Core Needle Biopsy for Breast Cancer as Effective, Safe as Surgical Biopsy

[Janette]

ROCKVILLE, Md -- December 17, 2009 -- Some methods of minimally invasive biopsy for breast cancer are nearly as accurate as surgical biopsy but have much less risk of harms, according to a report from the Agency for Healthcare Research and Quality (AHRQ).

The report compared traditional surgical biopsies with various types of core needle biopsies and provides important information so that physicians and patients can work together to make the best possible diagnostic choice for each individual patient.

Based on reviews of published scientific evidence to gauge the effectiveness, risk, and impact of core needle biopsies on patients, the report found that certain core needle biopsies could distinguish between malignant and benign lesions approximately as accurately as open surgical biopsy, which is commonly considered the gold standard method of evaluating suspicious lesions. Core needle biopsies have a much lower risk of severe complications than open surgical procedures.

The report also found that women who are initially diagnosed with breast cancer by surgical biopsy are more likely to undergo multiple surgical procedures during treatment than women who are initially diagnosed with breast cancer by core needle biopsy.

The report does not recommend changes to federal policy or to decisions regarding insurance coverage nor does it make clinical recommendations regarding under what circumstances open surgical biopsies or core needle biopsies should be pursued.

"One challenge of providing appropriate care for patients is finding balance between the accuracy of a test or procedure and causing the least harm and burden to patients," said Carolyn M. Clancy, MD, AHRQ, Rockville, Maryland. "This report indicates that core needle biopsy may strike that balance in many instances. Patients should continue to speak to their doctor when making important decisions about testing, and use all available information to make the decision that is right for them."

Open surgical biopsies are highly accurate and while generally considered safe, are surgical procedures that, like all surgeries, carry a small amount of risk. Given that only a fraction of women who undergo breast biopsy procedures are diagnosed with cancer, use of traditional biopsy leads to large numbers of women who do not have cancer undergoing an invasive surgical biopsy.

By contrast, a core needle biopsy is usually performed under local anaesthesia, costs less than open surgical biopsy, consumes fewer resources, and generally is preferred by patients.

The report found that recent technological improvements to core needle biopsy, including stereotactic guidance, ultrasound guidance and vacuum assistance, have improved the method's accuracy.


SOURCE: Agency for Healthcare Research and Quality