Less Need for Needles

Research carried out at Forth Valley Royal Hospital by one of our surgical specialists Dr Subodh Seth and colleagues Dr Raj Burgul and Dr Archana Seth, has shown that the number of painful and invasive breast biopsies in younger women can be halved – without the risk of missing cancer.

Dr Seth presented his findings to the Royal College of Surgeons in Edinburgh, his audit showed that breast lump needle biopsies could be reduced by more than 50 per cent following national evidence-based guidelines and using state-of-the-art imaging techniques. This approach helps quell the fear associated with this procedure as well as side effects such as pain, bleeding or bruising. It also reduces costs.

Dr Seth said: “Finding a breast lump is very distressing for women and having to then undergo a painful and traumatic biopsy just increases this distress. By reducing the need to take breast lump samples in certain groups of women, we can improve their healthcare experience, without the risk of missing any cancers.”

The first study analysed results for almost 900 cancer cases during a five-year period in the Forth Valley area, and a second study was carried out during 2013 involving 117 patients. These concluded that a biopsy was not always needed in younger patients presenting with a solid lump. It stated that if any malignant features were discovered, these would be evident on clinical examination or imaging – so routine core biopsies should not be advocated to rule out malignant cancer in younger patients.

Previously, triple assessment was advised for the assessment of breast lumps – clinical assessment, imaging like a mammography or ultrasound and then a breast biopsy.  So all women presenting with a breast lump were recommended for a needle biopsy. However breast cancer for women younger than 25 is extremely rare therefore breast needle biopsies were not always necessary.

According to Dr Seth:  “The quality of X-rays and ultrasounds now is so much better. The quality is so good that you can tell easily if a lump is benign. Of course, if there is any dubiety, then a biopsy is carried out”.

Reducing the number of biopsies benefits not only patients but medical professionals too. The number of medical professionals involved in taking and analysing the samples is vast. Surgeons and radiologists take the biopsies which pathologists analyse. Surgeons then meet with patients to deliver the results. And, of course, there are additional administrative costs too, such as writing and sending confirmation letters.