Tuesday, July 1, 2014

BREAST CANCER: Surgical Biopsy, Yes or No? and effect on lymph nodes

A medpage OncoBriefs in mid-June included excess surgical biopsies and what caused women to get them. 

According to the article, a large review of cases showed that various characteristics of doctors, including their age and where they trained, can be predictive; as can some patient group factors such as Medicaid.  (Do Medicaid patients have mostly these pro-surgical-biopsy doctors to choose from?)

I learned that the needle biopsy (after having one, I'm still not resigned to calling it a needle) was pronounced a reasonable standard of care back in the nineties, by such august groups as The American College of Surgeons.

Dr. Smith is quoted as saying:  "Still, too often in my practice, I see patients ... after having an excisional biopsy performed for diagnosis, when they obviously could have had a needle biopsy."

On the effect of those biopsies, later in the article Dr. Smith raised the topic that is everywhere I look lately, lymph nodes: '"An open surgical biopsy actually makes lymph node biopsy less accurate -- and lymph node status is the most important factor when making critical decisions about adjuvant therapy."'


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