More than one-third of Texas women still receive unnecessary breast biopsy surgery

May 17, 2013

Many women in Texas who are found to have an abnormality on routine mammogram or discover a lump in one of their breasts end up having an old-fashioned surgical biopsy to find out whether the breast abnormality is malignant. Since 2001, national expert panels have recommended that the first course of action for women with breast lumps or masses should be minimally invasive biopsy.

Minimally invasive biopsies are most commonly done under ultrasonographic or X-ray guidance, with either a fine needle or preferably a "core tissue extraction" needle. They do not require surgery or anesthesia and leave little to no scarring. Most importantly, a diagnosis of benign (non-cancerous) or malignant (cancerous) breast mass can be determined before any decisions about treatment are made.

In spite of these benefits, new research from the University of Texas Medical Branch published in the Journal of the American College of Surgeons shows that expensive, invasive surgical breast biopsies remained the first diagnostic step for 35 percent of women diagnosed with a breast mass between 2000 and 2008 in Texas. The investigators performed an exhaustive analysis of Texas Medicare data from 2000 to 2008, including more than 87,000 breast biopsies.

The traditional method of removing the mass through surgery to obtain a definitive diagnosis has a number of negative consequences. If the mass is benign, then the woman had surgery unnecessarily; in fact, only 40 percent of the women studied ended up having breast malignancies. Simply put, thousands of women throughout Texas underwent surgery just to find out they did not have cancer.

On the other hand, if the mass is malignant, more surgery will probably be required to remove more tissue, so the patient will end up having to have multiple surgeries instead of only one. Surgery is far more expensive than needle biopsy, so for the Medicare patients in this study who underwent biopsy surgery, the government had to pay a much steeper tab.

"There is no benefit to the patient in having an expensive, invasive surgical procedure instead of a ," said senior author Dr. Taylor Riall, UTMB associate professor of surgery and a lead investigator for the study. "We need to get the word out to women across the state that is not the procedure of choice for definitive diagnosis of a breast mass."

The American Society of Breast Surgeons, the American College of Radiology and the National Cancer Center Network have all endorsed minimally invasive as providing results that are as accurate as surgical biopsies.

"At UTMB, minimally invasive biopsies are our diagnostic procedure of choice. We do them more than 98 percent of the time," said Riall.

The National Cancer Center Network is trying to find out what barriers stand in the way of reaching a 90 percent rate of minimally invasive nationwide. The study is a step in providing crucial information that will help in the national effort.

Explore further: Surgical breast biopsy not overused, study suggests

Related Stories

Surgical breast biopsy not overused, study suggests

February 1, 2012

Contrary to earlier findings, surgical breast biopsies may not be as overused as previously thought, according to a study in the February issue of the Journal of the American College of Radiology. Surgical breast biopsies ...

Recommended for you

Scientists program robot for 'soft tissue' surgery

May 5, 2016

Not even the surest surgeon's hand is quite as steady and consistent as a robotic arm built of metal and plastic, programmed to perform the same motions over and over. So could it handle the slippery stuff of soft tissues ...

Pig hearts may save human lives: researchers

April 5, 2016

One day, cardiac patients may enjoy a new lease on life with pig hearts beating in their chests, said researchers reporting a major advance Tuesday in cross-species organ transplantation.

Outside the body, a heart beats via life-saving system

September 1, 2015

(Medical Xpress)—A system that enables heart transplants involving hearts that stopped beating in the donor's body continues to save lives. The Organ Care System (OCS) has been used in UK hospitals with good results.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.