Surgical breast biopsy not overused, study suggests

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.

Results from a previous study in 2011 in a surgical journal suggested that surgery is used for 30 percent of breast biopsies, an excessive number. However, in response, the authors of this JACR article thought that the reported results may overstate 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.

The nationwide Medicare Part B databases for 2004 to 2009 were used during the study. Trends in use of codes for five different types of breast biopsies, including needle biopsy with imaging, needle biopsy without imaging and surgical biopsy were determined.

Using a more appropriate analysis of the biopsy codes, Medicare data indicated that the true surgical breast biopsy figure is somewhere between two percent and 18 percent, and probably close to eleven percent.

"In the Medicare population nationwide, it seems the use of surgical biopsy is substantially less than the 30 percent previously alleged," said David C. Levin, MD, lead author of the study.

"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," said Levin.