Surgical Breast Biopsies Are Used Too Often

New studies show that far too many women with abnormal mammograms (about 300,000 female patients in the U.S.) are having surgical open biopsies.

These women should be undergoing needle biopsies instead, which is a much safer andless expensive option. While a needle biopsy uses just a small incision, an open biopsy involves an inch-long incision, stitches and sometimes anesthesia. It also leaves a scar and carries a much higher risk of infection.

A high number of breast biopsies actually turn out benignabout 80 percentwhich means most of these women don t even have cancer. A study found that 30 percent of breast biopsies were done surgically between the years of 2003 and 2008, when according to medical guidelines, the rate should be 10 percent or less. Dr. Melvin J.Silverstein, a breast cancer surgeon at Hoag Memorial Hospital Presbyterian in Newport Beach, California, and a clinical professor of surgery at the University of Southern California, calls this statistic outrageous.

The women on the operating table are not the ones to blame. Researchers believe this problem may be occurring for two reasons: doctors not following medical developments and guidelines, and doctors not wanting to lose money. Needle biopsies are performed by radiologiststhus, a surgeon would have to refer the patient to a radiologist and would not get paid for the needle biopsy. With an open biopsy, the surgeon receives the biopsy fee, which is double that of a needle procedure.

I see it all the time, said the surgeon, Dr. Elisa R. Port, the chief of breast surgery at Mount Sinai Medical Center in Manhattan. People are causing harm and should be held accountable. How can hospitals help put the brakes on this alarming statistic? Dr. Silverstein says hospitals could opt to ban open biopsies unless they are completely necessary, i.e., in cases in which a needle cannot reach the area. If it can be done with a needle, it has to be, he said. Women who are told that they need an open breast biopsy should ask their doctors why this is the case. They should also consider asking for a second opinion.
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