Biopsies best at
detecting breast cancer

Some common noninvasive tests for breast cancer aren't accurate enough to routinely replace biopsies, a government review concluded Thursday. Current guidelines recommend that women get a biopsy--removing some suspicious cells or tissue for examination--when a mammogram suggests the possibility of breast cancer.

Yet only about one in five women getting biopsies actually has breast cancer instead of some other condition, usually a benign one. Although biopsies today often can be done using a needle, there is intense interest in finding a noninvasive alternative.

The Agency for Healthcare Research and Quality reviewed four imaging methods already on the market: MRI scans, ultrasound, PET scans, and a type of nuclear medicine test called scintimammography. They're used for various breast-related purposes. MRI scans, for example, sometimes are used to help screen young women's denser breasts, which mammograms don't always penetrate. Ultrasound can distinguish when a lump is a fluid-filled cyst.

But if these tests routinely replaced biopsies, they would miss between 4% and 9% of cancer cases among women at average risk of the disease and possibly more among high-risk women, the agency concluded.

Some studies have shown that lesbians are at a higher risk of breast cancer than their heterosexual peers. (AP, with additional reporting by Advocate.com)