Breast Biopsy Surgery Is Used Too Often

A recent Florida study has found that breast biopsy surgery is being used far too frequently instead of minimally invasive needle biopsies for detection of breast cancer. http://www.ajsfulltextonline.com/article/s0002-9610(10)00611-2/abstract.

Many women will have abnormal mammograms or can physically detect a lump in their breasts at some point in their lives. According to medical guidelines, surgical biopsy of these areas should occur in no more than 10% of all cases. Minimally invasive needle biopsies are the preferred method of investigation in 90% of these cases.

The advantages of needle biopsy are that there is only a tiny incision, with minimal or no scarring, which requires only localized numbing of the area instead of more significant anesthesia. Additionally, needle biopsies are far less expensive than surgical biopsies.

Despite these clear advantages, a recent study published in the American Journal of Surgery based on over 172,000 biopsies demonstrates that Florida doctors are performing surgical biopsies in 30% of these cases. This is 3 times the expected rate based on medical guidelines.

The New York Times has reported, based on interviews with several doctors, that surgeons may be doing surgery because they do not earn a fee if they refer the patient to an anesthesiologist to perform the needle biopsy. http://www.nytimes.com/2011/02/19/health/19cancer.html?_r=1.

The cost of surgery instead of needle biopsy is estimated in the Florida study to have increased medical expenses by more than $37.2 million per year. The individual cost to women who have to accept more serious medical risks associated with anesthesia and surgery and who have to endure potentially significant scarring and breast deformity thereafter, may be even greater.

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