Minimally invasive breast biopsy lags in Texas

Current guidelines strongly endorse minimally-invasive breast biopsy as the standard for establishing the histologic diagnosis of a breast mass before interventional treatment. Minimally-invasive breast biopsy reduces the interval between diagnosis and starting therapy, and reduces cost compared with an open technique.

The report by Dr. Riall and her associates also touches on a legal aspect that demands our attention. Currently, about 20% of U.S. medical litigation centers on cases involving breast cancer and delayed diagnosis of these cancers. The demographic disparities in care that they identified in their study mean that it is essential for us to identify and resolve the specific barriers to performing minimally-invasive breast biopsy in certain regions and among certain groups of patients. In doing this, we could better achieve the goal of using the minimally-invasive approach in greater than 90% of patients, both in Texas and throughout the United States.

The principle reason why these barriers exist is possibly related to improper insurance coverage and inadequate access to the necessary technology. It is not surprising to me that 70% of the minimally-invasive biopsies were performed by radiologists, while only 26% were done by surgeons. Our goal should be to make access to this contemporary technology available to the entire U.S. population.

Dr. Kirby I. Bland is a surgical oncologist and professor and chairman of surgery at the University of Alabama, Birmingham. He made these comments as a designated discussant of the report. He had no disclosures.