title: The evaluation of national time trends, quality of care, and factors affecting the use of minimally invasive breast biopsy and open biopsy for diagnosis of breast lesions.
abstract: BACKGROUND
  Minimally invasive breast biopsy is a recommended biopsy method for suspicious lesions. This study examines national trends and factors associated with the use of open breast biopsy (OBB).
  
  
  METHODS
  The national inpatient sample database was used to examine trends and factors associated with the use of OBB. Factors associated with OBB were evaluated using chi-square test for univariate analysis and logistic regression for multivariate analysis.
  
  
  RESULTS
  OBB rate was 34%. Patients below 50 years of age had OBB rates of 47%, while those above 50 had OBB rates of 29.1% (P < .001). Higher OBB rates were observed in Asian (39.8%) and Hispanic (40.6%) women compared with white women (34.1%, P < .001). Private insurance patients were more likely to have OBB compared with Medicaid/Medicare patients (40.9% vs 30.6%, P < .001). About 1.2% of women who underwent OBB required multiple biopsies for diagnosis compared with .5% for minimally invasive breast biopsy (P < .001).
  
  
  CONCLUSIONS
  OBB is still performed in one third of women despite higher morbidity and less accuracy. Factors associated with higher OBB rate included younger age; Asian ethnicity; private insurance; small, rural, and nonteaching hospitals.
authors.affiliation: Department of Surgery, Division of Surgical Education, University of Toledo Medical Center, 3000 Arlington Avenue, Toledo, OH 43615, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Adepoju
authors.affiliation: Department of Surgery, Division of Surgical Education, University of Toledo Medical Center, 3000 Arlington Avenue, Toledo, OH 43615, USA.
authors.forename: Weikai
authors.initials: W
authors.lastname: Qu
authors.affiliation: Department of Surgery, Division of Surgical Education, University of Toledo Medical Center, 3000 Arlington Avenue, Toledo, OH 43615, USA.
authors.forename: Vivian
authors.initials: V
authors.lastname: Kazan
authors.affiliation: Department of Surgery, Division of Surgical Education, University of Toledo Medical Center, 3000 Arlington Avenue, Toledo, OH 43615, USA.
authors.forename: Munier
authors.initials: M
authors.lastname: Nazzal
authors.affiliation: Department of Surgery, Division of Surgical Education, University of Toledo Medical Center, 3000 Arlington Avenue, Toledo, OH 43615, USA.
authors.forename: Mallory
authors.initials: M
authors.lastname: Williams
authors.affiliation: Department of Surgery, Promedica Health System, 5800 Monroe Street Building G, Sylvania, OH 43560, USA. Electronic address: joseph.sferramd@promedica.org.
authors.forename: Joseph
authors.initials: J
authors.lastname: Sferra
mesh_terms: D001706:Biopsy / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data / Q000639:trends; D001940:Breast / Q000473:pathology* / Q000601:surgery; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D016208:Databases, Factual; D005260:Female; D006801:Humans; D016015:Logistic Models; D019060:Minimally Invasive Surgical Procedures / Q000592:standards / Q000706:statistics & numerical data* / Q000639:trends; D015999:Multivariate Analysis; D011787:Quality of Health Care / Q000706:statistics & numerical data / Q000639:trends*; D012189:Retrospective Studies; D014481:United States
keywords: Breast cancer; Minimally invasive breast biopsy; Open breast biopsy