Prebiopsy counseling could improve quality of life

Younger patients experience poorer short-term quality of life in relation to percutaneous breast biopsy procedures, therefore potentially warranting individualized prebiopsy counseling, according to a study published online Nov. 19 in Radiology.

As the incidence of breast cancer continues to rise, diagnostic techniques and treatment methods are constantly being improved. While screening mammography can benefit mortality, false-positive results pose serious health risks to patients. Many times, women who undergo mammography require additional diagnostic evaluation, such as breast biopsies.

“Percutaneous breast biopsies can be associated with pain and emotional distress,” wrote the study’s author, Kathryn L. Humphrey, MD, of Massachusetts General Hospital, and colleagues. “Understanding the factors that contribute to a woman’s diagnostic experience may help direct changes targeted at improving the percutaneous breast biopsy process.”

Humphrey and colleagues thus designed a study to investigate the effects of percutaneous breast biopsy on short-term quality of life. Women undergoing percutaneous breast biopsy in an academic medical center were recruited from December 2007 to February 2010 to participate in a mixed mode survey two to four days post-biopsy.

The Testing Morbidities Index (TMI), which assesses short-term quality of life in relation to diagnostic testing, was used by patients to describe their biopsy experiences. Ranging from zero (worst possible experience) to 100 (no adverse effects), the scale surveys seven attributes: pain or discomfort before and during testing, fear or anxiety before and during testing, embarrassment during testing, and physical and mental function after testing.

Once data analysis was performed, results indicated that the mean TMI score for 188 women was 82. Univariate analysis determined age and race as significant predictors of short-term quality of life related to breast biopsy. Multivariate analysis revealed that only patient age continued to be an independent significant predictor of overall TMI score. TMI scores decreased by about three points for every decrease in decade of patient age.

“Our study’s findings—that younger women undergoing breast biopsy have lower short-term quality of life scores—suggest that tailored prebiopsy counseling may lead to an improved breast biopsy experience,” the study’s authors wrote.

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