Breast biopsies no longer reliable

It is possible that breast biopsies are no longer the gold standard for resolving unclear mammograms or ultrasounds.

Although breast biopsies are good at differentiating between healthy tissue and caner, researchers are saying that biopsies are easily misinterpreted and that patients should seek second opinions.

Because of this uncertainty, women who receive results that fall into a gray area between normal and malignant are not really getting a clear and accurate result, according to The Boston Globe.

Studies are saying that the biopsy is less reliable when it comes to identifying subtle abnormalities. This uncertainty can lead patients into having surgery and other treatments they do not need, or to miss out on treatments they require.

New findings are challenging the common belief that a biopsy is the end-all answer to resolve any questions they might have about unclear mammograms.

Dr. Joann G. Elmore is a professor at the University of Washington School of Medicine in Seattle and is the first author of the new study on the accuracy of breast biopsies. She says that her study shows that a biopsy is not a definitive answer.

About 1.6 million women a year in the United States have breast biopsies. 20 percent of the tests find cancer. 10 percent identify atypia, cells inside breast ducts that are abnormal, but not cancerous. 60,000 of these women are found to have ductal carcinoma in situ, or DCIS. This refers to abnormal cells confined inside the milk ducts and are considered invasive. But experts disagree about whether or not DCIS is cancer.

Dr. Elmore and her pathologists examined many biopsy slides and then discussed and compared their diagnoses with a panel of leading experts who had seen the exact same slides. The result was that there were very important differences in their findings, especially in the gray zone.

The findings from the study were found disconcerting and a call to action for pathologists and breast cancer scientists. Improvement in the accuracy of biopsy readings and more consulting with one another on challenging cases are the recommendation.

It is thought that by consulting one another and creating clearer definitions for various abnormalities will create more consistent and precise diagnoses.

Second opinions were also encouraged, meaning that the patient would be assisted by the doctor to help find a pathologist for a second opinion on the slide made from the one biopsy.

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