May 4, 1999
Web posted at: 5:38 p.m. EDT (2138 GMT)

BOSTON (CNN) -- A painful surgical biopsy of breast tissue may no longer be necessary for many women, according to a comprehensive new study, which showed large-core needle biopsy was just as reliable, less expensive, and more comfortable than the surgical alternative for diagnosing breast cancer.

Dr. Jack E. Meyer led a team of researchers at Brigham and Women's Hospital in Boston to review 1,836 needle biopsies of suspicious breast lesions over six years. They found large-core needle biopsies "accurate, safe and well accepted by patients and referring physicians." The study was published in Tuesday's Journal of the American Medical Association, an issue focusing on cancer.

Meyer told CNN a new technology called the directional vacuum-assisted biopsy instrument has made needle biopsies even more efficient in the past three years and has "allowed us to sample smaller and fainter abnormalities."

In a needle biopsy, doctors remove tissue through the tip of a needle, then examine it under a microscope for cancerous cells. The vacuum-assisted device sucks tissue into the needle, gathering a larger, more accurate sample to send to the lab.

'You get a Band-Aid and you go home'

The study predicted many women will prefer needle biopsy over the surgical option because it requires only local anesthesia and is over in about an hour. "It's easy for women to tolerate. There are no stitches. When the procedure's over you get a Band-Aid and you go home," said Meyer.

Marcia Pilalas, 47, had the large-core needle biopsy and said just knowing she could avoid a surgical procedure was a relief. "The anxiety was extremely low," she said.

Increasing numbers of women have undergone breast biopsies in recent years, according to the authors of the JAMA study, as more women have gotten screening mammograms. Seventy to 80 percent of the biopsies find only benign abnormalities, not cancer, and no further surgical treatment is necessary.

Large-core needle biopsy costs much less, generally a half or a third as much as surgical breast biopsy. That fact may make it standard medical practice, especially for managed care patients.

The needle procedure does have some limitations, Meyer said, which would make a surgical biopsy necessary. Needle biopsy may not produce a good tissue sample for "abnormalities very, very close to the ribs, posterior in the breast, those that are very close to the nipple, anterior in the breast and for very, very faint calcifications," he said.