Study: 600,000 Women Get Unneeded Biopsies

CBS Evening News: Doctors Subjecting Women To Costly, Invasive Surgery For Cancer Check

(CBS)  Every year, an estimated 1.6 million woman get breast biopsies. A new study suggests that nearly 600,000 of those women are getting unnecessary surgical procedures, CBS News medical correspondent Jon LaPook reports.

When 33-year-old Gnalen Kouruma had a suspicious spot on her mammogram, she feared the worst.

"I thought I was going to die," she said.

Her doctor ordered a needle biopsy, the recommended first step in testing for breast cancer. But a study that has experts asking "where's the outrage?" finds 36 percent of women who need breast biopsies are getting invasive surgery, costing three times as much as the recommended procedure.

Why are surgeons ignoring their own guidelines?

"It's something they've been doing for the past 25 years; they're comfortable with the diagnostic accuracy," said Dr. I Michael Leitman, chief of general surgery at Beth Israel Medical Center and co-author of the study. "And they're somewhat hesitant to make a change."

A needle biopsy is done under local anesthesia, leaves a tiny scar and costs about $1,000 to $2,000. It rarely misses lesions.

A surgical biopsy requires sedation and stitches, and costs about $5,000 to $6,000. And it leaves a bigger scar.

"Some women even find they need to have further work to repair the breast biopsy they had, to show they didn't have cancer! That's really crazy," said Dr. Susan Love of the Dr. Susan Love Research Foundation.

For Kouruma, it was the best of all worlds - a minor procedure that found no cancer.

"I said, 'Oh, my God. Thank God,'" she said. "So I can live long to see my kids."

With about 90 percent of abnormal mammograms turning out to be benign, the most minimally invasive approach makes the most sense.

[juliemd]

Yes, can''t you see the $$$$ signs...

[ceo555]

Take notice of who allowed Paris Hilton to light up the White House and turn it Pink during the October breast cancer awareness month. I think it''s part of his population control.

[ceo555]

My doctor told me that I needed a Mammogram when I turned 40 years old and I told her that I didn''t think I should have to have one because I was not at risk. It didn''t run in my family and I breast fed both of our children for a whole year for each child and they claim that if you nurse your baby then it lessons your risk. She agreed with me , but then told me that there could still be a small chance that I could get breast cancer and highly recommended that I still go get a Mammogram. After her planting that seed of doubt in my mind then I listened to her and have been getting them for about 6 years. Recently she called me and told me that I needed a breast biopsy and it scared me. I couln''t sleep for two nights in a row and have constantly been talking about it and driving all of my family and friends crazy and they just want me to shut up about it. I went to see another doctor for a second opinion and she told me that my doctor was wrong and that I did not need a breast biopsy. I am very upset that I don''t trust doctors anymore and feel as though they don''t realy care about me. Now I have been doing alot of research on breast cancer and have found some good information. Go to www.menopause-metamorphosis.com and click on the boob poem or wisewomanweb.com also you can call 1-800-4 CANCER and they will mail you all kinds of resources and info.

[brainteaser2]

OK what is the alternative? If a woman is told she has a lump or a mamographic lesion and its a watch and wait situation they will 99% of the time go somewhere until they get a biopsy done. So the simple statistical fact that 600,000 of these biopsies could have been managed alternatively does not make them unnecessary. Until a more reliable method of screening is developed then I say please do the biopsies.

[newslink]

This is not a surprise. When a woman is faced with, "You have a lump" She will go through any test. Ask me how I know. The thoughts alone is frighting.

[tcsskg]

I work in surgery as a nurse anesthestist. Today I did anesthesia for two mastectomies. I spoke with the breast surgeon about the report on CBS last night. After speaking with him it scares me to think that many women were mislead. He told me if he is 90% sure a woman doesn''t have cancer he sends them to a radiologist for the needle biopsy. Needle biopsies are done by a radiologist and they only show if it is cancer or not. They do not specify the type of cancer and if it is cancer the patient has to go for a surgical biopsy as well spending even more money. The needle biopsy may give a woman a false sense of security. This story was not well researched. There are only 100 or so breast surgeons in this country and 50,000 radiologists with a very wealthy society with the great number of them. Do you really believe they are not trying to cash in on this business? The radiologists do not always inform patients with all their options and risk factors. This breast surgeon I spoke with is very detailed and spends an hour or more with a patient for their breast cancer talk. In closing I would just like to say that CBS should have researched this topic a little more before scaring the country or by giving women hope who really need aggressive treatment to save their lives.

[newsjunky5]

This sounds like an issue of continuing education for doctors who still use the old method, not one of padding the bill.

