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. 2013 Jul 9;109(1):242-8.
doi: 10.1038/bjc.2013.253. Epub 2013 May 21.

Trends in breast biopsies for abnormalities detected at screening mammography: a population-based study in the Netherlands

V van Breest Smallenburg  1 , J Nederend, A C Voogd, J W W Coebergh, M van Beek, F H Jansen, W J Louwman, L E M Duijm
Affiliations

Trends in breast biopsies for abnormalities detected at screening mammography: a population-based study in the Netherlands

V van Breest Smallenburg et al. Br J Cancer. .

Abstract

Background: Diagnostic surgical breast biopsies have several disadvantages, therefore, they should be used with hesitation. We determined time trends in types of breast biopsies for the workup of abnormalities detected at screening mammography. We also examined diagnostic delays.

Methods: In a Dutch breast cancer screening region 6230 women were referred for an abnormal screening mammogram between 1 January 1997 and 1 January 2011. During two year follow-up clinical data, breast imaging-, biopsy-, surgery- and pathology-reports were collected of these women. Furthermore, breast cancers diagnosed >3 months after referral (delays) were examined, this included review of mammograms and pathology specimens to determine the cause of the delays.

Results: In 41.1% (1997-1998) and in 44.8% (2009-2010) of referred women imaging was sufficient for making the diagnosis (P<0.0001). Fine-needle aspiration cytology decreased from 12.7% (1997-1998) to 4.7% (2009-2010) (P<0.0001), percutaneous core-needle biopsies (CBs) increased from 8.0 to 49.1% (P<0.0001) and surgical biopsies decreased from 37.8 to 1.4% (P<0.0001). Delays in breast cancer diagnosis decreased from 6.7 to 1.8% (P=0.003).

Conclusion: The use of diagnostic surgical breast biopsies has decreased substantially. They have mostly been replaced by percutaneous CBs and this replacement did not result in an increase of diagnostic delays.

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Figures

Figure 1
Figure 1
Mammography screening outcome from 1 January 1997 to 1 January 2011.
Figure 2
Figure 2
Trends in biopsy procedures after referral between 1 January 1997 to 1 January 2011.
See this image and copyright information in PMC

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