Age affects short-term quality of life after breast biopsy

Breast biopsies can adversely affect short-term quality-of-life, and the effects are more pronounced in younger patients, according to a new study published online in the journal Radiology.

More than 500,000 women in the United States have a breast biopsy each year. In the percutaneous method, a physician uses a needle to remove several small samples from the area of interest for pathological analysis. Percutaneous biopsies are associated with fewer complications than the surgical approach, but there are still significant short-term side effects, including pain and emotional distress.

"Short-term experiences can have a long-term impact," said Janie M. Lee, M.D., M.Sc., former staff radiologist at Massachusetts General Hospital (MGH) in Boston and assistant professor at Harvard. "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."

To learn more about the impact of percutaneous biopsy, researchers at MGH surveyed women two to four days after the procedure. They used a tool called the Testing Morbidities Index (TMI), a survey that assesses short-term quality of life based on seven attributes, including pain/discomfort and fear/anxiety before and during the procedure, and physical and mental function afterwards.

The patients rated each characteristic on a scale of one to five, and the final score was adjusted to a scale ranging from 0 for the worst possible experience to 100 for no adverse quality-of-life effects.

The 188 women, ranging in age from 22 to 80 years, had a mean TMI score of 82 out of 100. Patient age was the only significant independent predictor of the TMI score, which decreased by approximately three points for every decade decrease in patient age. The mean TMI score for women less than 40 years old was 76.4.

What is a breast biopsy?

A breast biopsy is a procedure in which part or all of a suspicious breast growth is removed and examined, usually for the presence of cancer. The growth sample is suctioned out through a needle or cut out using a surgical procedure. The sample is then examined and evaluated under a microscope by a pathologist to identify non-cancerous (benign) or cancerous (malignant) tissue.

Words used to refer to the abnormal area or growth before and after diagnosis may include lump, mass, lesion, and tumor.

"The most important result from this study is that women have short-term decreases in quality of life related to breast biopsy," said Dr. Lee, who has since moved to the University of Washington School of Medicine in Seattle, where she is associate professor of radiology, as well as the director of breast imaging at Seattle Cancer Care Alliance. "When we looked at the predictors of quality-of-life score, we found that the strongest predictor is younger age."