For many women, a mammogram often shows the first sign or sight of breast cancer. Once suspected, a biopsy is needed.
Over the last dozen or so years more than 70 percent of the patients diagnosed with breast cancer in Vermont were diagnosed with a less invasive method -- a needle biopsy -- rather than traditional open surgery.
"So the needle biopsy is a far superior way of getting a diagnosis simply because it's less invasive and can be done in the convenience of an office setting rather than having to go through surgery, with anesthesia and everything that goes along with surgery," said UVM-FAHC Surgical Oncologist Dr. Ted James.
But now there's even more reason to use that method -- improved treatment outcomes. Dr. James and his colleagues analyzed data from more than 1,100 breast cancer patients treated at hospitals in Vermont between 1998 and 2006. The results showed the likelihood of additional surgery to be significantly higher for those diagnosed with the open method versus the needle method. Just 44 percent who had the surgical procedure got by with one operation, compared to 76 percent who had a needle biopsy.
"The take home from this is, cancer should be diagnosed in the office not the operating room," Dr. James said.
But why -- why does the surgical biopsy mean a greater chance for cancer cells being left behind -- and more surgery? "When you're going in for an open biopsy, you don't really have a diagnosis and you're doing a diagnostic procedure. You're going to remove some tissue, enough to make a diagnosis but not necessarily to treat anything. So surgeons tend not to give as wide or not pay attention to margins," Dr. James said.
The open biopsy is sometimes needed, but even when it's not, about 30 percent of all biopsies are still done that way.
"My guess is that it has something to do with resources, and certainly I think the next steps here are for us to investigate what the potential barriers are so that we can expand the use of this technique and improve the quality of care of our patients," Dr. James said.
Improve their care, while cutting costs through less surgery and fewer re-admissions to the hospital.
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