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Are Breast Biopsies Accurate?


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3/19/2015
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Doctors often suggest that women get biopsies in order to see if there are any unusual growths there or to test a particular growth to see if it is cancerous. But are these accurate?

Many experts say that biopsies often show misleading results.

CBS news reports on the new information.

The new study shows that biopsy specialists often misdiagnose cancer, therefore reiterating the point that women should get second opinions before pursuing treatment options.

The study’s analysis shows that pathologists are very good at deciphering when invasive cancer is present in breast tissue. Their issue seems to come in the diagnosis part. The researchers say many of them are less adept at making the right diagnosis with less dangerous conditions or when biopsied tissue is normal.

How was the study conducted?

“The study involved 115 U.S. pathologists and 240 breast biopsy specimens. Their diagnoses were matched against those of three experts. It was an experiment and may not reflect what happens outside a research setting, but the authors say the results highlight the challenges of accurately interpreting tissue under a microscope,” according to CBS.

The research study has been published this week in the Journal of the American Medical Association as the findings relate to many women being that biopsies are so common. Over one and a half million biopsies are conducted every year. Some take place after women feel a lump or after a radiologist sees something unusual on a mammogram.

How is it performed?

The specialist takes tissue from the breast through a needle or from a surgically removed growth and examines it under a microscope. Earlier research has shown that reading a mammogram can also be difficult and lead to over or under treatment as many of the white blots on a mammogram look very similar.

The study’s leader author, Dr. Elmore, commented on her findings.

She said, “Pathologists correctly diagnosed abnormal, precancerous cells about half the time, no better than a coin toss. Treatment for this condition typically includes frequent monitoring and sometimes medication. About a third of these cases were misdiagnosed as not worrisome or normal, while 17 percent were deemed more suspicious or cancer.”

Around 160,000 American women get this treatment yearly and Dr. Elmore fears that they are being misdiagnosed based on the results of the study.

In around thirteen percent of cases it has been found that pathologists mistakenly made a cancerous finding in normal tissue. Researchers had similar trouble when it came to a condition called DCIS (ductal carcinoma in situ), 13 percent of these cases were misdiagnosed as less serious, while 3 percent were mistaken for invasive cancer. What is this disease? It involves abnormal cells confined to a milk duct and is diagnosed in around 60,000 American women each year. Instances of this disease have increased because of rising mammogram use, and it can sometimes disseminate, so usual treatment includes surgery and radiation.

Co-author Dr. David Rimm, a Yale University pathology professor who also interprets biopsies, also commented on the study. He said,

“Pathologists weren't allowed to consult with colleagues when they were uncertain about findings -- while in the real world those consultations happen frequently. Still, he said the results are troubling and highlight that pathology is an imperfect science.”

 

 



Category: Misdiagnosis and Failure to Diagnose


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