A panel of top cancer specialists maintains that if a
mammogram indicates a biopsy is needed, whenever possible, doctors should
perform a minimally invasive breast biopsy rather than a traditional open
This conclusion is one of many reached by a group of 22 cancer experts in a
consensus paper entitled, "Image-Detected Breast Cancer: State-of-the-Art
Diagnosis and Treatment," that was published in a recent issue of the
Journal of the American College of Surgeons (193:297-302, 2001). The paper
was also presented in a panel discussion before the start of the annual meeting
of the American College of Surgeons held this year in New Orleans.
The consensus panel comprised leading surgeons, radiologists, and
pathologists who work with breast cancer patients. They urged doctors to adopt
more speedily the proven technologies in mammography, breast ultrasound, and
minimally invasive breast biopsy, and encouraged insurance carriers to provide
better reimbursement. Limited access to currently available techniques and
treatments and inadequate reimbursement of physicians are threatening continued
strides in the diagnosis and treatment of breast cancer, the panel concluded.
The specialists drafted their consensus paper at a breast cancer conference
sponsored by the University of Southern California (USC)/Norris Comprehensive
Cancer Center and the Keck School of Medicine of USC.
The panel included Melvin J. Silverstein, MD, professor of surgery at the
Keck School and conference chair; Michael Edwards, MD, associate professor of
surgery at the University of Louisville (James Graham Brown Cancer Center); Jay
Harness, M, professor of clinical surgery, UC Davis (Alameda County Medical
Center); and Michael Lagios, MD, clinical associate professor of pathology,
At a Crossroads
"Over the last 20 years, we’ve seen major improvements in the medical
community’s ability to diagnose and treat patients with breast cancer,"
said Dr. Silverstein. "However, we’re now at a crossroads, and more
doctors need to adopt the newer state-of-the-art technologies and techniques
that until now have only been common practice in the leading institutions. Wider
use of currently available techniques will further improve patient selection,
reduce breast cancer recurrence, mortality, and morbidity of therapy, improve
cosmetic results, and decrease overall costs."