Navigation Links
Surgeons' unanimous consensus: Needle biopsy is gold standard for breast cancer diagnosis

Newport Beach, Calif. October 5, 2009 A special report published in the October issue of the Journal of the American College of Surgeons indicates that an alarming 35% 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 recently convened at the International Consensus Conference on Image Detected Breast Cancer III and 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. 1,2 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 Dr. Melvin Silverstein, medical director of Hoag Breast Care Center; clinical professor of surgery at the Keck School of Medicine, University of Southern California; and chair of the 2001, 2005 and 2009 Consensus Conferences. "Considering only 15-20% 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."

Last year, approximately 1.7 million women underwent a breast biopsy to have a suspicious lump or imaging abnormality examined.1 During a breast biopsy, a small sample of tissue from the abnormal lesion is removed and sent to a pathologist to be analyzed microscopically to check for breast cancer. The tissue sample can be removed either through an open surgical biopsy or less invasive needle biopsy.

Women who undergo open surgical biopsy are generally put under anesthesia, and a physician creates an incision in the breast through which part of the lump is removed. Because an incision is required, open surgical biopsy carries the risk of infection, complications and scarring. Open biopsy also costs about two to four times more on average than a needle biopsy. During a needle biopsy, women are given local anesthesia, and a thin needle is used to withdraw small cores of tissue from the suspicious area. In some cases, imaging equipment may be used to guide the needle to the right spot. Unlike open surgical biopsy, minimally invasive needle biopsy may result in some bruising, but usually does not leave a scar. Additionally, the risks associated with needle biopsy are significantly less, as is patient recovery time.

"There are very few instances when needle biopsy is so technically difficult to perform due to a lesion's position or other factors, that an open surgical biopsy would be needed as the initial diagnostic procedure," said Dr. Silverstein.

At Hoag Breast Care Center, minimally invasive needle biopsy is the standard of care. In fact, only about one percent of the diagnostic biopsies performed at the center require an open surgical procedure. Needle biopsies provide detailed information about the nature of the breast tumor including biologic markers, histologic tumor grade, and lymphovascular invasion. This information can all be identified in the biopsy sample to aid in therapeutic decision-making before surgical intervention.

"If a lesion is diagnosed to be cancer before operative intervention, the surgeon can more precisely plan the optimal location of the incisions for maximum breast conservation," Dr. Silverstein explains. "With pre-operative planning, more complete and precise removal of the cancer and its margins is more likely, generally sparing patients a second surgery. Additionally, the surgeon can make better use of oncoplastic techniques."

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.


Contact: Carolyn Hawley
Hoag Memorial Hospital Presbyterian

Related medicine news :

1. The California Center for Cardiothoracic Surgery ( Surgeons are Leaders in Lung Cancer Surgery
2. Plastic Surgeons to Discuss Cleavage Rejuvenation, Do-It-Yourself Lasers and Other Hot Topics with the Media
3. Leading Baltimore Plastic Surgeons Join Plastic Surgery Portal Network
4. American Society of Plastic Surgeons hosts 78th annual meeting
5. American Society Of Plastic Surgeons Hosts 78th Annual Meeting
6. Fall Chores Spark Safety Advice From Orthopaedic Surgeons
7. U.S. Faces Shortage of Heart Surgeons
8. Plastic surgeons should be part of disaster relief planning, response
9. Statement from the American College of Surgeons Regarding Growing Democrat Support for Medical Liability Reform to be Included in Health Care Reform
10. Top Newport Beach Plastic Surgeon Appointed President of Orange County Society of Plastic Surgeons
11. Consumers Research Council of America Names Plastic Surgeon Oleh S. Slupchynskyj, M.D. as One of Americas Top Surgeons for the Second Time
Post Your Comments:
(Date:11/25/2015)... ... November 25, 2015 , ... Brillianteen, McGaw YMCA’s ... learning in its 65th Anniversary Brillianteen Revue, scheduled for March 4-6, 2016. Auditions ... 65 years, Brillianteen has been a treasured tradition for numerous families in the ...
(Date:11/25/2015)... ... November 25, 2015 , ... “While riding the bus, ... from Bronx, N.Y. “I thought there had to be a convenient and comfortable way ... , The PROTECTOR enables disabled individuals to safely travel during cold or inclement weather. ...
(Date:11/25/2015)... ... 25, 2015 , ... Castlewood Treatment Center for Eating Disorders, ... as a result of the $20,000 raised at the center’s recent golf ... Club in Eureka, will help individuals who otherwise might not seek treatment for ...
(Date:11/25/2015)... ... November 25, 2015 , ... "When I ... regular bras were incredibly uncomfortable," said an inventor from Bronx, N.Y. "In order ... developed the patent-pending RECOVERY BRA for added comfort and support. The bra is ...
(Date:11/25/2015)... ... November 25, 2015 , ... An unlikely ... resulting in a way for homeless people to have a more dignified and ... new initiative whereby they are repurposing plastic bags into sleeping mats for the ...
Breaking Medicine News(10 mins):
(Date:11/26/2015)... November 26, 2015 ... addition of the  "2016 Future Horizons ... Cell Surface Marker Testing Market: Supplier ... to their offering.  --> ... of the  "2016 Future Horizons and ...
(Date:11/25/2015)... , Nov. 25, 2015  Linden Care, LLC, a ... treatment outcomes for patients suffering from chronic pain, said ... a Temporary Restraining Order (TRO) enjoining Express Scripts from ... companies. --> --> ... of its legal options. --> ...
(Date:11/25/2015)... Kitov Pharma ceuticals ... biopharmaceutical company focused on the development of therapeutic candidates ... announced the closing of its previously announced underwritten public ... each representing 20 ordinary shares of the Company, and ... and warrants were issued in a fixed combination of ...
Breaking Medicine Technology: