Surgical biopsy with intra-operative frozen section. An accurate and cost-effective method for diagnosis of musculoskeletal sarcomas.
The most appropriate protocol for the biopsy of musculoskeletal tumours is controversial, with some authors advocating CT-guided core biopsy. At our hospital the initial biopsies of most musculoskeletal tumours has been by operative core biopsy with evaluation by frozen section which determines whether diagnostic tissue has been obtained and, if possible, gives the definitive diagnosis. In order to determine the accuracy and cost-effectiveness of this protocol we have undertaken a retrospective audit of biopsies of musculoskeletal tumours performed over a period of two years. A total of 104 patients had biopsies according to this regime. All gave the diagnosis apart from one minor error which did not alter the management of the patient. There was no requirement for re-biopsy. This protocol was more labour-intensive and 38% more costly than CT-guided core biopsy (AU$1804 vs AU$1308). However, the accuracy and avoidance of the anxiety associated with repeat biopsy outweighed these disadvantages.
Ashford
R U
RU
Department of Orthopaedics, New South Wales Bone & Soft Tissue Sarcoma Service, Royal Prince Alfred Hospital, Missenden Road, Camperdown, New South Wales 2050, Australia.
McCarthy
S W
SW
Scolyer
R A
RA
Bonar
S F
SF
Karim
R Z
RZ
Stalley
P D
PD
D001706:Biopsy / Q000191:economics / Q000379:methods; D001707:Biopsy, Needle / Q000379:methods; D001859:Bone Neoplasms / Q000191:economics / Q000473:pathology* / Q000601:surgery; D002985:Clinical Protocols; D003362:Cost-Benefit Analysis; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008485:Medical Audit; D008875:Middle Aged; D019042:Muscle Neoplasms / Q000191:economics / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D012509:Sarcoma / Q000191:economics / Q000473:pathology* / Q000601:surgery; D012983:Soft Tissue Neoplasms / Q000191:economics / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed