Preoperative Needle Biopsy Improves Breast Cancer Treatment

A new study has found that preoperative needle breast biopsies can show results equal to those of traditional open biopsy.

Researchers at the University of Vermont (UVM; Burlington, USA) conducted a study to evaluate diagnostic biopsy methods in 1,135 women who had been diagnosed with breast cancer and treated at hospitals in the state of Vermont between1998 and 2006. To do so, Vermont cancer registries were combined with Medicare data to identify women diagnosed with breast cancer during the study period. Demographics, margin status, surgical evaluation of axillary nodes, and total number of operations were correlated to biopsy method.

The results showed that percutaneous needle biopsy (PNB) was the initial biopsy method in 713 (62.8%) patients, increasing from 48.7% in 1998 to 73.6% between 2004 and 2006. Patients living in urban settings were more likely to receive PNB (70.6%) than patients living in rural areas (57.5%). Patients who had an open biopsy were more likely to have positive margins (37.4%) than those who had a needle biopsy (20.1%). The open biopsy approach also led to more reexcisions (76.4%) for removal of malignant tissue than PNB patients (44%). The study was published in the October 2012 issue of the Journal of the American College of Surgeons.

“The potential impact of PNB on the quality of patient care and health care costs is substantial,” concluded lead author associate professor Ted James, MD, and colleagues of the department of surgery. “Emphasis should be placed on understanding the barriers to the use of preoperative PNB and developing strategies to expand its use in the management of breast cancer.”

An open biopsy procedure typically involves a full surgical incision, and some form of anesthesia. A PNB procedure, on the other hand, allows physicians to locate the breast lesion without actually opening the breast. Instead, imaging techniques are used to guide a needle and extract a sample of the tissue in question. The minimally invasive approach can be performed using a topical anesthetic and can take place in an office setting or radiology suite. There is also less discomfort and a quicker recovery time compared with open surgical biopsies.

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