Patient perceptions of stereotaxic large-core breast biopsy

OBJECTIVE. Thestress experienced bywomen undergoing surveillance mammographyfor benign lesions was compared with that experienced by women undergoing core biopsy of benign lesions. MATERIALSANDMETHODS.Aretrospective survey wasmailed towomen inwhomwere diagnosed breast abnormalities that were likely to be benign and that were stable at short-interval follow-up mammography (n = 174) or in whom a core biopsy of the breast was performed, with benign findings (n = 116). The survey included questions about stress related to the diagnostic experience as well as questions about who advised the women of the results of their breast imaging studies and about the information provided. RESULTS. Eighty eligible surveys werereceived fromthewomen whounderwent shortinterval follow-up mammography, and 58 surveys were received from the women who under went biopsies. The self-reported overall stress experienced by the women who underwent core biopsies was significantly greater (p < .001) than that reported by the group who were fol lowed up with mammography. The level of anxiety was not affected by the patient's percep tion of the probability that the lesion represented carcinoma. We found no significant differences in stress between women who discussed their mammogram results with a radiolo gistandwomenwho were notifiedby theirprimarycareprovider. CONCLUSION. Short-interval follow-up mammography continues tobeacceptable for theevaluationof lesionsthatareprobablybenign,evenwhen patientanxietyis considered.T he widespread use of screening mammography has resulted in the detectionof clinically occult and probably benign lesions in up to 11% of pa tients [ fl. Periodic mammographic surveil lance has been shown to be effective in the management of such abnormalities [1, 2]; however, the increasing availability of breast core biopsy has created controversy about the appropriate role of such biopsies in the evalua tion of these probably benign lesions. Series from the surgical literature have shown posi tive predictive values as low as 8% for core bi opsy [3,4]; authors of these studies have advocated the use of core biopsy instead of surveillance mammography.The suggestion has been made that needle biopsy should be used in lieu of periodic mammography to allay patient anxiety [5,6].Presumably, a definitive and timely diagnosis would entail less stress for the patient than would the uncertainty attending an extended period of surveillance.Becauseno previous empiric studies have focused on the relative stress experienced by women undergoing pe riodic mammographicsurveillanceas com pared with those undergoing immediate core biopsy, we conducted a retrospective, mailed survey to investigate this issue. Materials and MethodsA search of mammography reports from January I, 1994I, , until October 1, 1996, at two institutions yielded 174 women in whom had been diagnosed abnormalities that were probably benign (category lesions under the Breast Imaging Reporting andData System of the AmericanCollege of Radiology [7]) and that were stable at shor...

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“…Mild to moderatelevels of anxiety in women undergoing core biopsy have been reported previously, albeit on prebiopsy ques tioning [9].…”

Section: Discussionmentioning

confidence: 56%

Short-interval follow-up mammography versus immediate core biopsy of benign breast lesions: assessment of patient stress.

Lindfors¹,

O'Connor²,

Acredolo³

et al. 1998

American Journal of Roentgenology

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“…[1][2][3][4][5][6][7][8][9][10] Previous studies have reported high rates of concordance between the histologic findings of core biopsy and surgical biopsy. An exception is atypical ductal hyperplasia (ADH), which is an unreliable core biopsy diagnosis that requires surgical biopsy, 1,8,10 -13 because low-grade ductal carcinoma in situ (DCIS) and ADH may be confused on core biopsy due to the small volume of tissue sampled.…”

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confidence: 99%

Fourteen‐gauge needle core biopsy of mammographically evident radial scars

Cawson¹,

Malara²,

Kavanagh³

et al. 2003

Cancer

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The effect of pH on the precipitation of soy protein between pH 4 and 6.8 was investigated. Precipitation between pH 5.7 and 6.8 gave a binary liquid‐liquid separation in which a protein‐rich secondary liquid phase containing between 20 – 30 wt % protein of 80 – 99% purity in glycinin formed as droplets of 1 – 10 μm. The droplets could be coalesced upon centrifugation to form a homogeneous bottom liquid layer. The high‐protein concentration phase was stable (did not precipitate or crystallize) for up to several months when stored at 4°C. Stable high‐protein liquid phases have not previously been reported. In the pH region for which liquid‐liquid separation occurred (pH 6.15 to 5.35), the droplet‐size distribution was controlled by nucleation and growth. No drop breakage, and little or no drop coalescence was observed. Mixer speed and geometry did not have a large effect on the size of the protein‐rich droplets in suspension. Nucleation occurred in two separate bursts at pH 6.15 and pH 5.85, followed by growth of the new nuclei as pH was decreased. Thus, the drop‐size distribution was monomodal between 6.15 and 5.85, and bimodal between pH 5.85 and 5.35. At pH 5.6 and below, protein precipitated as amorphous material which intertwined with and bound primary particles into aggregates. These agglomerates grew with decreasing pH, particularly below pH 5.35, as more protein precipitated with amorphous material acting as a binder. The addition of NaCl prevented the liquid‐liquid separation at higher pH. Instead solid precipitates of a different morphology were formed at low‐pH only. © 2007 American Institute of Chemical Engineers AIChE J 2007

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“…Although studies have shown a correlation between a patient's lack of understanding of a breast biopsy procedure and higher reported anxiety levels, no interventions have been tested to increase patient understanding and decrease anxiety related to the procedure. 4,5 3) Appropriate timing of procedures.. There are wide variations in the timing of breast biopsies.…”

Section: Significance To Cancer Researchmentioning

confidence: 99%

“…Women experienced less pre-procedure anxiety if they were over 50 years old, married, or had a greater understanding of the core biopsy procedure. Handy et al 4 showed a statistically significant correlation between a patient's lack of understanding regarding the procedure and the patient's expected level of discomfort. Other studies have had similar results.…”

Section: Background and Preliminary Investigations Informed Consentmentioning

confidence: 99%

Education and Outreach for Breast Imaging and Breast Cancer Patients

Farria¹

2002

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Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing this collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington. VA 22202-4302, and During the past year, we obtained IRB approval from the DOD to begin data collection in December, 2001. However, the practice of the Breast Health Center, where the study was planned, had changed. Because randomization of patients according to core biopsy scheduling was no longer, we had a series of meetings with the Breast Health Center and Siteman Cancer Center administrators. At these discussions, we decided to revise the protocol. The revised protocol is submitted. Patients will still be randomized into different groups based on the informed consent process, but the timing of the core biopsy would not be manipulated. We still plan to collect observational data on this variable, however. Currently, we are seeking IRB approval of the revised protocol. Once this protocol is approved by the IRB's of both Washington University and DOD, we can begin data collection. The revision of the protocol has led to significant delays in the second phase of this project.

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Patient perceptions of stereotaxic large-core breast biopsy

Cited by 21 publications

References 5 publications

Short-interval follow-up mammography versus immediate core biopsy of benign breast lesions: assessment of patient stress.

Short-interval follow-up mammography versus immediate core biopsy of benign breast lesions: assessment of patient stress.

Fourteen‐gauge needle core biopsy of mammographically evident radial scars

Education and Outreach for Breast Imaging and Breast Cancer Patients

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