Anxious wait for biopsy results can be reduced

I reported a while ago on research which indicated that the stress of waiting for a breast biopsy result may cause adverse health effects in women. Now  thanks to a very generous donation by a breast cancer survivor, breast cancer patients in Toronto could receive same-day diagnosis and treatment plans that drastically reduces those anxiety-filled waits.

A $12.5-million donation from breast cancer survivor Emmanuelle Gattuso and her husband, broadcasting pioneer Allan Slaight, funded Princess Margaret Hospital’s rapid tissue processor, which accurately reads biopsies in six to eight hours, as well as more pathologists and technicians.

“I think it’s going to make an enormous difference, not only for women, but also their families, for their colleagues and their friends,” said Gattuso, who recovered after her diagnosis in 2003. “They can organize. Once you know what you have to deal with, I think it’s much easier to deal with it, and women have told us that over and over again.”

Dr. David McCready, the Gattuso chair in breast surgical oncology and head of the breast site group at Princess Margaret, came up with the idea for the rapid diagnosis centre after he noticed patients referred to him waited about 37 days for a diagnosis.

“Get a mammogram, come back, get an ultrasound, go back, get the result, get a biopsy, another week or so later get the result, and then a referral,” McCready said. “All of these little steps can take not in itself a very long period of time, a few days, a week, but added up, that wait time can sometimes be very, very difficult.”

The faster diagnosis does not have any impact on treatment or waiting times for chemotherapy or surgery, McCready said. Yesterday, the hospital launched a new fundraising effort to raise a further $12.5 million to expand the centre to 3,000 patients by the last phase of the pilot project in 2013 to 2018.

The steps of rapid diagnosis are:

• Patients arrive at the Rapid Diagnostic Breast Cancer Centre between 8 a.m. and 10 a.m.
• Imaging and a core biopsy are done, with the tissue going into the rapid tissue processor.
• Within hours, a pathologist analyzes the tissues and reports the results in the afternoon.
• Surgical oncology team tells the patient whether the findings are benign or malignant.
• If the tissue is malignant, a treatment plan is offered, such as surgery, radiation and chemotherapy.

Getting a treatment plan at Day 1 or Day 30 probably would not make a huge difference in a woman’s outcome, so policy-makers likely wouldn’t invest in it, said Mike Evans, a Toronto-based family physician.

“This is why this donation is so great,” Evans said, adding it bypasses policy-makers to get the funding and offer a service that is “incredibly important” for anxious patients, and will likely cause other cancer programs across Canada to follow suit.

Source: CBC News