Technology to Reduce Breast Biopsies
Hester Hill Schnipper, LICSW, OSW-C Program Manager, Oncology Social Work
OCTOBER 18, 2017
As we all know, annual mammograms and, when appropriate, breast MRIs identify many early breast cancer and have saved many lives. One difficulty is that they also lead to more breast biopsies and (the good news!), many of them are not malignant. I suspect that virtually all women would consider a biopsy, later found to have been unnecessary, a fair price to pay to eliminate the possibility of an early cancer. Looked at, however, from the broader public health perspective and from the vantage point of someone who does experience real difficulties from the surgery, it maybe was a less good bargain.
One of the Holy Grails in breast screening has been the ability to better differentiate cancers from other benign problems. Even better would be a way to distinguish lesions that are never going to become invasive cancer from those that are dangerous. From Science News comes this report from the North American Radio logical Society that is a huge step in that direction:
Machine learning identifies breast lesions likely to become cancer
A machine learning tool can help identify which high-risk breast lesions are likely to become cancerous, according to a new study appearing online in the journal Radiology. Researchers said the technology has the potential to reduce unnecessary surgeries.
High-risk breast lesions are biopsy-diagnosed lesions that carry an increased risk of developing into cancer. Because of that risk, surgical removal is often the preferred treatment option. However, many high-risk lesions do not pose an immediate threat to the patient's life and can be safely monitored with follow-up imaging, sparing patients the costs and complications associated with surgery.
"There are different types of high-risk lesions," said study author and radiologist Manisha Bahl, MD, MPH, from Massachusetts General Hospital (MGH) and Harvard Medical School, both in Boston. "Most institutions recommend surgical excision for high-risk lesions such as atypical ductal hyperplasia, for which the risk of upgrade to cancer is about 20 percent. For other types of high-risk lesions, the risk of upgrade varies quite a bit in the literature, and patient management, including the decision about whether to remove or survey the lesion, varies across practices."