UB Medical School Offers New Technique That Analyzes Breast Tissue Without Need For Surgery

BUFFALO, N.Y. -- A new technique for analyzing suspicious breast tissue that eliminates the need for a surgical biopsy is now being offered at the UB Breast Diagnostic Center, affiliated with the university¹s national Women¹s Health Initiative clinical trial center in the School of Medicine and Biomedical Sciences.

The UB center is the only facility in Western New York with equipment dedicated to perform the procedure, called stereotactic automated large-core needle biopsy. The procedure is available to the general public, in addition to women enrolled in the Women¹s Health Initiative clinical trial.

Victor Panaro, M.D., UB clinical professor of radiology and nuclear medicine and director of the UB Breast Diagnostic Center, said the new method can provide tissue samples of tiny cancers no larger than a grain of sand without requiring the patient to endure the trauma, time, expense and disfigurement of surgery.

The procedure also eliminates problems associated with previous needle-biopsy methods, including fainting caused by the specter of a large needle and the need for patients to sit upright and still for 2 1/2 hours or more.

Furthermore, the procedure can be done for one-third to one-half the cost of a standard surgical biopsy. The UB Breast Diagnostic Center, housed in 82 Farber Hall on the South (Main Street) Campus, has been open since mid-December. Panaro has performed 22 biopsies to date.

The technique is designed specifically to diagnose nonpalpable lesions that are usually detected by routine mammography. Only about 10-20 percent of abnormal lesions turn out to be cancerous, Panaro said, noting that some 700,000 women each year have to undergo surgery, with its accompanying risks, to get a definitive diagnosis.

Comparison studies have shown the new method to be as accurate as surgical biopsy in determining malignancy of nonpalpable breast cancers, he said. Such tiny cancers are curable in 90 percent of cases when diagnosed at this early stage.

The technology and the machine used to perform this non-surgical needle biopsy -- called the Fisher Mammotest -- was developed in Sweden. The procedure is now offered at major medical centers in the U.S.

To accomplish the biopsy, the patient lies prone on a padded platform equipped with a hole to accommodate the breast. Panaro said lying prone is more comfortable for the patient, decreases failure rate and increases accuracy.

Under compression, the breast is x-rayed from two angles, and the image is digitized and appears on a video screen. The image is enhanced until the abnormal tissue can be pinpointed precisely. The computer calculates horizontal, vertical and depth coordinates of the site to be biopsied and positions the needle at the point of entry.

After the radiologist makes a tiny incision in the skin -- about 1/2 centimeter -- a spring-loaded needle shoots into and out of the tissue in 25/1000 of a second.

"This procedure takes about 45 minutes, rather than all day or overnight in a hospital," said Panaro. "Patients can return to work immediately. The tiny incision heals completely with no scarring." Results of the biopsy are available in 24-48 hours.

"Patient reviews have been uniformly favorable," Panaro said. "There¹s no question they would chose this option over surgery."