A prospective review of the decline of excisional breast biopsy.
BACKGROUND
Although excisional breast biopsy has long been considered the standard for breast cancer diagnosis, core biopsies are now used more frequently. Whether core biopsy can eventually replace excisional biopsy remains unknown. The purpose of this study was to evaluate the relationship between diagnostic excisional and core biopsies relative to surgical treatment procedures.


METHODS
We analyzed our data collected prospectively from 1995 through 2000, which included inpatient and outpatient surgical data, office visits, and radiology biopsy data including stereotactic, mammotome, and ultrasound core biopsies. The Cochran-Armitage trend test was used to assess the shift in diagnostic technique.


RESULTS
From 1995 through 2000 there were 2,631 core biopsies performed, 2,685 excisional biopsies, 2,881 surgical procedures for breast cancer, and 51,109 office visits. Although the percentage of core biopsies relative to excisional biopsies increased from 31% to 68% (P <0.001), the percentage of biopsies relative to the number of office visits remained stable at 10% to 11%. The percentage of breast cancer procedures relative to office visits also remained stable at 5% to 6%.


CONCLUSIONS
Our data indicate that core biopsies are being performed more often than excisional biopsies. Nevertheless, one in three biopsies done at our institution is excisional.
Crowe
Joseph P
JP
The Cleveland Clinic Breast Center, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
Rim
Alice
A
Patrick
Rebecca
R
Rybicki
Lisa
L
Grundfest
Sharon
S
Kim
Julian
J
Lee
Katherine
K
Levy
Lawrence
L
D001706:Biopsy / Q000379:methods / Q000706:statistics & numerical data* / Q000639:trends*; D001707:Biopsy, Needle / Q000706:statistics & numerical data / Q000639:trends; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D005544:Forecasting; D006801:Humans; D009819:Office Visits; D011446:Prospective Studies