A comprehensive study of health care data from Florida shows that physicians are using surgical biopsy to investigate suspicious breast lesions much more often than is warranted, researchers reported in a study published online February 8 in the American Journal of Surgery. Medical guidelines recommend that in most cases doctors use a needle biopsy rather than more invasive open surgical biopsy to investigate suspicious lesions found during breast imaging exams such as mammography.
Dr. Stephen Grobmyer and his colleagues at the University of Florida examined records from the Florida Agency for Health Care Administration outpatient surgery and procedure database. Although the percentage of patients in Florida who had minimally invasive breast biopsy (MIBB), also known as percutaneous needle biopsy, increased over the 5-year study period (2003 to 2008), the rate of open surgical biopsy in 2008 was still around 30 percent. That rate was substantially higher than the 5 to 10 percent that a 2009 consensus panel suggested as an appropriate rate of open biopsy, the study authors noted. The use of MIBB was higher at academic medical centers than at nonacademic centers.
MIBB causes less scarring and fewer complications, such as infection and bruising, and is less expensive than open surgical biopsy. Most biopsied breast lesions turn out to be benign. And because MIBB is highly accurate, the authors noted, in most cases having a needle biopsy can prevent the need for a patient to have an open surgical biopsy procedure.
“These findings suggest the need for further efforts to educate practitioners and patients about the numerous advantages of MIBB for the evaluation of suspicious image-detected breast lesions,” the authors wrote. “Achieving a reduction in the rate of open surgical biopsy should remain a priority.”
NCI Cancer Bulletin for March 8, 2011 - National Cancer Institute
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