Breast biopsy: is it really necessary?
The technological systems we use in breast cancer screening have developed so rapidly that we encountered some abnormalities in most of the breasts we examined. This situation is both good and bad. Good,because if what we find is cancer, we can find it at an earlier stage. Bad,because although most of the abnormalities we find on the scan are not cancer, they are all offered a biopsy, which means unnecessary biopsies. leads to an increase. An abnormality is found in approximately 300 out of every 1000 women who come for screening. Whereas, on average, only 5 of these abnormalities are cancer. In other words, 295 (98.3%) of 300 patients who underwent biopsy due to abnormal findings. unnecessary biopsy is at risk. In our country, where the tradition of recommending a biopsy to everything in the breast is valid, breast biopsies performed on women who go to screening at least 98% ofIt should be known that it is unnecessary!
Contrary to popular rumor, benign formations do not turn into cancer!The formation is either benign or bad from the very beginning!
Many of my patients surgical biopsy knocks on my door to consult his proposal. The story they tell is roughly as follows: A mass was found on a mammography scan. surgeon , “don’t worry, this mass is 90% likely benign, but let’s remove it anyway, if it stays in the breast, it can turn into cancer” he said. What a false statement!
The claim that “if the mass remains in the breast, it turns into cancer” is nonsense! Because a mass is either cancer or not in the first place. First of all, to the masses who are claimed to have “transformed” later. misdiagnosis it’s set! Misdiagnoses are caused by non-experts trying to make a diagnosis.
The foundation of health building is correct diagnosis! In breast diseases, the diagnosis is made completely radiologically. your radiologistIt is the job of the surgeon or other branch specialists!
The audience I found “benign” I can be sure it is. So I suggest neither biopsy nor follow up. There is no need to ‘name’ the mass with biopsy, as long as I can say it is “benign”. So, I send my patient to see him at his next screening one year.
If I think the mass I found is “98-99% likely benign” “probably benign” I define. In this case I usually want to check after 6 months.
If I think the mass I’ve found is less than 98% likely to be Benign, do this “suspicious” I call it a biopsy and start considering the biopsy option. The frequency of making a “suspicious” diagnosis by the radiologist in scanned patients should not exceed 10%. Only 50-60% of even these “suspicious” formations develop cancer.
Pay attention to a very important point! The degree of suspicion of a formation may vary from one radiologist to another (due to experience differences). For example, I think the “probability” of a mass being “benign” is 99%, for another radiologist it may be 40%. This means “going to the biopsy” instead of “going home” for the patient.
The fact that the interpretations of radiologists are not standard is due to their accumulation in different directions and degrees. Accurate recognition is not an easy and short-term skill. The radiologist’s inability to master the subject causes him not to be sufficiently selective in his findings, avoiding taking responsibility and participating in the ‘decision’ phase. Ignoring that he is a doctor and moreover, the real addressee of the issue. “Take the report to your doctor, he will tell you what you have”Therefore, unnecessary surgical biopsies are often unavoidable for patients.
In the absence of a systematic and planned training and service effort, the point that technology has brought us is, an increase in unnecessary biopsies!ironically, “technology is not at the service of the patient, but the patient is at the service of technology”!
Protect your breast! How Does?
1. Take control. Get to know your breast. Do not delegate your learning and decision-making responsibilities. Do not hesitate to ask and question.
2. Try to be sure whether the finding in your breast requires a biopsy. The best source for this are breast radiologists!