[spadeisspade]

How about cervical biopsies? These are so common that when I was told I "needed" one, I had a handful of women (family and friends) relate that they had also had them. Cervical cancer is definitely the most preventable yet most deadly cancers. But they explained to me that this was just a way to form a baseline for my pap smears and that I definitely did not have cancer. Hello? Doesn''t biopsy mean "we think you might have cancer?" It was frightening, expensive, painful and I feel like I was sort of bullied into it because I honestly thought something could be wrong.

[ms1-1-1]

These test are for profit, the driving force in synthetic medical care.
---------------------------
Posted by baileycc at 02:15 PM : Jan 06, 2009


LET''s REMEMBER ALSO A FEW FACTS OF LIFE ...HOSPITALS AND INSURANCE COMPANIES MAKE MAMOUTH PROFITS OF USELESS TESTs ... the problem is every physician tries to impress us with ''EXPERT'' status and when it comes right to the point they don''t have a clue what the hail their talking about... I had a lump on my leg looked like a pimple but hard round and felt like a pebble under my skin the damage the doctors did to me removing that little 1/16 pebble like pimple left me with a scar the size of a 50 cent coin, they ordered cancer test on it after it was removed and never to this day told me the results except a phone call from a nurse to say test results are negative duh .... my insurance paid a whopping 37,000 for that and removal of stiches and the like I have a life time killer scar for that little thing...

[ms1-1-1]

- how do you think hospitals generat money?

FRAUDULENT -- BILLING BEEN GOING ON FOR DECADES HARDLY NEWS...

These test are for profit, the driving force in synthetic medical care.

[troubles101-2009]

Needle biopsies are useless. I would be a dead woman today if I had went by the results of a needle biopsy. In ''95 I found a lump in my left breast. The needle biopsy indicated it was beneign. I opted to have the lump removed & the lump revealed it was indeed cancer. Four chemo & 33 radiation treatments later, I''ve been cancer free for almost 14 years. Always question the results of tests, research your situation but don''t take what your doctor tells you as a final decision about your health issues.

[carlylaine]

MY GAWD WHAT A SHOCK!!!!! You mean to tell me that doctors are ruining women''s breasts for money!!!!

Unheard of!!!!

[erasmus606]

Thanks for having this site for comments.

Posted by NurseID at 10:19 PM : Jan 05, 2009

You are a freakin'' whacko. Do you think anyone is going to take your comments seriously after posting it a million times?

[nurseid]

Previous comments reflect my concerns. I''m a breast cancer survivor and a nurse. My decision, made with with my surgeon, to have an open biopsy was based on my psychological health after learning at age 48 that I had cancer, the fact that all reports say "the earlier the detection, the better." and feeling that the accuracy of an open biopsy was much less in question than a needle biopsy for the small area of concern seen on xray. When my biopsy showed that I had breast cancer, finally staged at Stage 1, I rested abit better knowing that while I waited for those staging studies, that my original tumor was gone. Please, who sponsored the study that your story cited? I worry that it was done by those who benefit on the radiology side. . .when I was preparing for surgery a radiologist actually challenged me with his unsolicited comment "so why are you having surgery; you should be having a stereotactic biopsy". There are definitely "turf wars" on this topic and the patient, in the end, loses. It''s good to inform about choices for diagnosis, but I worry when stories don''t give the public the full information needed to decide for themselves what is best for them (eg open biopsy accuracy and study sponsorship). Dr. Susan Komen is certainly an expert and her opinion means a great deal to me. . but scarring vs being alive because my cancer was detected. . . no question: being alive! Thanks for having this site for comments.

[nurseid]

Previous comments reflect my concerns. I''m a breast cancer survivor and a nurse. My decision, made with with my surgeon, to have an open biopsy was based on my psychological health after learning at age 48 that I had cancer, the fact that all reports say "the earlier the detection, the better." and feeling that the accuracy of an open biopsy was much less in question than a needle biopsy for the small area of concern seen on xray. When my biopsy showed that I had breast cancer, finally staged at Stage 1, I rested abit better knowing that while I waited for those staging studies, that my original tumor was gone. Please, who sponsored the study that your story cited? I worry that it was done by those who benefit on the radiology side. . .when I was preparing for surgery a radiologist actually challenged me with his unsolicited comment "so why are you having surgery; you should be having a stereotactic biopsy". There are definitely "turf wars" on this topic and the patient, in the end, loses. It''s good to inform about choices for diagnosis, but I worry when stories don''t give the public the full information needed to decide for themselves what is best for them (eg open biopsy accuracy and study sponsorship). Dr. Susan Komen is certainly an expert and her opinion means a great deal to me. . but scarring vs being alive because my cancer was detected. . . no question: being alive! Thanks for having this site for comments.

