Researchers affiliated with the National Comprehensive Cancer Network (NCCN) have reported that needle biopsy for the initial evaluation of breast cancer is preferable to surgical biopsy. Compared to surgical biopsy, needle biopsy resulted in a lower incidence of reexcision, reduced number of operations, and shortened time to completion of surgery. These results were presented at the 28th annual San Antonio Breast Cancer Symposium (SABCS).

A breast biopsy is the removal of cells or tissue from the breast. The cells are viewed under a microscope in order to determine whether they are cancerous. The biopsy may involve use of a needle to remove cells or may involve surgery to remove part or all of the area that is suspicious for cancer. Physicians differ in their choice of biopsy procedure; researchers continue to evaluate the possible superiority of one procedure over the other.

The multicenter study recently conducted by the NCCN evaluated 6,282 women who underwent needle biopsy (55%), open surgical biopsy (42%), or other (3%) for the initial evaluation of possible breast cancer. These procedures were performed between 1997 and 2002. Biopsies showed that 16% had stage 0 or ductal carcinoma in situ disease, 46% had stage I disease, and 38% had stage II disease. Most patients (61%) underwent breast-conserving surgery and the rest underwent mastectomy.

Stephen B. Edge, MD, from Roswell Park Cancer Institute in Buffalo, New York, and colleagues conducted the study to test their hypothesis that patients who undergo initial needle biopsy require fewer reexcisions of the breast, lower total number of operations (breast and axilla), and reduced time to complete surgery than those who undergo surgical biopsy.

Of the 3481 women who underwent needle biopsy, 23% had to have a breast reexcision compared with 92% of the 2650 women who underwent surgical biopsy. Patients who underwent a reexcision also required more days to complete surgery compared with those who did not undergo a reexcision (45 vs. 29 days, respectively).

The researchers concluded that “the use of needle biopsy may be a useful quality benchmark for breast cancer care.”

Reference: Edge S, Ottesen R, Lepisto E, et al. Surgical biopsy to diagnose breast cancer adversely affects outcomes of breast cancer care; finding from the National Comprehensive Cancer Network. Proceedings from the 28th annual San Antonio Breast Cancer Symposium. December 2005. Abstract #12.

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