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 surgical biopsy.
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, Stanford University.
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."