rate, depending on their individual stiffness."

Cancerous tumors are like stiff springs. Normal tissue and benign lesions compress more easily.