caa a22 4500 44533889X CHVBK 20180317142805.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1245/s10434-011-1808-y doi (NATIONALLICENCE)springer-10.1245/s10434-011-1808-y Needle Versus Excisional Biopsy for Noninvasive and Invasive Breast Cancer: Report from the National Cancer Data Base, 2003-2008 [Elektronische Daten] [Richelle Williams, Katharine Yao, Andrew Stewart, David Winchester, Mary Turk, Addie Gorchow, Nora Jaskowiak, David Winchester] Background: Needle biopsy to diagnose breast cancer may soon become a quality measure for which hospitals are held accountable. This study examines the utilization of needle versus excisional biopsy in a contemporary cohort of patients and identifies factors associated with biopsy type. Methods: Women with nonmetastatic, clinical Tis-T3 breast cancers diagnosed between 2003 and 2008 were selected from the National Cancer Data Base, which captures information from ~79% of breast cancers in the United States. Patients whose cancer was diagnosed by needle biopsy (fine-needle aspiration or core) were compared with patients diagnosed via excision, analyzing patient, hospital, and tumor characteristics. Logistic regression was used to identify important predictors of biopsy type. Results: Of 373,837 patients, 303,677 (81.2%) underwent needle biopsy while 70,160 (18.8%) had excisional biopsy to diagnose their cancer. The needle biopsy rate increased from 73.8 to 86.7% whereas excisional biopsy declined from 26.2 to 13.3% over the study period (P<0.001). In 2008, patients were statistically significantly more likely to undergo excisional biopsy if they had stage 0 disease; were treated at low-volume (<25 cases/year), community, or Atlantic census region hospitals; were <40years old at diagnosis; were less educated; or were Asian/Pacific Islander (P<0.001). The median rate of needle biopsy at high-volume hospitals (≥140 cases/year) was 89.6%. Conclusion: The use of needle biopsy is increasing. Tumor stage, hospital volume, and hospital location were the most statistically significant predictors of biopsy type. Rates of needle biopsy at high-volume hospitals suggest that appropriate utilization of this preferred diagnostic method should approach 90%. Society of Surgical Oncology, 2011 Williams Richelle Department of Surgery, University of Chicago Medical Center, Chicago, IL, USA aut Yao Katharine Department of Surgery, NorthShore University Health System, Evanston, IL, USA aut Stewart Andrew Cancer Programs, American College of Surgeons, Chicago, IL, USA aut Winchester David Department of Surgery, NorthShore University Health System, Evanston, IL, USA aut Turk Mary Department of Surgery, NorthShore University Health System, Evanston, IL, USA aut Gorchow Addie Department of Surgery, NorthShore University Health System, Evanston, IL, USA aut Jaskowiak Nora Department of Surgery, University of Chicago Medical Center, Chicago, IL, USA aut Winchester David Cancer Programs, American College of Surgeons, Chicago, IL, USA aut Annals of Surgical Oncology Springer-Verlag 18/13(2011-12-01), 3802-3810 1068-9265 18:13<3802 2011 18 10434 https://doi.org/10.1245/s10434-011-1808-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1808-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Williams Richelle Department of Surgery, University of Chicago Medical Center, Chicago, IL, USA aut NATIONALLICENCE 700 1- Yao Katharine Department of Surgery, NorthShore University Health System, Evanston, IL, USA aut NATIONALLICENCE 700 1- Stewart Andrew Cancer Programs, American College of Surgeons, Chicago, IL, USA aut NATIONALLICENCE 700 1- Winchester David Department of Surgery, NorthShore University Health System, Evanston, IL, USA aut NATIONALLICENCE 700 1- Turk Mary Department of Surgery, NorthShore University Health System, Evanston, IL, USA aut NATIONALLICENCE 700 1- Gorchow Addie Department of Surgery, NorthShore University Health System, Evanston, IL, USA aut NATIONALLICENCE 700 1- Jaskowiak Nora Department of Surgery, University of Chicago Medical Center, Chicago, IL, USA aut NATIONALLICENCE 700 1- Winchester David Cancer Programs, American College of Surgeons, Chicago, IL, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/13(2011-12-01), 3802-3810 1068-9265 18:13<3802 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer