Rates and indications for surgical breast biopsies in a community-based health system
Laurel Soot1, Roshanthi Weerasinghe1, Lian Wang2
1Providence Cancer Center, Providence Health and Services Oregon, 4805 NE Glisan Street, Portland, OR 97213, USA.
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.
