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 ...

Longer wait for mammogram after benign breast biopsy may be warranted

May 2, 2013
(HealthDay)—Women who have a breast biopsy that turns out to be benign are typically told to undergo another imaging test, such as a mammogram, in six to 12 months. Now, a new study suggests that the longer interval might ...

Preoperative needle breast biopsies can lead to improved treatment outcomes

October 1, 2012
Chicago: Women suspected of having breast cancer now have more reasons to be diagnosed with a needle biopsy instead of a traditional open surgical biopsy. Besides avoiding the risks and discomfort of an open surgical procedure, ...

Racial disparities still seen in use of breast cancer treatments

December 5, 2012
(HealthDay)—Black women with breast cancer are less likely than their white peers to benefit from improved surgical techniques used to treat their disease, according to a new study.

African American women with breast cancer less likely to have newer, recommended surgical procedure

December 5, 2012
African American women with early stage, invasive breast cancer were 12 percent less likely than Caucasian women with the same diagnosis to receive a minimally invasive technique, axillary sentinel lymph node (SLN) biopsy, ...

Recommended for you

World's first child hand transplant a 'success'

July 19, 2017
The first child in the world to undergo a double hand transplant is now able to write, feed and dress himself, doctors said Tuesday, declaring the ground-breaking operation a success after 18 months.

Knee surgery—have we been doing it wrong?

July 18, 2017
A team of University at Buffalo medical doctors have published a study that challenges a surgical practice used for decades during arthroscopic knee surgery.

New tools help surgeons find liver tumors, not nick blood vessels

July 17, 2017
The liver is a particularly squishy, slippery organ, prone to shifting both deadly tumors and life-preserving blood vessels by inches between the time they're discovered on a CT scan and when the patient is lying on an operating ...

Researchers discover indicator of lung transplant rejection

July 13, 2017
Research by scientists at Dignity Health St. Joseph's Hospital and Medical Center's Norton Thoracic Institute was published in the July 12, 2017 issue of Science Translational Medicine titled "Zbtb7a induction in alveolar ...

New device could make closing surgical incisions a cinch

July 7, 2017
Like many surgeons, Dr. Jason Spector is often faced with the challenge of securely closing the abdominal wall without injuring the intestines. If the process goes awry, there can be serious consequences for patients, including ...

Success with first 20 patients undergoing minimally invasive pancreatic transplant surgery

June 29, 2017
Surgeons at Johns Hopkins Medicine report that their first series of a minimally invasive procedure to treat chronic pancreas disease, known as severe pancreatitis, resulted in shorter hospital stays, less need for opioids ...

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.