New Study Analyzes Need for Biopsies During Follow-Up Care in Breast Cancer

New research on breast cancer biopsies and counseling after treatment will allow surgeons to have more meaningful conversations with their patients, according to a study published in JAMA Surgery.

In 2017, the American Cancer Society recorded 252,710 women diagnosed with breast cancer, while 63,410 were diagnosed during the early stages of the disease.

“This is a genuine concern for patients. Many feel very anxious over the future need for biopsies and the potential of another diagnosis,” Henry Kuerer, MD, PhD, the study’s corresponding author, said in a statement. “Women will often choose a mastectomy rather than have the fear and stress associated with future biopsies or another cancer diagnosis.”

After a review of previous literature, Kuerer said that data were not recorded that analyzed breast cancer recurrence rates and how often cancer will develop in the second breast after treating the first breast.

Kuerer and colleagues at The University of Texas MD Anderson Cancer Center analyzed 120,000 women diagnosed and treated for early-stage breast cancer to determine the possibility of additional breast biopsies patients will need during follow-up care.

The study incorporated 2 national databases—MarketScan and SEER-Medicare—that included 41,510 breast cancer patients in the first database and 80,369 in the second. Patients included in the study were diagnosed with stage I to III of the disease between 2000 and 2011. MarketScan includes patients with private insurance who are 64 years and younger and SEER-Medicare includes patients over the age 65.

The 5- and 10-year overall incidence of breast biopsy was recorded. The MarketScan cohort saw incidence rates of 14.7% at 5 years and 23.4% at 10 years. SEER-Medicare patients saw an incidence rate of 11.8% at 5 years and 14.9 % at 10 years.

The researchers found that the 5-year incidence of breast biopsy was higher in women treated with brachytherapy than those who underwent whole-breast radiation. After a mastectomy in one breast, the 5-year biopsy rates for the other breast were 10.4% in the MarketScan group and 7.8% for the SEER-Medicare group.

“This information is something I can use daily when discussing breast cancer treatment options,” Kuerer said. “The important message is that the rate of biopsy for patients is relatively low and the overwhelming majority of the biopsy results will be benign and not require further treatment.”

This study is assisting additional research conducted by MD Anderson that evaluates the need for surgery in patients diagnosed with early-stage breast cancer who achieve a pathological complete response to chemotherapy or targeted therapy.

References

Van la Parra RFD, Liao K, Smith BD, et al. Incidence and outcome of breast biopsy procedures during follow-up after treatment for breast cancer. JAMA Surg. Published online January 31, 2018. doi:10.1001/jamasurg.2017.5572.