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Needle Biopsy for Breast Cancer Diagnosis?

Posted Dec 18 2009 12:00am
In an earlier blog, I very briefly discussed a press release in which a panel of breast disease specialists agreed that needle biopsy should now be considered the 'gold standard' for initial diagnosis of breast cancer.  On December 15, 2009, the U.S. Dept. of Health & Human Services' Agency for Healthcare Research and Quality published a free final report on the effectiveness of core-needle biopsy for initial breast cancer diagnosis.  Some of their findings are listed below.

The sensitivity of open surgical biopsy for detecting breast cancers was estimated to be 98-99%.  In contrast, the sensitivity of core-needle biopsy ranged from 85.8% to 99.2% depending on the specific type of core-needle biopsy.  The higher the sensitivity, the lower the chance of missing a breast cancer.
  • Stereotactically-guided, vacuum assisted = 99.2% sensitivity
  • Stereotactically-guided, automated gun = 97.8% sensitivity
  • Ultrasound-guided, automated gun = 97.7% sensitivity
  • Ultrasound-guided, vacuum assisted = 96.5% sensitivity
  • Freehand, automated gun = 85.8% sensitivity
Core-needle biopsies were reported to have a substantially lower risk of complications compared to open surgical procedures.  A range of 2 - 10% of open surgical procedures were shown have severe complications compared to less than 1% of core-needle biopsies on average.  These complications included:
  • Severe pain during the biopsy - 1.7%
  • Severe bleeding - 0.72%
  • Infection - 0.15%
  • Hematoma - 0.09%
The report goes on to discuss some of the other aspects of core-needle biopsy that might make it worth consideration for some patients.  These included:
  • Core-needle biopsy costs less
  • Core-needle biopsy uses fewer resources
  • Women were generally satisfied with the cosmetic results of needle biopsy
  • Use of needle biopsy as the first invasive diagnostic test resulted in fewer surgical procedures compared to women subjected to an open surgical biopsy.
Some of the numbers above are pretty amazing!  The incidence of complications is dramatically lower with the needle biopsy procedure compared to the open surgical procedure.  Considering that some types of needle biopsy procedures have a sensitivity level similar to that of the open surgical biopsy procedure, the reduced risk of complications make the needle biopsy an important topic to discuss with your physician if he/she is recommending surgery.  Currently, open surgical biopsies are considered the gold standard.  However, only 20 - 30% of women who are subjected to a biopsy are actually diagnosed with breast cancer.  This means that a large number of women are subjected to an unnecessary surgery and the discomfort and potential complications that come with it.  By reading this report, you can learn more about your options and enhance your breast cancer awareness.

Enhancing our awareness of breast cancer is an important step towards reducing our breast cancer risk.  To learn more about some of the things you can do to help reduce your breast cancer risk, visit www.fightBCnow.com to read my book Fight Now: Eat & Live Proactively Against Breast Cancer.
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