Biopsies after Breast Cancer

Hester Hill Schnipper, LICSW, OSW-C Program Manager, Oncology Social Work

MARCH 05, 2018

 First, A REPEAT ANNOUNCEMENT: the platform for this blog (and a whole lot of other stuff) is changing on Monday. I am told that it will be seamless, and however your currently log on will continue to work. If not, please email me at hhill@bidmc.harvard.edu.

  And now to today's topic: the incidence of breast biopsies in the ongoing care of women post breast cancer/AKA breast cancer survivors. We all know the anxiety that is associated with annual mammograms and breast MRIs; the worry, of course, is that something will be spotted, and we will once again fall down the rabbit hole of panic and sadness and biopsies and who knows what else.

  This anxiety is an often-given reason by women who opt for bilateral mastectomies at the time of a first breast cancer diagnosis. Even when that surgery is not medically necessary or recommended, and that is usually the case, there are women who are too worried about having to fear mammograms and possible biopsies for the rest of their lives. The reasoning is something like: Just take them off, and I will never again have to deal with this.

  The very major flaw in that thinking is that "just taking them off" rarely makes any difference in the prognosis of the known breast cancer, and the real danger for any of us is in the cancer we already have/have had. There are exceptions, usually for women who carry one of the BRCA gene mutations or have an intense family history or other medical issues.

  What is interesting to me is that when I read the title of this article, I thought I knew what it would be about--and I was completely wrong. I assumed it was going to suggest that women who have had breast cancer are, yes indeed, almost always religious about having annual mammograms, and that, if there is a shadow of a doubt about anything, they want biopsies. Not much tolerance among us for the "Let's watch it and come back in six months". Most of us respond: No way! Biopsy it right now!

  In fact, the study turns out to be about the relatively low incidence of biopsies in the future for women post breast cancer. The finding is intended to help surgeons talk with new patients about their future risks and, perhaps, to dissuade them from having more surgery (e.g. bilateral mastectomies) than they need.

Here is the start and a link to read more:

 MD Anderson study evaluates need for biopsies
during follow-up care in women with early
breast cancer

In an analysis of more than 120,000 women diagnosed with
and treated for early-stage breast cancer, researchers from
The University of Texas MD Anderson Cancer Center
determined the rate of additional breast biopsies needed for
these patients during their follow-up care.
The findings, reported in JAMA Surgery, are the first
comprehensive nationwide population-based study
regarding the need for breast biopsies performed during
follow up after treatment for invasive breast cancer.
According to the American Cancer Society, 252,710 women
will be diagnosed with breast cancer in 2017, and of those,
63,410 will have early-stage disease.
Research and data help physicians counsel women about
breast cancer recurrence rates, how often cancer in one
breast develops in the second breast. However, in a
thorough review of the literature, no data offered clues
about how often a patient, after having had breast cancer, will require a biopsy, explains Henry Kuerer, M.D., Ph.D., the study's corresponding author.

Read more: https://www.eurekalert.org/pub_releases/2018-01/uotm-mas013018.php