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 or not – 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.
Up to 1 million biopsies are performed each year on suspicious breast tissue detected by mammograms and self-exams, but as many as eight in 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 of 17 cancerous tumors, and 105 of 106 harmless lesions.
The technique was pioneered in the 1990s at the University of Texas Medical School at Houston by Jonathan Ophir and his colleagues.
To explain elastography, Ophir likens the body to a box-spring mattress: “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.
Both traditional ultrasound and elastography use echoes from high-frequency sound waves to create pictures of what is going on inside the body, but elastography goes a step further.
In traditional ultrasound, a doctor or technician places a handheld device on the skin that sends high-frequency sound waves into the body. Organs and tissue reflect the sound back as echoes, which are sent to a computer that turns them into a picture. Many people have seen ultrasound images of fetuses in the womb.
Elastography, though, also gauges movement. As the doctor moves the handheld device against the breast, the device collects echoes before and after the compression or movement of the breast tissue.
The resulting images show stiff tissues as dark areas and soft tissues as light areas.
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