Laurel Soot1, Roshanthi Weerasinghe1, Lian Wang2, Heidi D Nelson3. 1. Providence Cancer Center, Providence Health and Services Oregon, 4805 NE Glisan Street, Portland, OR 97213, USA. 2. Medical Data Research Center, Providence Health and Services Oregon, Portland, OR, USA. 3. Providence Cancer Center, Providence Health and Services Oregon, 4805 NE Glisan Street, Portland, OR 97213, USA; Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA. Electronic address: heidi.nelson@providence.org.
Abstract
BACKGROUND: High rates of surgical breast biopsies in community hospitals have been reported but may misrepresent actual practice. METHODS: Patient-level data from 5,757 women who underwent breast biopsies in a large integrated health system were evaluated to determine biopsy types, rates, indications, and diagnoses. RESULTS: Between 2008 and 2010, 6,047 breast biopsies were performed on 5,757 women. Surgical biopsy was the initial diagnostic procedure in 16% (n = 942) of women overall and in 6% (72 of 1,236) of women with newly diagnosed invasive breast cancer. Invasive breast cancer was diagnosed in 72 women (8%) undergoing surgical biopsy compared with 1,164 (24%) undergoing core needle biopsy (P < .001, age adjusted). Main indications for surgical biopsies included symptomatic abnormalities, technical challenges, and patient choice. CONCLUSIONS: Surgical biopsy was the initial diagnostic procedure in 16% of women with breast abnormalities, comparable with rates at academic centers. Rates could be improved by more careful consideration of indications.
BACKGROUND: High rates of surgical breast biopsies in community hospitals have been reported but may misrepresent actual practice. METHODS:Patient-level data from 5,757 women who underwent breast biopsies in a large integrated health system were evaluated to determine biopsy types, rates, indications, and diagnoses. RESULTS: Between 2008 and 2010, 6,047 breast biopsies were performed on 5,757 women. Surgical biopsy was the initial diagnostic procedure in 16% (n = 942) of women overall and in 6% (72 of 1,236) of women with newly diagnosed invasive breast cancer. Invasive breast cancer was diagnosed in 72 women (8%) undergoing surgical biopsy compared with 1,164 (24%) undergoing core needle biopsy (P < .001, age adjusted). Main indications for surgical biopsies included symptomatic abnormalities, technical challenges, and patient choice. CONCLUSIONS: Surgical biopsy was the initial diagnostic procedure in 16% of women with breast abnormalities, comparable with rates at academic centers. Rates could be improved by more careful consideration of indications.
Authors: Anna N A Tosteson; Qian Yang; Heidi D Nelson; Gary Longton; Samir S Soneji; Margaret Pepe; Berta Geller; Patricia A Carney; Tracy Onega; Kimberly H Allison; Joann G Elmore; Donald L Weaver Journal: Breast Cancer Res Treat Date: 2017-09-06 Impact factor: 4.872