Study: Surgical Breast Biopsy Numbers Not Excessive After All

Contrary to earlier findings, surgical breast biopsies may not be as overused as previously thought, according to a study in the February issue of the Journal of the American College of Radiology. Surgical breast biopsies are more invasive than needle biopsies, requiring an incision and the use of general anesthesia.

A 2011 study in The American Journal of Surgery suggested that surgery is used for 30 percent of breast biopsies, an excessive number. But lead author David C. Levin, MD, of Thomas Jefferson University Hospital in Philadelphia, Penn., and colleagues took a closer look. They suspected that the reported results may have overstated the percentage of biopsies performed as surgical biopsies. As a result, they sought to more accurately assess the use of needle biopsy compared with surgical biopsy.

They used Medicare Part B databases for 2004 to 2009 and determined trends in use of codes for five different types of breast biopsies, including needle biopsy with imaging, needle biopsy without imaging and surgical biopsy. Using what the authors deemed to be a more appropriate analysis of the biopsy codes, Medicare data indicated that the true surgical breast biopsy figure is somewhere between 2 percent and 18 percent, and probably close to 11 percent.

“In the Medicare population nationwide, it seems the use of surgical biopsy is substantially less than the 30 percent previously alleged,” Levin said. “Given that the recommended rate is ten percent, it seems that surgeons and radiologists are collaborating well and that surgical breast biopsy is not being overused.”