Needle Biopsy Underused in Patients With Breast Cancer
Factors associated with surgeon consultation before biopsy, receipt of biopsy identified
MONDAY, June 9, 2014 (HealthDay News) -- Needle biopsy appears to be underused in patients with breast cancer, according to a study published online June 9 in the Journal of Clinical Oncology.
Jan M. Eberth, Ph.D., from the Arnold School of Public Health at the University of South Carolina in Columbia, and colleagues analyzed nationwide Medicare data for 89,712 patients with breast cancer and 12,405 surgeons. They investigated the contribution of the patient's surgeon on needle biopsy use and the downstream impact of needle biopsy on breast cancer care.
The researchers found that needle biopsy was used in 68.4 percent of patients, and 53.7 percent of patients had a consultation with a surgeon before biopsy. Medicaid coverage, rural residence, residence more than 8.1 miles from a radiologic facility performing needle biopsy, and no mammogram within 60 days before consultation were patient factors associated with surgeon consultation before biopsy. For patients with pre-biopsy surgeon consultation, absence of board certification, training outside the United States, low case volume, earlier decade of medical school graduation, and lack of specialization in surgical oncology were surgeon factors that were negatively associated with needle biopsy receipt. The risk of multiple cancer surgeries was 33.7 and 69.6 percent, respectively, for patients undergoing needle biopsy versus no biopsy (adjusted relative risk, 2.08).
"Needle biopsy is underused in the United States, resulting in a negative impact on breast cancer diagnosis and treatment," the authors write. "Surgeon-level interventions may improve needle biopsy rates and, accordingly, quality of care."
Several authors disclosed financial ties to the medical device industry.