[nurseid]

Previous comments reflect my concerns. I''m a breast cancer survivor and a nurse. My decision, made with with my surgeon, to have an open biopsy was based on my psychological health after learning at age 48 that I had cancer, the fact that all reports say "the earlier the detection, the better." and feeling that the accuracy of an open biopsy was much less in question than a needle biopsy for the small area of concern seen on xray. When my biopsy showed that I had breast cancer, finally staged at Stage 1, I rested abit better knowing that while I waited for those staging studies, that my original tumor was gone. Please, who sponsored the study that your story cited? I worry that it was done by those who benefit on the radiology side. . .when I was preparing for surgery a radiologist actually challenged me with his unsolicited comment "so why are you having surgery; you should be having a stereotactic biopsy". There are definitely "turf wars" on this topic and the patient, in the end, loses. It''s good to inform about choices for diagnosis, but I worry when stories don''t give the public the full information needed to decide for themselves what is best for them (eg open biopsy accuracy and study sponsorship). Dr. Susan Komen is certainly an expert and her opinion means a great deal to me. . but scarring vs being alive because my cancer was detected. . . no question: being alive! Thanks for having this site for comments.

[nurseid]

Previous comments reflect my concerns. I''m a breast cancer survivor and a nurse. My decision, made with with my surgeon, to have an open biopsy was based on my psychological health after learning at age 48 that I had cancer, the fact that all reports say "the earlier the detection, the better." and feeling that the accuracy of an open biopsy was much less in question than a needle biopsy for the small area of concern seen on xray. When my biopsy showed that I had breast cancer, finally staged at Stage 1, I rested abit better knowing that while I waited for those staging studies, that my original tumor was gone. Please, who sponsored the study that your story cited? I worry that it was done by those who benefit on the radiology side. . .when I was preparing for surgery a radiologist actually challenged me with his unsolicited comment "so why are you having surgery; you should be having a stereotactic biopsy". There are definitely "turf wars" on this topic and the patient, in the end, loses. It''s good to inform about choices for diagnosis, but I worry when stories don''t give the public the full information needed to decide for themselves what is best for them (eg open biopsy accuracy and study sponsorship). Dr. Susan Komen is certainly an expert and her opinion means a great deal to me. . but scarring vs being alive because my cancer was detected. . . no question: being alive! Thanks for having this site for comments.

[nurseid]

Previous comments reflect my concerns. I''m a breast cancer survivor and a nurse. My decision, made with with my surgeon, to have an open biopsy was based on my psychological health after learning at age 48 that I had cancer, the fact that all reports say "the earlier the detection, the better." and feeling that the accuracy of an open biopsy was much less in question than a needle biopsy for the small area of concern seen on xray. When my biopsy showed that I had breast cancer, finally staged at Stage 1, I rested abit better knowing that while I waited for those staging studies, that my original tumor was gone. Please, who sponsored the study that your story cited? I worry that it was done by those who benefit on the radiology side. . .when I was preparing for surgery a radiologist actually challenged me with his unsolicited comment "so why are you having surgery; you should be having a stereotactic biopsy". There are definitely "turf wars" on this topic and the patient, in the end, loses. It''s good to inform about choices for diagnosis, but I worry when stories don''t give the public the full information needed to decide for themselves what is best for them (eg open biopsy accuracy and study sponsorship). Dr. Susan Komen is certainly an expert and her opinion means a great deal to me. . but scarring vs being alive because my cancer was detected. . . no question: being alive! Thanks for having this site for comments.

[nurseid]

Previous comments reflect my concerns. I''m a breast cancer survivor and a nurse. My decision, made with with my surgeon, to have an open biopsy was based on my psychological health after learning at age 48 that I had cancer, the fact that all reports say "the earlier the detection, the better." and feeling that the accuracy of an open biopsy was much less in question than a needle biopsy for the small area of concern seen on xray. When my biopsy showed that I had breast cancer, finally staged at Stage 1, I rested abit better knowing that while I waited for those staging studies, that my original tumor was gone. Please, who sponsored the study that your story cited? I worry that it was done by those who benefit on the radiology side. . .when I was preparing for surgery a radiologist actually challenged me with his unsolicited comment "so why are you having surgery; you should be having a stereotactic biopsy". There are definitely "turf wars" on this topic and the patient, in the end, loses. It''s good to inform about choices for diagnosis, but I worry when stories don''t give the public the full information needed to decide for themselves what is best for them (eg open biopsy accuracy and study sponsorship). Dr. Susan Komen is certainly an expert and her opinion means a great deal to me. . but scarring vs being alive because my cancer was detected. . . no question: being alive! Thanks for having this site for comments.