Pooja Jagmohan | PubMed Health

PubMed2025

Profile of the BREATHE cohort for risk-based breast screening in Singapore.

The BREAst screening Tailored for HEr (BREATHE) study was established to pilot a personalised, risk-based breast cancer screening programme for a multi-ethnic Asian population. Between October 2021 and December 2023, 4592 women aged 35-59 were enrolled (73% response rate). Follow-up from February 2022 to June 2024 included 4112 participants (8.6% loss to follow-up). Data collected encompassed demographics, lifestyle factors, reproductive risks, breast cancer awareness, screening behaviours, programme satisfaction, mammography outcomes (density and recall status), and genotype data. Above-average breast cancer risk increased with age: 2% in women aged 35-39, 31% in 40-49, and 42% in 50-59. Findings suggests that women valued the knowledge of their breast cancer risk and were motivated to attend mammography. The BREATHE study confirms the feasibility and acceptability of a personalised risk-based screening programme in a multi-ethnic Asian population, highlighting the value of tailored protocols to improve early detection and outcomes. Further details are available in the study protocol and online at https://blog.nus.edu.sg/breathe/ .

Humans↗

PubMed2025

Image-guided biopsy of breast lesions-when to use what biopsy technique.

In recent years, minimally invasive diagnostic options for breast lesions have expanded, but consensus on optimal biopsy techniques and imaging combinations remains lacking. This study, driven by an adapted RAND-UCLA Appropriateness Method and insights from eight experts in breast biopsy from across the world, aims to create consensus for selecting biopsy techniques. Highlighted findings suggest Vacuum-Assisted Biopsy (VAB) for lesions visible exclusively at mammography/tomosynthesis (with or without contrast enhancement) or MRI. Core-needle biopsy (CNB) takes precedence for masses over 5 mm visible under US. The selection of other biopsy techniques during US-guided procedures depends on lesion type, size, and sampling indication. VAB is preferred for smaller masses (< 5 mm), complex cystic and solid lesions with small solid parts, small intraductal masses, architectural distortions, and calcifications visible on US. In re-biopsy scenarios for inconclusive findings or high-risk lesions, the panel suggests two VAB extensions: Extended Vacuum-Assisted Biopsy (EVAB) for unambiguous lesion classification and Vacuum-Assisted Excision (VAE) for complete lesion removal. Furthermore, the panel provides detailed input on how to handle specific cases, such as re-biopsy for lobular neoplasia, flat epithelial atypia and atypical ductal hyperplasia. Surgical excision is advised for DCIS and benign or borderline phyllodes tumors found through initial CNB or VAB. In conclusion, an international expert group formulated recommendations on diagnostic breast biopsies under image guidance, aiming to ensure accurate diagnosis worldwide by providing practical advice on needle selection and biopsy approach. KEY POINTS: Evidence-based literature on the preferred biopsy technique and imaging combination for the diagnosis of breast lesions is sparse, and a general consensus is not available. The selection of biopsy technique for different image-guided procedures depends on lesion type, size, and sampling indication. This international expert panel consensus statement addresses standard approaches for varying biopsy indications.

Breast cancer↗