Non-surgical methods can be just as effective in the diagnosis of breast cancer as the option of surgical biopsy, which carries greater risk of harm to the patient, said a new report issued by the Department of Health and Human Services' Agency for Healthcare Research and Quality's (AHRQ) Effective Healthcare program.
First initiated in 2007, the report compared various types of core-needle biopsies--a method in which tissue is removed through a hollow needle inserted into the skin using using stereotactic mammography or ultrasound image guidance--compared with the more commonly utilized open surgical biopsy.
The report is based on scientific studies and reviews of prior published material that weigh the risk of surgical biopsies and measure the impact of core-needle biopsies on patients.
Core needle biopsies can be performed under local anesthesia. In contrast, surgical biopsies--which can be performed under general anesthesia, sedation plus local anesthesia or local anesthesia alone--involves the removal of tissue through a surgical incision and are considered to be highly accurate, said the report.
Despite their accuracy, surgical procedures carry some risk of complications to the patient under any circumstances. Core-needle biopsy is less invasive, more cost-effective and a preferred alternative to surgery, according to the report.
Moreover, the report said that the majority of women undergo invasive surgical biopsies are found to not have cancer.
Women who are initially diagnosed with breast cancer by surgical means have also been proven to more likely undergo multiple surgical procedures throughout the course of their treatment when compared to those diagnosed by way of core needle biopsy.
"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 AHRQ Director Carolyn M. Clancy, MD. "This report indicates that core needle biopsy may strike that balance in many instances.”
The report concluded by stressing that the agency does not advocate changing federal policy regarding insurance coverage, or make any clinical recommendations for either core needle or surgical biopsies, as this is a decision that must be left up to the patient and the physician.