New, improved breast biopsies
Swab test to make sure a woman's results are her own, not a mistake
BRIDGEPORT, Conn. – By doing swabbing his patient's cheek, Dr. Andrew Kenler, who is a breast surgeon at Bridgeport Hospital in Bridgeport, Connecticut, is preventing a horrible mistake.
"About 1000, maybe 1500, women are told ‘Hey Mrs. Jones you have breast cancer,' and she does not," explained Kenler.
He says so many steps go into testing breast biopsies that human errors can occur, and do. This simple DNA test ends the mix ups and, more importantly, the consequences.
"She can have unnecessary surgery, lumpectomy, mastectomy, [and] unnecessary chemotherapy," Kenler said.
He advises all his patients to take the know error test. It costs $300 and every positive breast biopsy is sent to the test's lab in Indianapolis to match with the DNA on file. A match means his patient is getting her correct results.
For Jacquelyn Conlon, it wasn't what she wanted to hear two years ago.
"I had stage 2A breast cancer," Conlon said.
She got the truth because as thousands of women are told they "do" have it but actually don't, another woman is being told she "doesn't" have it and she does.
"It gives you the confidence that your diagnosis is truly indeed your diagnosis," Conlon explained.
She got her answer, completed her treatment, and lives cancer-free today.
In some cases the test is covered by insurance, in instances where it is not, many women have chosen to pay $300 out of pocket and purchasing the know error test themselves.
Imaging techniques, like a MRI or a mammogram, along with physical exams of the breast can lead doctors to suspect that a person has breast cancer. However, the only way to know for sure is to take a sample of tissue from the suspicious area, called a biopsy. Usually, if the doctor notices anything suspicious he or she will order a biopsy. The tissue sample is examined by a pathologist to see if cancer cells are present or not. (Source: http://www.breastcancer.org/symptoms/testing/types/biopsy)
HOW IT IS DONE: There are several ways to do a breast biopsy, including:
- Fine-needle aspiration biopsy: the doctor inserts a thin needle into a lump and removes a sample of cells or fluid.
- Core needle biopsy: the doctor inserts a needle with a special tip and removes a sample of breast tissue about the size of a grain of rice.
- Open (surgical) biopsy: the doctor will make a small cut in the skin and breast tissue to remove part or all of a lump. This may be done as a first step to check a lump or if a needle biopsy does not provide enough information.
- Vacuum-assisted core biopsy: this is performed with a probe that uses a gentle vacuum to remove the breast tissue sample. The small cut does not require stitches and leaves a very small scar. (Source: www.webmd.com)
DR. KENLER: "There's about 1.2 million what we call core biopsies, needle biopsies of the breast annually in the United States. I do about 400 a year where a woman presents either with a mass sometimes that they feel but most commonly, most often, a mass that's seen by ultrasound and/or by a mammogram. They come into your office and you see it and, under image guidance, you place a needle within the mass or the calcifications. The specimen is then placed in a formalin jar and sent to your pathologist. Sometimes radiologist perform these biopsies, so they have to send out these specimens and there are about eighteen steps from the time that the surgeon performs the core biopsy until a report is generated that tells the patient if they do or you do not have cancer. There are approximately 300,000 breast cancers diagnosed annually in the United States. One in 100 times you tell a patient you have cancer and you don't. That's the mistake rate. Now for every false positive, unfortunately there's a sister lesion, a sister error, that the woman you told who doesn't have cancer actually does. There are 6000 cases annually where either you do have cancer and you don't or you don't have cancer and you do. Obviously the former, where you tell a patient you do have cancer and she doesn't, is more egregious and potentially leads to unnecessary chemotherapy, hormonal therapy, surgery, even mastectomies as we're probably going to talk about. Two thirds of the time you catch them, but a third of the time you don't. So annually about 1000, maybe 1500, women are told that they have breast cancer but do not. They then go on to receive unnecessary surgery, radiation, or possibly chemo." (Source: Dr. Kenler)
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