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Recent Report On Breast Biopsies Is Nothing New, Says White Plains Doctor

Dr. Sunny Mitchell, Director of Breast Surgery at White Plains Hospital. Photo Credit: Submitted
Dr. Lyda Rojas, a breast surgeon with the Mount Kisco Medical Group. Photo Credit: Submitted

WHITE PLAINS, N.Y. -- Breast biopsies were in the news this week.

A recent article in the New York Times (go here for story) reports on a new study from The Journal of the American Medical Association (JAMA) that says breast biopsies are good at telling the difference between healthy tissue and cancer, but less reliable for identifying more subtle abnormalities.

According to the study, women whose results fall into the gray zone between normal and malignant — with diagnoses like “atypia” or “ductal carcinoma in situ” — should seek second opinions. Researchers say misinterpretation can lead women to have surgery and other treatments they do not need, or to miss out on treatments they do need.

These ideas challenge the common belief that a biopsy will, in itself, resolve any questions that might arise from an unclear mammogram or ultrasound.

Breast Surgeon Dr. Lyda Rojas of the Mount Kisco Medical Group points out, however, this is nothing new.

"It is well-known among pathologists and breast surgeons of the discrepancy concerning aytpia and ductal carcinoma in situ," she said. "Second opinions and further testing is a standard practice when the biopsy is in the grey zone."

Furthermore, she said, the grey zone exists in medicine as in other aspects of life.

“It is worthwhile to note that with the application of stereotactic and ultrasound-guided biopsy, 85 percent of these biopsies are benign," she said. "This represents progress since these women are now able to avoid surgery.”

Adds Dr. Sunny Mitchell, director of breast surgery at White Plains Hospital , whenever an abnormality is found on a mammogram that looks suspicious enough to red flag the radiologist, the most appropriate course of action is a biopsy.

"It can be inconvenient and anxiety provoking to have a biopsy but the alternative is to watch a cancer develop and not detect it until it is larger," she said. "The benefit of imaging is that we're able to detect cancers when they are small."

Eventually, she said, the technology will improve, but for now, she believes biopsies, under the proper recommendations of a radiologist, are the best course of action.

According to the report, about 1.6 million women a year have breast biopsies in the United States with approximately 20 percent of those tests finding cancer.

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