A report of the Journal of the American College of Surgeons indicates that an alarming 35 percent of initial diagnostic breast biopsies in the United States are still being done using unnecessary open surgical techniques. This in spite of the fact that it costs as much as three times more than the much less invasive and equally accurate needle biopsy technique.
A panel of leading breast disease specialists unanimously agreed that percutaneous needle biopsy represents "best practice" and should be the "gold standard" for initial diagnosis of breast abnormalities. The recommendations were reached after building clinical evidence since the preceeding Consensus Conferences in 2001 and 2005, yet little progress is being made in reducing the number of open surgical biopsies being performed nationwide.
"In spite of considerable agreement in the medical literature and national recommendations published by industry thought leaders such as the American College of Surgeons and the American Society of Breast Surgeons, there was only a small decrease in the number of surgical biopsies since our last conference four years ago. This slow rate of adoption is appalling considering the overwhelming benefits of needle biopsy versus open surgery for the initial diagnosis of breast cancer," said Melvin Silverstein, medical director of Hoag Breast Care Center. "Considering only 15 to 20 percent of abnormalities found by mammography turn out to be cancer, this means a significant number of women with benign lesions are undergoing unneeded diagnostic surgery when needle biopsy is equally effective for discovering cancer."
The panel's report in the Journal of the American College of Surgeons established comprehensive guidance for the diagnosis and treatment of patients with breast cancer. In addition to establishing best-practices for the method of breast biopsy, the paper describes stronger positions in support of the use of magnetic resonance imaging in diagnosis and preoperative planning, shortened radiology treatments, and the incorporation of oncoplastic techniques into surgical breast cancer practice.
MEDICA.de; Source: Hoag Memorial Hospital Presbyterian