title: Why should diagnostic benign breast biopsies weight less than twenty grams?
abstract: To reduce the cosmetic deformity resulting from diagnostic biopsies, current breast screening guidelines recommend that 80% of biopsy specimens that subsequently prove to be benign should weigh less than 20 g. The relationship between specimen weight and cosmesis is unknown and evidence to support a 20 g upper limit is lacking. Patient satisfaction following all benign biopsies weighing more than 20 g (n = 49) and a random sample of 30 of those weighing less than 20 g (n = 103) performed by one screening unit, over a 6 year period, was assessed by a postal questionnaire. Overall, 32% of patients were unhappy with the cosmetic outcome of their surgery. Patient dissatisfaction appeared to increase with specimen weight (6/23 [26%] < 20 g versus 13/36 [36%] > 20 g) but no statistically significant relationship between weight and cosmesis was apparent (P = 0.57). Reducing benign breast biopsy specimen weights to a minimum is a desirable objective. However, the current quality standard is not evidence-based, is too stringent and should be revised. Strategies need to be introduced to improve patient satisfaction following breast wire-localisation biopsies. In particular, patients should be counselled pre-operatively regarding possible adverse cosmetic outcome.
authors.affiliation: South Warwickshire General Hospitals NHS Trust, Lakin Road, Warwick CV34 5BW, UK.
authors.forename: S J
authors.initials: SJ
authors.lastname: Parker
authors.forename: M
authors.initials: M
authors.lastname: Wheaton
authors.forename: M G
authors.initials: MG
authors.lastname: Wallis
authors.forename: S A
authors.initials: SA
authors.lastname: Harries
mesh_terms: D001707:Biopsy, Needle / Q000009:adverse effects / Q000379:methods / Q000523:psychology; D001837:Body Weights and Measures; D001940:Breast / Q000473:pathology*; D001941:Breast Diseases / Q000473:pathology*; D004954:Esthetics; D005260:Female; D006801:Humans; D008403:Mass Screening; D017060:Patient Satisfaction; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies