Breast Biopsies and a Woman's Quality of Life

Breast biopsies can have a negative effect on quality of life

(RxWiki News) If a woman is told something doesn’t look right after a mammogram, the doctor is likely to order a biopsy to confirm or dismiss the presence of breast cancer. How does having this procedure affect the woman?

A new study found that breast biopsies negatively impacted a woman’s short-term quality of life.

Younger women were particularly affected by anxiety before and after the procedure and pain during the biopsy.

The authors of this study suggested that counseling before biopsy could help ease the distress around the procedure.

"Ask what you should expect before, during and after any medical test."

Janie M. Lee, MD, MSc, former staff radiologist at Massachusetts General Hospital in Boston and assistant professor at Harvard, and colleagues surveyed women several days after they had a breast biopsy.

Women in this study had undergone what’s known as percutaneous biopsy, which uses a thin needle to extract tiny tissue samples that are evaluated under a microscope to diagnose breast cancer.

Ultrasound machines are used during the procedure to locate the suspicious area and guide the clinician's work.

Percutaneous biopsies are the standard way breast cancer is diagnosed these days, as they are much simpler than surgical biopsies.

While the procedure itself is fairly simple, the short-term side effects can be significant, with emotional distress being the primary one.

Dr. Lee said in a press release announcing the study results, "Short-term experiences can have a long-term impact. If people have a less than positive experience during biopsy, then they might be less likely to come back for screening the next time they are due."

Dr. Lee and colleagues surveyed 188 women aged 22 to 80 two to four days after they had undergone a breast biopsy.

A survey called the “Testing Morbidities Index” (TMI) was used. This tool looks at seven quality of life attributes: pain/discomfort and fear/anxiety before and during the procedure, and physical and mental function afterwards.

These researchers adjusted the one-to-five TMI scale to a 0-100 range, with 0 meaning the worst possible experience and 100 meaning no negative quality-of-life effects.

So, the lower the score, the worse the quality-of-life impact.

Among the entire group, the average TMI score was 82 out of 100.

When these researchers looked more closely at the data, they saw that younger women had worse experiences, with the TMI score decreasing three points for every decade decrease in the woman’s age.

The average TMI score for women under the age of 40 was 76.4 — six points worse than the average score among all the participants.

“Survey respondents reported that the three attributes of diagnostic testing that most influenced their short-term quality of life were anxiety before and during the biopsy and pain during the procedure,” the researchers wrote.

Patrick D. Maguire, MD, a radiation oncologist with Coastal Carolina Radiation and Oncology in Wilmington, NC, and author of When Cancer Hits Home: An Empowered Patient is the Best Weapon Against Cancer, told dailyRx News, ”The results of this study indicating decreased quality of life for patients measured shortly after breast biopsy are certainly consistent with my clinical experience.”

Dr. Lee, who is currently associate professor of radiology at the University of Washington School of Medicine in Seattle and the director of breast imaging at Seattle Cancer Care Alliance, said, "The prospect of life-threatening disease can produce a lot of anxiety in anyone. Younger women typically have less experience with the health care system in general, and it may be their first time going through a diagnostic testing experience."

This study was published in Radiology, the journal of the Radiological Society of North America (RSNA).

The National Institutes of Health supported this research.

One of the authors disclosed having financial activities with three commercial enterprises. No other author reported any potential conflicts of interest.

Review Date: 
November 21, 2013