Evaluating breast biopsy practice and breast biopsy marker utilisation in the clinical setting

Abstract

Introduction: Breast Screen Australia and Breast Screen Aotearoa guidelines recommend breast biopsy marker (BBM) use in indicated patients. This study aims to evaluate breast biopsy practice and BBM utilisation by modality. Methods: An online survey was disseminated to radiologists who identified 'breast imaging' as their area of practice in the Royal Australian and New Zealand College of Radiologists (RANZCR) customer relationship management system. Survey questions addressed participant demographics and factors relating to BBM use. Results: Most respondents (72%) place between 1 and 4 BBMs per week. Almost all (99%) respondents perform ultrasound-guided biopsy of the breast or axillary nodes, with 85% performing stereotactic or tomosynthesis-guided breast biopsy and 27% performing MRI-guided breast biopsy. BBM utilisation differs by modality, with 97% respondents always placing a BBM post-MRIguided breast biopsy, 50% always placing a BBM post-stereotactic-guided biopsy and 3% always placing a BBM post-ultrasound-guided breast biopsy. Conclusions: Almost all radiologists perform breast biopsy using ultrasound, stereotactic/tomosynthesis or MRI guidance. BBM utilisation varies by modality, with 72% of respondents placing between 1 and 4 clips per week. Reasons for placing or not placing BBM aligned with prior studies. This is the first study to evaluate the number of breast biopsies performed by radiologists on a weekly or monthly basis, providing a useful platform for comparison in the local setting.

Female representation in radiology subspecialty interest groups in Australia and New Zealand

“…In a recent study surveying breast radiologists and trainees in Australasia, 2 of 271 respondents (<1%) identified as non-binary. 45 Although the effect size would have been negligible when reporting the relative proportion of female versus male SIG members, we recognise that our results fail to include a portion of the radiology community.…”

Localisation accuracy with iodine‐125 seed versus wire guidance for breast cancer surgery

“…Other advantages of seed localisation include lower levels of discomfort and stress 12 and improved ease of use by both surgeons and radiologists; 10 however, the seeds are a sealed source of radioactivity and are therefore subject to handling protocols and location tracking between insertion and retrieval. 11 Once the seed is inserted, it remains within the breast and clinically significant movement (arbitrarily defined as a maximum clip-to-lesion distance >10 mm) [13][14][15] is thought to be rare, 11,[13][14][15][16] When performing preoperative localisation of a lesion (without bracketing), the radiologist aims to place the reference point of the localising device within or as close as possible to the lesion or accurately sited marker clip (clip ≤10 mm of lesion site) if the lesion is no longer visible. For ROLLIS, the reference point is the 4.5 mm titanium seed, whereas, for HWL, the reference point is the 2 cm thickened segment of the hook wire (TSHW).…”

“…Other advantages of seed localisation include lower levels of discomfort and stress 12 and improved ease of use by both surgeons and radiologists; 10 however, the seeds are a sealed source of radioactivity and are therefore subject to handling protocols and location tracking between insertion and retrieval. 11 Once the seed is inserted, it remains within the breast and clinically significant movement (arbitrarily defined as a maximum clip‐to‐lesion distance >10 mm) 13 , 14 , 15 is thought to be rare, 11 , 13 , 14 , 15 , 16 having been reported in 1 in 1000 cases by McGhan et al. and in 0 of 48 cases by Alderleistein et al.…”