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Breast Biopsy Utilization
A Population-Based Study
Karthik Ghosh, MD, MS;
L. Joseph Melton III, MD;
Vera J. Suman, PhD;
Clive S. Grant, MD;
Sylvester Sterioff, MD;
Kathy R. Brandt, MD;
Charles Branch, MD;
Thomas A. Sellers, PhD;
Lynn C. Hartmann, MD
Arch Intern Med. 2005;165:1593-1598.
Background Breast biopsy, to determine the nature of a clinical or radiographic breast abnormality, was presumed to have increased in frequency with the widespread use of screening mammography. However, scant data exist regarding the utilization of breast biopsies in the community population.
Methods Through the resources of the Rochester Epidemiology Project, the medical records of women 18 years and older who had a breast biopsy from January 1, 1988, through December 31, 1999, were reviewed for the type of biopsy, presentation at biopsy, and tissue pathological findings. The overall and age-specific utilization rates of breast biopsies were assessed, as were changes in the breast biopsy technique after the introduction of image-guided core-needle biopsy in 1992.
Results The overall annual utilization rate of breast biopsies was 62.6 per 10 000 women per year and remained stable throughout the study. Excisional breast biopsies showed a decreasing trend and core-needle biopsies increased during the study duration. The age-adjusted incidence of benign results of breast biopsies for the study duration was 38.9 per 10 000 women. The benign-malignant ratio remained constant despite changes in the biopsy procedure.
Conclusions This population-based study provides much-needed data regarding the frequency of breast biopsies and benign results of breast biopsies in a community population. The utilization rate of breast biopsies remained fairly constant throughout the study period despite the introduction of the image-guided, core-needle biopsy procedure in 1992. A multidisciplinary breast practice, along with established guidelines for breast biopsy, can ensure appropriate use of new technology and thereby improve patient care.
Author Affiliations: Division of General Internal Medicine, Department of Internal Medicine (Dr Ghosh), Division of Epidemiology (Dr Melton), Cancer Center Statistics, Department of Health Sciences Research (Dr Suman), Department of Surgery (Drs Grant and Sterioff), Department of Radiology (Dr Brandt), and Division of Medical Oncology, Department of Oncology (Dr Hartmann), Mayo Clinic, Rochester, Minn; Department of Surgery, Olmsted Medical Center, Rochester (Dr Branch); and H. Lee Moffitt Cancer Center & Research Institute, Tampa, Fla (Dr Sellers).
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